| The Drum Beat – 634 – Polio Communication |
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| This issue of The Drum Beat highlights some of the most updated information posted to The Communication Initiative’s Polio theme site – please visit us often and enrich our site by sending your polio communication experiences, strategies, resources, and ideas to vaccines@comminit.com |
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| LESSONS FROM INDIA |
| 1. Emergency Preparedness and Response: Capacity, Tackling Complacency, Focusing on Polio and Partnership for the Long Term |
| This report shares the key points from a communication review carried out from November 29 – December 7 2012 to explore the state of polio immunisation communication in India (now removed from the World Health Organization (WHO)’s list of polio-endemic countries), where, however, there remains the risk of poliovirus importations, especially from countries like Pakistan, Afghanistan, and Nigeria. In this context, the Government of India has declared that any case of polio will be treated as a public health emergency; all states have prepared an Emergency Preparedness and Response Plan (EPRP). The communication plans under the EPRPs identify and map: areas and communities that may need special focus, stakeholders that can be involved to mobilise the community, initiatives that would be undertaken, etc. For appropriate media engagement and response, a proactive plan, clearly identifying spokespersons at various levels, has been prepared. The communication review team was asked to review emergency preparedness and response capacity and partnership. |
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| 2. CORE Group Polio Project: Examples of Videos, Brochures, Training Tools and Community Mobilisation Materials |
| This PowerPoint presentation, with accompanying PDF document, describes and shares communication materials from the CORE Group (the Child Survival Collaborations and Resource Group), with a focus on its efforts to mobilise community involvement in the polio eradication programme and to improve routine immunisation (RI) in high-risk areas of Uttar Pradesh, India. These materials have been sharpened over time and are now being used, for example, to record data and facilitate participatory techniques toward behaviour change. |
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| 3. The Revolutionary Optimists |
| This multi-platform advocacy campaign mobilises children in Kolkata, India, to go door-to-door with home-made megaphones, mobile phone technology, and global positioning system (GPS) maps. They encourage neighbours to participate in polio vaccination programmes and track and collect data around health issues that impact them – water, sanitation, and infectious diseases. The Revolutionary Optimists is captured by a documentary to be released in 2013. |
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| 4. CORE India Combined Routine and Polio Immunization Drive 2010 |
| The CORE Group Polio Project (CGPP) in India undertook a communication-centred initiative to deliver the oral polio vaccine (OPV) as well as routine immunisation (RI) to underserved, high-risk areas. Formed in 1999 in Uttar Pradesh, CGPP’s India Secretariat implements the project via an extensive network of Community Mobilization Coordinators (CMCs) who conduct social mobilisation activities in high-risk areas to promote acceptance of the OPV. |
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5. Social Mobilization: Lessons from the CORE Group Polio Project in Angola, Ethiopia, and India
by Elaine Murphy, PhD |
| «Marking a shift from the earlier dominance of epidemiological perspectives, today behavior-change communication – advocacy, interpersonal communication, and social mobilization – is recognized internationally as the way forward in this final phase of polio eradication.» This report: places the CORE Group Polio Project (CGPP) within the context of the GPEI, defines and describes three varieties of social mobilisation (SM), and presents as case examples CGPP’s SM work in India, Angola, and Ethiopia to reach difficult-to-access populations critical for polio eradication. Eleven lessons learned are elaborated. [Sep 2012] |
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| POLIO IN PAKISTAN & AFGHANISTAN |
| 6. Global Polio Eradication: Not There Yet |
| This Lancet editorial discusses the «devastating setbacks» that hampered the global effort to halt all wild poliovirus transmission (WPV) by the end of 2012 as established by the 24-year-old Global Polio Eradication Initiative (GPEI). In mid-December 2012, 9 health workers were shot dead while travelling from house to house to administer polio vaccine to children during the national anti-polio campaign in Pakistan. Then, on January 1 2013, 6 female Pakistani aid workers and a male doctor were shot dead. As noted here, it is female health workers who «are standing fearlessly and selflessly on the frontline of Pakistan’s war against polio, because culturally only women are allowed to enter into houses to talk to mothers and vaccinate their children.» [Jan 2013]
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7. The Wrong Way to Fight Polio
by Helen Epstein |
| Helen Epstein reflects on what were, at the time of writing, recent murders of 9 members of a polio vaccination team, funded by the United Nations (UN)-led GPEI, in Pakistan; the gunmen were thought to be linked to the Taliban. «The heroic approach», labelled and described by Epstein as «the lavishly funded, multiple immunizations the polio program requires», does not always, in her assessment, make sense to local political leaders and warlords or to ordinary poor people who are struggling just to keep their children alive. [Dec 2012] |
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8. Reaching the missed children for Polio Vaccination – bringing innovation in a local way
by jawahir |
| «The Communication Network (COMNet) in Quetta [Balochistan, Pakistan] has found a unique way to immunize missed children amongst mobile and migrant population….COMNet team hired a «Jhoola», a manually operated swing for the children….The Jhoolas were placed at 3 different settlement areas….During the activity, the parents were briefed on importance of vaccination and hygiene. Female social mobilizers went tent-to-tent to inform families about vaccination and bring out children for immunization. A large number of children gathered around the swing; parents brought their children enthusiastically to play and receive polio drops.» [Nov 2012] |
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| 9. Follow up to the Independent Review of the Afghanistan Polio Eradication Programme Held in July 2012 |
| As part of the global effort to eradicate polio, this report shares the insights of a 4-person team who met in Afghanistan in November 2012. The programme has used sources such as pre-existing maps of radio and media channels together with District-level information to identify media outlets to work with and feels strongly that information, education, and communication (IEC) materials «have an important role to play». Furthermore, a new interpersonal communication (IPC) training module has been developed; plans were for all social mobilisers and vaccinators to have received this new training by the end of December. Clusters identified as at high risk (high child absence and low awareness) now have a social mobiliser accompanying vaccinator teams assisting them to access children at the doorway, «providing more complete polio and routine messaging and helping to identify missed children….Social mobilizers are also being integrated more closely with the vaccinators through joint training and microplanning and there is pilot project to have social mobilizers go out before the round to mark the number of children in each household to provide vaccinators with a more accurate enumeration of children in their area.»
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| 10. Report of the Communications Review: Pakistan Polio Eradication Programme |
| A number of recommendations are presented in a chart organised according to each of the 4 review groups and different levels of focus. For example, the mass media review group suggested that, at the national level, the polio programme should focus on building media relationships and strengthening journalist Polio Eradication Initiative (PEI) knowledge and reporting capacity through media workshops, take-away media packs, and more media events prior to immunisation rounds. Also recommended is that a media crisis plan be developed that includes supporting materials. Further ideas include: «Ensure government is the leading voice on polio. Improve coordination between partners through editorial meetings, aligning media and communication plans and improving staff training on EPI and communication to improve partner relations.» [May 2012] |
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11. Towards Polio Eradication
by Elias Durry |
| From a World Health Organization (WHO) staff person and senior member of the Polio Eradication Initiative (PEI) in Pakistan, this opinion piece explores, amongst other things, misinformation and rumour, which is a central issue with regard to communication surrounding the oral polio vaccine (OPV) in Pakistan. In his words: «At a time when Pakistan was moving in the right direction towards complete polio eradication, security incidents followed by a series of incorrect media reports in various sections of the press…have seriously jeopardised the recent successes of Pakistan’s fight against polio.» [Jan 2013] |
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12. Communicating with Context: Polio Eradication and the Political Economy of Vaccination
by Seb Taylor |
Writing in the context of recent reviews of the Polio Eradication Initiative (PEI) in Pakistan and Afghanistan, Seb Taylor argues that communication for polio eradication can be strengthened in 3 ways:
- «First, generating a more textured analysis of the national and sub-national political, economic and institutional context in which the eradication programme happens.
- Second, exploring ways in which communications can be used to change and enhance the material conditions of the lives of those people targeted for vaccination.
- Third, understanding the complex and often multiple identities and attitudes of key actors and interlocutors in the polio eradication programme, in order to target communication interventions within the programme’s core constituency – its health workers and vaccinator teams.
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| 13. Missed: Polio Communications Quarterly Update |
| With a focus on Pakistan and Nigeria’s most vulnerable communities, this report provides insight about the role that community push-back is playing in the transmission of the polio virus and how the GPEI can mitigate these social risks to reach every missed child. «New mass media campaigns that build on the power of interpersonal communications are underway in Afghanistan and Pakistan, with the ultimate goal of igniting a broad social movement against polio. Population awareness has already begun to rise in both countries as a result. As the media campaign continues to roll out in a series of planned phases, it must move beyond raising awareness to reinforce on-the-ground efforts of promoting local ownership and engagement.» [Oct 2012] |
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| PLEASE TAKE A BRIEF SURVEY! |
| The Communication Initiative is involved with other agencies in a series of polio communication reviews. These are designed to provide positive, critical feedback that support improving the effectiveness of polio communication activities. To inform our contributions to this polio communication review process, we would welcome your critical insight, analysis, and perspective on present polio communication strategies and activities. We are seeking reflections and ideas – whether you are directly involved or not in polio action. Both perspectives are important.
Please do contribute to this process by completing the survey here.
Your submissions will be in complete confidence. No names or other identifying information will be associated with any of the responses. If you have any questions, contact Chris Morry: cmorry@comminit.com |
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| POLIO IN AFRICA |
14. Polio: Is it too late for participation?
by Wendy Quarry |
«Communication professor and writer, Silvio Waisbord got it right ten years ago when he noted that the rift between those who see communication as behavioral change and those who support a more participatory approach has still not healed. I thought about this during a recent review of Polio Communication in Nigeria. Here a ‘top-down’ full-scale behavioral change approach is in full swing despite an apparent need to adopt longer-term, participatory and more ‘bottom-up’ approaches to reach ‘missed’ or non-compliant households. When asked to write about my impressions of this review, my first thought was the difficulty the polio machine might face in pausing long enough to build in a new approach. The train has so clearly left the station and is gaining momentum based on the hope that its power alone would solve the problem. Perhaps in other countries, but not Nigeria. Here the reasons for non-compliance are complex within an equally complex environment. This is in direct contrast to Canada decades ago where I had my first brush with the disease.» [Nov 2012]
- We welcome responses and further thoughts on the questions Wendy raises. You can do so by logging on to the Polio Network site. If you are not yet registered, you can do so here – make sure you select ‘Join Polio Networks’.
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| 15. Music and Mothers: Intensified Communication Efforts in the Fight against Polio in Chad |
| This news piece from the GPEI explores the role of community mobilisation – interpersonal communication (IPC) by women and the use of music – to encourage Chad’s mothers to vaccinate their children. For example, the Government, with the support of GPEI partners, carried out a communication campaign involving an open air, free-admission concert to raise awareness in N’Djamena. Amongst the messages expressed by a famous Chadian singer: «Youth, I say this: when you see the vaccinators, it is to give two drops against polio. So ask your parents to allow them to vaccinate your siblings. Parents leave behind the preconceptions.» [Jan 2013] |
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| 16. Polio-Free Chad: UNICEF Quarterly Newsletter on the Polio Eradication Initiative in Chad |
| «In 2011, 132 Chadian children were paralysed by wild polio, whereas there were just 5 in 2012. In this effort, «[r]eaching the sizeable nomadic population has been vital….The Programme has sought the help of these communities to develop strategies to find and vaccinate their children. This innovative work, which has also involved the veterinary sector, and the contacting of nomadic leaders by mobile telephone, is paying dividends in Chad and could be replicated elsewhere in the Global Programme.» Also, while vaccine refusal «has barely been an issue in Chad», community engagement remains key, as the percentage of children missed for «social reasons» is still high. «Caregivers’ poor awareness of vaccination campaigns is now rated as high-risk by UNICEF, not helped by the fact that many core communications personnel are not yet in place in the field.» [United Nations Children’s Fund (UNICEF), Jan 2013] |
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| 17. Volunteer Community Mobilizer Network Nigeria |
| Selected from their respective settlements, female volunteers have been trained to work as «change agents» in the community and are responsible for house-to-house mobilisation for polio and routine immunisation. They have started to identify and characterise chronically missed children and non-compliant parents through a community-friendly approach. [National Primary Health Care Development Agency (NPHCDA), the United Nations Children’s Fund (UNICEF), and Polio Eradication Initiative (PEI) partners – with the support of the Bill and Melinda Gates Foundation (BMGF) and the Centers for Disease Control and Prevention (CDC)] |
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| 18. Tsangaya School Strategy |
| To address an upsurge of polio cases in Nigeria in August 2012, the Tsangaya School Strategy involves the full engagement of religious schools, institutions, and leaders, and teachers, whom organisers say are critical community leaders and opinion-makers. The concept is that, for polio eradication to succeed, it is important to engage and ensure the full participation of all sectors of society and in particular the communities themselves. [UNICEF, with the support of the Centers for Diseases Control and Prevention (CDC)] |
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| 19. Final Report from the Nigeria [Polio] Communication Review |
| This report provides a consolidated summary of the major findings and recommendations of a 4-day polio communication review that was undertaken in 4 states of Nigeria (Sokoto, Kano, Katsina, and Kaduna) by 4 teams. The teams found that the programme remains vulnerable to rumour and misinformation, and communication has a major role to play in reducing this vulnerability. Suggested areas of improvement with regard to community engagement in this regard include ideas such as this: information, education, and communication (IEC) materials should be «developed in a manner consistent with proven behavior change communication methodologies. Messaging and content must be data-driven and thoroughly pre-tested to ensure acceptability in the target community, with a particular emphasis on local language and/or low-literacy content.» [Oct 2012] |
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| 20. Final Report: 24th Meeting of the Expert Review Committee (ERC) on Polio Eradication & Routine Immunization in Nigeria |
| According to the report, the ERC was encouraged by a number of developments in the national programme. For example, a pact signed by traditional leaders to lead repeat vaccination efforts in poor-performing wards «offers a new avenue to bring their influence to some of the fundamental challenges with vaccinators and accountability». Also, the ERC notes that a revised national communication strategy would create an enabling environment for delivering oral polio vaccine (OPV) if it can be rolled out in time to support the low-transmission season Immunization Plus Days (IPDs). «Finally, under-pinning everything, is the hope that the government can succeed in truly elevating completion of polio eradication to an emergency status at all levels.» [Sep 2012] |
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| GLOBAL IDEAS & RESOURCES |
| 21. Polio’s Last Stand: Report of the Independent Monitoring Board of the Global Polio Eradication Initiative |
| In going forward, according to the Independent Monitoring Board (IMB) of the GPEI: «There is one ingredient…that is still missing in the affected countries – absolute ownership. Ownership means parents demanding the vaccine, making it their mission to protect their children. Ownership means local leaders grasping the challenge of wiping polio from their area. Ownership means a critical mass in the population believing that their children can, must and will be protected through the eradication of polio.» [Nov 2012] |
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22. Immunisation for All: No Child Left Behind
by Kirsten Mathieson and Lara Brearley |
| Noting that one child in five around the world misses out on basic vaccinations, this report identifies country-level strategies to reach the unreached. It also identifies factors at the global level that will help to create a more conducive environment for countries to achieve and sustain universal immunisation coverage. [Dec 2012] |
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| 23. E-learning Course on Vaccine Safety Basics |
| This free, interactive online course – one module of which focuses specifically on communication – aims to establish a shared understanding among professionals whose work is linked to vaccine safety issues. [WHO] |
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| 24. The Shot Felt ‘Round The World |
| This 60-minute documentary on polio tells the story of Dr. Jonas Salk and his research team, who pulled together with a community and a nation (the United States) which «rolled up its collective sleeves to conquer the most-feared disease of the 20th century.» The film is a resource around which an advocacy and education programme has been built. [May 2011] |
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| 25. Global Guidelines: Independent Monitoring of Polio Supplementary Immunization Activities (SIA) |
| This guide from the GPEI is designed for polio eradication programme managers who are involved in the planning and operations of SIAs. It explains how to establish a system of independent and credible monitoring of SIAs in an effort to provide reliable and timely data to monitor progress and take corrective action. [Oct 2010] |
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| This issue of The Drum Beat was written by Kier Olsen DeVries. |
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| The Drum Beat is the email and web network of The Communication Initiative Partnership – ANDI, BBC Media Action, Bernard van Leer Foundation, Calandria, CIDA, Citurnas ldta., DFID, FAO, Fundación Nuevo Periodismo Iberoamericano (FNPI), Ford Foundation, Heartlines, Imaginario, Inter-American Development Bank, International Food Policy Research Institute (IFPRI), International Institute for Communication and Development (IICD), Johns Hopkins Bloomberg School of Public Health Center for Communication Programs, MISA, Ohio University, Oxfam Novib, PAHO, The Panos Institute, The Rockefeller Foundation, SAfAIDS, Sesame Workshop, Soul City, Swiss Agency for Development and Cooperation, UNAIDS, UNDP, UNICEF, USAID, World Health Organization (WHO), W.K. Kellogg Foundation.
The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.
Chair of the Partners Group: Garth Japhet, Founder, Soul City garth@heartlines.org.za
Executive Director: Warren Feek wfeek@comminit.com |
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| The Editor of The Drum Beat is Kier Olsen DeVries. |
| Please send additional project, evaluation, strategic thinking, and materials information on communication for development at any time. Send to drumbeat@comminit.com
The Drum Beat seeks to cover the full range of communication for development activities. Inclusion of an item does not imply endorsement or support by The Partners.
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