13,527 Polio Perspectives from the SBCC Summit, The Drum Beat, 756, May 16, 2018

The Drum BeatPolio Perspectives from the SBCC Summit – The Drum Beat 756
May 16, 2018
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From The Communication Initiative Network – where communication and media are central to social and economic development.
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The Drum Beat 753 – Engagement Guide to the 2018 SBCC Summit introduced you to the 2nd International Social and Behavior Change Communication Summit featuring Entertainment Education (SBCC2/EE6). Held April 16-20 2018 in Nusa Dua, Indonesia, it brought together 1,200 people keen to understand – and advance – what works in shifting social norms, changing behaviours, and amplifying the voices of those with the most at stake in the success of development efforts. Some of those in attendance – and, presumably, some of you – have an interest, specifically, in the role of polio communication in the SBCC field.

This Drum Beat is designed to cull for you some of the knowledge to emerge across specific themes articulated at the various polio-related Summit sessions. We do so in the hope of generating discussion as you access the presentations we are sharing through The CI’s Groups process. We hope to share more as we receive them, and encourage you to pose questions, make suggestions, and, more broadly, engage with people with similar interests in ensuring that communication’s role in polio eradication is recognised and strengthened.

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POLIO COMMUNICATION AT THE SUMMIT: OVERVIEW OF 12 INTERRELATED THEMES
  • 1. Polio communication often occurs in complex social, cultural, and political contexts.
    This was the theme of one session on What Works in Complex Settings? Polio communication has had to confront difficult issues in some very complex settings – for example, in (parts of) Somalia, Yemen, Nigeria, India, Syria, Pakistan, and Afghanistan. Much has been learned that is of value both for the continued struggle to eradicate polio and in support of organisations working on other development issues in equally complex settings. For example, Senator Ayesha Raza Farooq, a member of Pakistan’s Senate and the prime minister’s point person on the nation’s polio eradication programmes since November 2013, described Pakistan as a classic example of the diverse challenges the programme faces, stressing that there is no “one size fits all” solution and giving examples of the outside-of-the-box, sometimes nontraditional approaches designed to achieve results.
    Click here to listen to the audio recording from the What Works in Complex Settings? session (Adobe Flash Player must be enabled).
  • 2. Building trust is critical and must be a continuous process.
    Several Summit presentations and much dialogue highlighted this critical element of polio work. In her remarks at the above-mentioned panel, for example, Folake Olayinka of the Maternal and Child Survival Program (MCSP) talked about distrust in oral polio vaccine (OPV) safety and the rumours that fuelled massive polio vaccine refusals in 2003/2004 in northern Nigeria. Many approaches have been developed in different contexts around the world to build trust. Senator Farooq discussed one in her keynote address. After social data indicated that frontline vaccinators were key to reaching caregivers and parents in households, Pakistan made a paradigm shift and put vaccinators at the centre of programme communications as Sehat Muhafiz – Guardians of Health. ‘Strangers No More’, one communication campaign developed as part of the programme, sought to build trust by presenting vaccinators as mothers, fathers, and members of the community with full lives, talents, and skills not limi! ted to their role in the polio programme.
    Click here for a summary of the Senator’s keynote address.
  • 3. Listening is key.
    Folake Olayinka, in her remarks on Nigeria in the Complex Settings panel, described the importance of working at a very local level. Daily review meetings initially focused on the polio programme’s operations but began to incorporate reasons behind refusals; this allowed MCSP to go back to communities and take corrective actions based on the data. This is connected to the need, she said, to be flexible – redesigning strategies to respond to the felt needs of communities. Rina Dey described in her remarks at that same panel the need to listen not only to communities but also to local non-governmental organisations (NGOs) and community-based organisations (CBOs). In Somalia, the CORE Group Polio Project has engaged these groups, who are able to reach areas otherwise completely inaccessible (where children are hiding), and to build their communication capacity.
  • 4. Advocacy helps ensure buy-in and commitment to the cause.
    Anna Sukhodolska of the United Nations Children’s Fund (UNICEF) Ukraine remarked on the role of high-level international advocacy in dealing with the 2015-2016 outbreak of circulating vaccine-derived poliovirus (CVDP), which made a difference even though the government did not want to announce the outbreak. Senator Farooq underscored the importance of large-scale commitment and coordination by the Government of Pakistan and local and Global Polio Eradication Initiative (GPEI) partners. The prime minister declared polio eradication as one of the top three governmental priorities, and chief ministers, the health minister, chief secretaries, commissioners, and deputy commissioners are all fully involved and committed to the cause. Polio eradication also enjoys broad-based support across Pakistan.
  • 5. It is necessary to recognise and adapt around social norms.
    Per Senator Farooq, the Pakistan programme realised that access to homes posed a major challenge due to prevalent cultural norms. Their approach to the problem was to employ more trusted, local, and female community-based vaccinator (CBVs). These CBVs helped vaccinate even those children who may be sleeping, on the move, or visiting. Many believed that this approach would fail in Gadap and Chaman/Qilla Abdullah, thinking that perhaps community members were too conservative to accept local women taking up such a leading role. Instead, female CBVs have been found to be instrumental in helping change norms and perceptions about vaccinations nationwide, and now 84% of CBVs are female. And because they are local, the communities look after them.
  • 6. Holistic thinking requires using every opportunity that one interacts with beneficiaries to offer other health services.
    In her remarks, Folake Olayinka discussed the fact that distrust in the northern Nigeria context was also fueled by lack of basic health services, which led communities to wonder why vaccinators were visiting their doorsteps when there was no treatment for fever available at the local health clinic. Recognising the imperative of responding to the felt needs of the community led to the evolution/redesign of the National Immunization Days (NIDs)/Sub-National Immunization Days (SNIDs) and incorporation of other basic maternal and child health (MCH) services/products into what became known as Immunization Plus days (IPDs). On a related point, Anna Sukhodolska pointed, in the Complex Settings panel, to the dysfunctional health system in Ukraine that contributed to challenges related to communication about the vaccine.
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Looking for more? Access:

POLIO and ROUTINE IMMUNIZATION at the WHAT WORKS? SUMMIT
This is the space for dialogue and debate on some of the polio- and routine-immunisation-focused presentations at the Summit. To submit questions and share insights and ideas – whether you were a Summit participant or not – log in (or register for free with The CI) and click here.

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  • 7. Polio communication is shaped by data.
    This was the topic around which 3 polio communicators oriented their presentations in the session Necessary Bedfellows – But How to Connect? Data and SBCC. They joined in the recognition that the polio social mobilisation strategy was, crucially, informed by data. Increasingly, as the polio initiative advanced, this was micro data as discrete as block-level information. For example, the data on missed children (those not vaccinated) was collected and analysed; it helped drive the norms, behaviour, and voice work. The goal of this preformed panel was to examine the inter-relationship between data and SBCC through the lessons learned from the polio experience in India, Nigeria, and Pakistan, and from a global perspective.
    Click here to listen to the audio recording from the session and to view presentation slides from it (Adobe Flash Player must be enabled).
  • 8. Data inform efforts to reach every child.
    Amanda Quintana and Ellyn W. Ogden of the United States Agency for International Development (USAID) argue that good data drive quality programming. Stratifying information is collected from the national to household level and in categories such as clusters, complacency, trust, and accountability. Senator Farooq characterises Pakistan’s CBV initiative as being key to reaching every single child. (More broadly, the programme has dedicated much energy to registering, mapping, and vaccinating families on the move.) UNICEF’s Rustam Haydarov and Harvard Opinion Research Program (HORP)’s Dr. Gillian SteelFisher discuss how social data, including “hard” knowledge, attitudes, and practices (KAP) data gathered through a partnership between UNICEF and HORP, are critical in achieving high coverage and, more broadly in generating evidence to shape the polio programme in the “last mile”.
    Click here to access The Importance of Why: How Polio Communications Helps Reach Every Child.
  • 9. Formative research helps guide communication strategies and activities.
    Though from a non-immunisation-related presentation, in the session Shot Talk: Communicating about Immunization, Hillary Murphy detailed how the Strengthening Partnerships, Results, and Innovations in Nutrition Globally (SPRING) Project conducted formative research to design the behaviour change strategy to accompany micronutrient powder (MNP) distribution in rural Uganda. Key informant interviews and focus group discussions revealed that people trust health workers and village health teams to provide formal advice. They felt involving radio show hosts would be a good way to spread the message about MNP and that messaging should utilise churches and women’s groups to reach women and markets to reach fathers. Finally, politicians should not be involved in promotion of MNP, as they were seen as being biased.
    Click here to access Exploring Social and Behavior Change Communication to Support Delivery of Micronutrient Powders in Rural Uganda.
  • 10. Community members can be engaged in vaccination and in surveillance.
    In exploring the global evolution of data-based polio communications and how that was implemented and monitored in/with countries, Lora Shimp of MCSP and JSI discussed a cadre of field-based, local communication mobilisers for polio and beyond (the Social Mobilization Network, or SMNet, in India), which creates neighbourhood maps and name-based registers of children and tracking chart of polio doses circled for each round per child. Rina Dey described in her remarks at the Complex Settings panel the CORE Group Polio Project’s use of community-based surveillance. They began by involving influential people – community leaders and religious leaders – but moved to shopkeepers (where people will go for day-to-day needs even in times of conflict) and barbers. These community members can act as informers for listening to the community around vaccination issues and feeding information back to the programme. In this way, the goal of polio eradication is shared at every level.
    Click here to access Lessons Learned in Using Data in Polio Communications – How?
  • 11. Information and communication technologies (ICTs) have a role to play in research to inform vaccine communication.
    In a Shot Talk session, Roel Lutkenhaus, Jeroen Jansz, and Martine Bouman of the Netherlands shared research that sought to explore how vaccine hesitancy is discussed online. The researchers analysed conversation networks as stakeholder analysis, conducting formative research to identify online communities, frames and narratives, and social influencers. In that same session, UNICEF’s Rizky Syafitri spoke of, among other things, the way in which Rapid Pro, a short messaging service (SMS)-based platform, was used to collect data and provide real-time data feedback for the Indonesia measles-rubella (MR) campaign. Using this tool, UNICEF was able to track rumours through daily media monitoring of print, radio, and social media. It allowed communication for development (C4D) teams to work with government and respond quickly through direct outreach to parents, schools, and politicians, as well as through tailored media messaging.
    Click here to access #Vaccine Hesitancy: Analyzing Online Conversations as Formative Communication Research.
    Click here to access How to Immunize 35 Million Children in 60 Days? 
  • 12. Transitioning polio assets involves, in part, understanding how to retain/sustain and also transfer the skills/knowledge gained.
    Rina Dey made this point during the Complex Settings panel, also discussing a related challenge of how to sustain population immunity – that vigilance is key to successful surveillance until the entire world is certified polio free. Rustam Haydarov notes that the HORP partnership serves a broader C4D function in UNICEF, which is just one example of how some of the rich research – as well as the insights and lessons learned – will survive long after polio itself has been defeated.
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PLEASE TAKE OUR SURVEY
ENQUIRY: Your priorities, opportunities and challenges!
What kinds of challenges and opportunities infuse your communication and media development, social and behavioural change work? This survey is a chance for you to let us know! In 2018, we will report back on results and trends so you can gain insights from your peers in the network.
Click here to lend your voice.
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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.

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