The Drum Beat 320 - Communication for Polio Eradication
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The global eradication of polio continues to prove very challenging. Many of these challenges require diverse and ongoing communication responses and interventions. This issue of The Drum Beat provides summaries and links to the full presentations from the Annual Meeting of the Technical Advisory Group (TAG) on Communication for Polio Eradication (convened jointly by UNICEF/WHO), held in Yaounde, Cameroon, June 22-24 2005.
At this meeting, country presentations were made by teams from 16 countries, including 6 polio endemic countries (India, Afghanistan, Pakistan, Egypt, Nigeria and Niger); 6 countries experiencing re-established transmission (Sudan, Chad, Mali, CAR, Burkina Faso and Cote d'Ivoire); and 4 countries with cases arising fr importation (Yemen, Cameroon, Guinea and Benin). Each country presented its current and proposed communication strategies for the next 6-12 months designed to provide communication support for the final push to eradicate polio. A summary of each country presentation is included here, as is a Summary Report detailing key findings and recommendations from the meeting.
Please also see The Drum Beat #264 for the presentations and summaries from the 2004 Annual Meeting of the Advisory Group on Communication for Immunisation and Polio Eradication.
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GLOBAL COMMUNICATION FOR POLIO ERADICATION
1. Global Polio Eradication Initiative Overview - June 2005
A summary of the trends and status of the global polio eradication programme, providing an overall epidemiological framework for the communication strategies presented on a country-by-country basis later in the meeting. Facts presented include: the total number of global poliovirus cases increased from 784 cases in 2003 to 1,256 cases in 2004, with 555 cases reported to June 2005. As of June 2005, there were 6 polio endemic countries and 14 countries with imported virus (for a total of 20 countries), of which 6 had experienced retransmission. Major developments since the last annual meeting held in June 2004 in New Delhi are reported, and a summary of key risks and priorities, (of which financing gaps are identified as a major risk) is also provided.
Click here for the full presentation [PDF].
Contact Jonathan Veitch, World Health Organization (WHO) veitchj@who.int
2. Summary Report
This report provides an overview of the meeting results and recommendations including: a summary of the status of the prior year's TAG meeting recommendations; significant progress made during the current year and key findings from the meeting. In addition both global and country-specific recommendations are detailed. These were developed from the Peer Review Panel recommendations and subsequent feedback provided by both global partners and country communication teams.
Click here for the Summary Report [PDF].
Click here for the Summary Report [PDF, in French].
Contact Chris Morry, The Communication Initiative cmorry@comminit.com
COUNTRY STRATEGIES
3. AFGHANISTAN - Communication and Polio Eradication Programme
This presentation provided an overview of the epidemiological history, current trends and risk factors in Afghanistan (one of 6 polio endemic countries), as well as the country-specific communication strategies. An outline of the eradication programme is provided, including the number of cases in 2003 (8), 2004 (4) and 2005 (3, to June). Social mobilisation and programme communication activities include: announcements in urban/semi urban/ rural areas by social mobilisers; increased number of female volunteers to reach families; radio spots aired during National Immunisation Days (NIDs) via national radio and mobile theatre performances in schools and communities. A summary of activities planned for the remainder of 2005 and for 2006 is also provided.
Click here for a summary.
Click here for the full presentation [PDF].
Contact Montse Povill, UNICEF mpovill@unicef.org
4. BENIN - Communication and Polio Eradication Programme
This presentation, the original of which is in French, provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Benin experienced importation of the poliovirus in 2003 (2 cases) and 2004 (6 cases). No cases have been reported in 2005 (to June). Development communication strategies such as advocacy, social mobilisation and communication for behaviour change are implemented in order to mobilise leaders and all social groups in favour of polio eradication activities.
Click here for a summary.
Click here for the full presentation [PDF, in French].
Contact Michèle Akan Badarou, UNICEF mbadarou@unicef.org
5.BURKINA FASO - Communication for Polio Eradication in Burkina Faso
This presentation, the original of which is in French, provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Burkina Faso experienced re-established transmission of wild poliovirus (after importation) in 2003 (11 cases) and 2004 (9 cases). No cases have been reported in 2005 (to June). The presentation outlines some factors that influence polio supplementary immunisation activities (SIAs) in the country. These include: delays in resource mobilisation and the launching of communication activities prior to NIDs, as well as insufficient supervision of communication activities. The Polio Eradication Initiative (PEI) challenge for the second half of 2005 is to draw up communication action plans based on epidemiological and sociological data analysis. A schedule of planned November and December NID activities is provided.
Click here for a summary.
Click here for the full presentation [PDF, in French].
Contact Modeste Yaméogo, UNICEF myameogo@unicef.org
6.CAMEROON - Social Mobilisation for Polio Eradication in Cameroon
This presentation, the original of which is in French, provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Cameroon experienced importation of wild poliovirus in 2003 (2 cases), 2004 (13 cases) and 2005 (1 case to June). The communication environment is made up of a large and well diversified network of public and private media, non-governmental organisations (NGOs) and local associations. Results of a post-NID monitoring survey revealed that the primary communication channels were: vaccinators and health agents (38%), social mobilisers (34%), radio (28%). Challenges include reaching all households (more than 30% of those missed were not visited), improving the quality of training of local teams and advocating for more funding in favour of data-based communication activities at the community level. Two more rounds of polio NIDs are planned for November and December 2005.
Click here for a summary.
Click here for the full presentation [PDF, in French].
Contact Martin Engoulou mengoulou@yahoo.com
7.CAR - National Communication Plan for Polio Eradication in CAR (Central African Republic)
This presentation, the original of which is in French, provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. CAR experienced re-established transmission of wild poliovirus (after importation) in 2003 (1 case) and 2004 (30 cases). No cases have been reported to June 2005. Communication objectives for 2005 are presented. Communication strategic principles include: priority given to interpersonal communication, use of local media and the involvement of religious leaders and associations. Polio eradication activities related to the above principles are listed. Some ways to strengthen routine vaccination are listed and planning details for the two NIDs scheduled for November and December 2005 are provided.
Click here for a summary.
Click here for the full presentation [PDF, in French].
Contact Pascal Bondha rozono@netcourrier.com
8. CHAD - Communication for Polio Eradication in Chad
This presentation, the original of which is in French, provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Chad experienced re-established transmission of wild poliovirus (after importation) in 2003 (25 cases) and 2004 (24 cases). No cases have been reported to June 2005. Development communication strategies such as advocacy, social mobilisation and communication for behaviour change are implemented; some results of communication activities are listed. The main challenge of the programme is to utilise the current support of development partners for the drafting of a sound and effective communication strategy. NIDs were planned for November and December 2005.
Click here for a summary.
Click here for the full presentation [PDF, in French].
Contact Achta Aboubakar Abderamane, UNICEF aabderamane@unicef.org
9. COTE D'IVOIRE - Communication for Polio Eradication in Cote d'Ivoire
This presentation, the original of which is in French, provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Côte d'Ivoire experienced re-established transmission of wild poliovirus (after importation) in 2003 (1 case) and 2004 (17 cases). No cases have been reported to June 2005. Advocacy and social mobilisation activities have been implemented in order to involve authorities and partners in supporting vaccination activities. The results of some of the communication activities are presented. According to communication rapid assessments, the two main channels through which parents are informed about vaccination are public criers (46%) and radio/television (30%). A summary of NID activities planned for November and December 2005 is provided in the presentation.
Click here for a summary.
Click here for the full presentation [PDF, in French].
Contact Mr Kouacou Epa, UNICEF ekouakou@unicef.org
10.EGYPT - Communication Interventions in Support of Polio Eradication Program in Egypt
This presentation provided an overview of the epidemiological history, current trends and risk factors in Egypt (one of 6 polio endemic countries), as well as the country-specific communication strategies. Egypt experienced one case of wild poliovirus in each of 2003 and 2004, with no cases reported to June 2005. NID performance indicators are reported for the NIDs held in February, March and May of 2005. Detailed analysis was provided of the missed children in the most recent NID. The primary reasons given for non-immunisation were: vaccination team did not visit the home (30%); mother busy/traveling/unaware (25%); child born after the NID (20%); and just took routine immunisation (9%). The strategic direction for 2005 is provided, including specific measurable communication objectives, such as "maintaining public knowledge of key indicators related to Polio vaccination and NIDs to above 95%". A focus on raising community awareness in 20 high risk areas is detailed, as are activities designed to institutionalise social mobilisation within the Ministry of Public Health micro-planning processes.
Click here for a summary.
Click here for the full presentation [PDF].
Contact Sahar Hegazi, UNICEF shegazi@unicef.org
11.GUINEA - Communication Activities for Immunisation in Guinea
This presentation, the original of which is in French, provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Guinea experienced importation of the poliovirus in 2004 (7 cases). No cases have been reported to June 2005. Communication objectives were defined in the presentation. Communication strategies such as advocacy, social mobilisation and communication for behaviour change are used to obtain high level political commitment and development partners' support. Special strategies to reach vulnerable groups are utilised. Threats to the interruption of transmission by December 2005 are also detailed.
Click here for a summary.
Click here for the full presentation [PDF, in French]
Contact Barry I. S. Almamy, UNICEF abarry@unicef.org
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COUNTRY STRATEGIES (cont.)
12.INDIA - Communication for Polio Eradication - India Update
This presentation provided an overview of the epidemiological history, current trends and risk factors in India (one of 6 polio endemic countries), as well as the country-specific communication strategies. An outline of the eradication programme is provided, including the number of cases in 2003 (225), 2004 (134) and 2005 (18, to June). The 2005 cases are concentrated in identified high-risk districts located in Uttar Pradesh (U.P.) and Bihar. These areas are now the focus for improving operations, communication and the deployment of human resources. The central components of the India communication strategy continue to be: political advocacy, social mobilisation and behaviour change communication. Refinements to this strategy, designed to achieve the goal of reaching the last case of polio, are detailed. The social mobilisation network in U.P. is discussed. Community Mobilisers (CMCs) are key to the strategy, with a total of 6,158 members in the social mobilisation network as of May 2005. A team approach involving CMCs and Muslim influencers in underserved areas is also presented and the positive impact reported. In addition, a comprehensive transit strategy which was implemented at key transit points and on Bihar-bound trains from U.P. is described. Data is also presented detailing the sources of information regarding Oral Polio Vaccine (OPV), and the impact of media spots, as well as some specific steps taken in connection with the introduction of monovalent Oral Polio Vaccine (mOPV).
Click here for a summary.
Click here for the full presentation [PDF].
Contact Michael Galway, UNICEF mgalway@unicef.org
13.MALI - Communication and Social Mobilisation for National Immunisation Days (NIDs) in Mali
This presentation, the original of which is in French, provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Mali experienced re-established transmission of wild poliovirus (after importation) in 2004 (19 cases), with 3 cases reported to August 2005. The media environment is made up of a local radio network of 250 stations, 35 newspapers, and a range of traditional communicators. There is also a National Centre for Health Information, Education and Communication, though the most requested/used channel for informing parents about vaccination and health matters is the radio. NIDs were planned for November and December 2005.
Click here for a summary.
Click here for the full presentation [PDF, in French].
Contact Chouahibou Nchamoun, UNICEF cnchamoun@unicef.org
14.NIGER - Communication and Polio Eradication Programme
This presentation, the original of which is in French, provides an overview of the epidemiological history, current trends and risk factors in Niger (one of 6 polio endemic countries), as well as the country-specific communication strategies. An outline of the eradication programme is provided, including the number of cases in 2003 (40), 2004 (19) and 2005 (2, to June). The communication environment in Niger is characterised by persistent refusal areas, especially in Niamey (the capital), and highly mobile, hard-to-reach groups (ie. nomads and islanders) around the border with Nigeria. The communication strategic principles adopted by the country for polio eradication include: the strengthening of advocacy, increased social mobilisation, the involvement of community rulers and organisations in the communication process along with the use of effective communication channels.
Click here for a summary.
Click here for the full presentation [PDF, in French].
Contact Elhousseynou Dia diaelhousseynou@yahoo.fr
15.NIGERIA - Polio Eradication in Nigeria - Social Mobilisation Partnership
This presentation provides an overview of the epidemiological history, current trends and risk factors in Nigeria (one of 6 polio endemic countries), as well as the country-specific communication strategies. An outline of the eradication programme is provided, including the number of cases in 2003 (355), 2004 (782) and 2005 (169, to June). Current risks in the communication environment which specifically impact supplementary immunisation activities (SIAs) are identified and an overview of the current communication programme is provided. Graphs are presented detailing the reasons for children being missed in the April 2005 NID due to either "no visit being done", "child absent", or "non-compliance". Reasons for non-compliance are also presented. Specific communication objectives for 2005 are detailed, including a goal to resolve all non-compliance cases and to reach all households, and specific communication activities are described. Risks to the programme are also detailed. A Supplementary National Immunisation Day (SNID) was planned for August 2005, with two NIDs scheduled for September and November 2005.
Click here for a summary.
Click here for the full presentation [PDF].
Contact Nance Webber, UNICEF nwebber@unicef.org
16. PAKISTAN - Communication Support for the Pakistan Polio Eradication Initiative
This presentation provided an overview of the epidemiological history, current trends and risk factors in Pakistan (one of 6 polio endemic countries), as well as the country-specific communication strategies. An outline of the eradication programme is provided, including the number of cases in 2003 (103) 2004 (53) and 2005 (10, to June). The communication strategy is two-fold, and is designed to maintain high levels of polio immunisation coverage in the general population and to provide intensive, targeted support activities designed to reach the persistent, low-level transmission virus reservoirs that are typically characterised by: impoverished families, living in multi-family homes, parents with no formal education, and children under 2 years old. Messages are data driven, and polio programme communication has been gain-framed, using positive messages and vivid materials with a reported 86% unprompted recognition. In high-risk districts, process indicators include micro-planning, training, supervision and increasing the number of women vaccinators. Detailed research methods and indicators are presented. NIDs are planned for 2005 and 2006, however funding gaps still exist for both years.
Click here for a summary.
Click here for the full presentation [PDF].
Contact Jeffrey Bates, UNICEF jbates@unicef.org
17. SUDAN - Sudan Communication For Polio Eradication
This presentation provides an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Sudan experienced re-established transmission of wild poliovirus (after importation) in 2004 (127 cases), with 3 cases reported to June 2005. From April 2004 to May 2005, 6 NID campaigns were conducted. High risk areas are identified, and sources of knowledge for the May 2005 NIDs were identified as being from radio (53%), television (21%), megaphone (17%) and other (8%). Community radio listening groups were also engaged to provide a forum and opportunity for community dialogue on polio. A summary of the situation in Southern Sudan was also provided, and communication strategies detailed including advocacy with local leaders and the United Nations (to improve security & access); advocacy with non-governmental organisations (NGOs) and the UN (to improve logistics); training and awareness campaigns; and identification, mobilisation and training of local human resources to improve contact with various tribes and cultures.
Click here for a summary.
Click here for the full presentation [PDF].
Contact Justus Olielo, UNICEF jolielo@unicef.org
18. YEMEN - Communication For Polio Eradication - Republic of Yemen
This presentation provided an overview of the epidemiological history, as well as the country-specific communication strategies and challenges. Yemen experienced importation of wild poliovirus in 2005, with 264 cases reported to June 2005. The key problem is identified as being that there is a low level of immunity in the population and an accumulation of susceptible children. The solution proposed is to conduct a series of high quality house-to-house campaigns. The communication strategy includes an effort to convey clear messages on vaccine safety and to allay misperceptions through mass media/interpersonal communication, and to reduce vaccine avoidance/resistance behaviour by receiving endorsement of vaccination from Sheikhs/Imams/eminent doctors. NID campaigns in Yemen were scheduled for August, September and October 2005.
Click here for a summary.
Click here for the full presentation [PDF].
Contact Naseem-Ur Rehman, UNICEF nrehman@unicef.org
19.POST ERADICATION WORKING GROUP REPORT
The objectives for the Working Group were to: identify and prioritise the key communication issues within the polio eradication continuum; develop a preliminary outline for integration of these issues into the end-game strategy; and discuss a proposed timeline and follow-up steps. The continuum is described as including three phases: the interruption of transmission and avoidance of importations, regional certification and global certification. An outline of a Communication Plan for the initial phase (interruption) is proposed. Issues addressed include: maintaining coverage, vigilant surveillance, media strategies, political commitment and the importance of developing a rapid response plan in the event of importation.
Click here for a summary.
Click here for the full presentation [PDF].
Contact Lora Shimp, John Snow International (JSI) lshimp@jsi.com
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This issue was written by Shan Thomas.
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