Polio Strategy Perspectives Survey

"Those who are heavily involved in polio work feel there are higher levels of public conversation, accurate information and local perspectives than those with less involvement."

This is just one of the findings of a survey conducted by The Communication Initiative (The CI) of small sections of its network with direct experience of the polio eradication programme in very high-priority countries. The survey sought to gain insight into a range of issues such as perceptions of public trust, leadership style, messaging, and reaching hard to reach populations from a targeted group.

There were 142 respondents to the February to March 2013 survey, most (80%) of whom were from Pakistan, India, or Nigeria. They work on polio eradication in areas including mobilisation, research, media/journalism, training, programme management, strategy development, technical support, creative activities (e.g., theatre, radio, and audiovisual), vaccine procurement, and logistics. Some are on Stop Transmission of Polio (STOP) teams; others are community volunteers.

Key findings that emerged from the survey's analysis of those heavily involved in polio work compared with those somewhat or not at all involved in polio work include:

• Public trust: Those heavily involved rated public trust higher than those less involved.
• Local engagement: Those heavily involved rated engagement of religious community, tribal, and traditional leaders and local community groups higher than less involved.
• Leadership: Those heavily involved agreed with describing leadership as data-driven, responsive, and partnership-based more than those less involved.
• Decision making: Those less involved described the programme as having a top-down approach more often than those who described themselves as heavily involved.
• Public conversation: Those heavily involved described the programme as having higher levels of public conversation, accurate information, and prominent local perspectives than the less involved.
• Innovation: Those heavily involved rate the programme much higher for innovation, though close to 50% of both groups gave the programme an average rating.
• Polio and routine immunisation (RI): Those heavily involved more often described the relation between polio and RI as being close and strategic but separate.

How do different priority countries compare on some of the core strategic foundations for the polio programme? Key findings:

• Public trust: Respondents in Nigeria rated this strongly as mixed; those in Pakistan rated public trust as low.
• Local engagement: Pakistan felt that religious and tribal groups are not engaged, and Nigeria felt that community groups are not engaged.
• Leadership: Pakistan had the lowest ratings of all groups, rating leadership low in the area of being "decisive and determined".
• Public conversation: Pakistan felt that there are more inaccuracies and less public conversation than other countries.
• Innovation: Pakistan rated innovation significantly lower than other countries.
• Polio and RI: Pakistan rated separate and parallel approaches highest; India gave the lowest rating for information sharing; and Nigeria gave the highest rating for there being a close strategic working relationship.

Aggregate findings, in sum, include:

• Overall, most respondents were positive about the polio programme's strategies and direction.
• Most describe public trust as mixed.
• With regard to messaging, clarity on the dates of Special Immunisation Activities (SIAs) and need for vaccine rated high but low on what to expect from vaccinators. Nearly 30% of respondents felt that messaging is not getting to hard-to-reach populations. Respondents rated religious and migrant populations lowest in terms of message saturation.
• Overall, respondents say that local government officials are actively engaged. However, technology and communication companies, tribal leaders, and religious leaders are not effectively engaged.
• Nearly all felt the the polio programme uses mass media well.
• Digital technologies had the lowest effectiveness ratings - least effective was the use of Geographic Information Systems (GIS)/Global Positioning System (GPS).
• In terms of leadership, respondents rated United Nations (UN) agencies, government, and health workers as most effective. They described polio programme leadership as determined, active, responsive, and partnership-based but rated the leadership as poor at being astute and collegial. 
• The polio programme is perceived by most to have a decision making process that flows from the top down.
• India scored highest in the realm of public conversation, while Pakistan was rated as having the least public conversation with the most inaccuracies.
• Most respondents rated innovation between high and average.
• The relationship between polio and RI was generally rated as poorly integrated but improving.

Click here for the 36-slide PowerPoint presentation.