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Cross Border Presentation - Eastern Region [Afghanistan/Pakistan]

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Summary

This PowerPoint presentation was prepared for a September 2007 United Nations Children's Fund (UNICEF)-hosted meeting dedicated to examining cross-border polio communication efforts in Afghanistan and Pakistan. In support of the final global push towards polio eradication, regional presentations were given by in-country communication and health practitioners working on either side of the shared border. These were assessed by an external panel of experts in the fields of development communication, mass media, epidemiology, and anthropology, who provided communication programme recommendations based on data presented by the country teams, as well as data gathered on field visits to the endemic states. Communication strategies presented at this meeting were primarily focused on:

  1. Analysing the results of programmes implemented through September 2007
  2. Detailing activities on national and sub-national levels, specific to collaboration between Ministries of Health, mobile populations, campaign synchronisation, media, and political advocacy strategies
  3. Suggesting communication strategy and programme refinements for the next 6- to 12-month period, designed to support both Pakistan's and Afghanistan's polio eradication efforts



This presentation gives an overview of cross-border communication activities related to the polio eradication initiative (PEI) in Afghanistan's eastern region. It discusses the challenges that cross-border population movements pose to the PEI, as well the steps taken by the programme in order to manage these issues. It illustrates the major transit points along the Pakistan border, established and planned polio vaccination points that correspond to these routes, and monthly trends in population movement. Cross-border polio meeting schedules and outcomes are discussed. Acute flaccid paralysis (AFP) reporting trends in border districts over time (from 2004-2007) are examined in detail. The presenters conclude with some suggested recommendations for improving cross-border polio communication in the Eastern Region.


The Ministries of Health and implementing PEI partners in Pakistan and Afghanistan have undertaken the following activities to enhance cross-border collaboration:

  • Synchronisation of supplementary immunisation activities (SIAs)
  • Sharing of data and notification regarding AFP cases
  • Regular meetings involving provincial and regional teams from both countries
  • Installation of 14 permanent border vaccination teams



The team identified the following five major challenges relating to cross-border movements, and their corresponding programme response:

  1. Challenge

    2.  – Daily movement of 10,000 to 12,000 individuals through formal cross-border points.

    Response – Vaccinators present at all established crossing points and cross-border coordination meetings.

  2. Challenge

    3.  – Movement in tribal bordering villages.

    Response – Enlisting of border villages and separate vaccination coverage for villages. In addition, active searches are conducted for AFP cases at the remote border villages.

  3. Challenge

    4.  – Since 2002, cyclic returnee repatriation has been conducted.

    Response – Vaccination teams present at repatriation camps making active searches within those camps for AFP cases.

  4. Challenge

    5.  – New returnee camps.

    Response – Vaccination teams specific to these camps.

  5. Challenge

    6.  – Cross-border AFP cases.

    Response – Early notification by teams on each side of border, and sharing of data between them.



To date, there are three formalised cross-border points in the Southern region, five in the South Eastern region and six in the Eastern region. Data presented here reflects an almost two-fold increase in the number of children vaccinated for OPV by cross border teams from January 2006 to January 2007 (22,090 and 45,424 children respectively).


Pakistan/Afghanistan cross-border meetings are held during the first week of each month, and involve participation at the national, provincial, and district levels. Through discussions at these meetings, it has been agreed that:

  • Following vaccination, the thumb, instead of the little finger, of the child will be marked.
  • One team is to be recruited at Kama Daka during SIAs on the Afghanistan side.
  • One team is to be assigned to the Benshahie crossing point from the Pakistan side.
  • Coverage and supervision checklist formats should be shared.
  • All Lalpoora area border villages are to be covered by the Afghan side.
  • Border village lists, maps, and additional coverage are to be presented and shared with teams on both sides.



The following are a few of the recommendations put forth by the team as suggestions for improving cross-border communication in the Eastern Region:

  • Monitoring of the cross-border teams in the early morning and afternoon
  • Finalising standardised cross-border team coverage and monitoring checklists
  • Sharing information related to inaccessible/not covered areas and refusals
  • Cross-border notification of polio compatible cases



Click here to download the full PowerPoint presentation.

Source

Technical Advisory Group (TAG) Meeting on Communication for Polio Eradication held in Afghanistan, September 25-27 2007.