14th Meeting of the Expert Review Committee (ERC) On Polio Eradication & Routine Immunization in Nigeria

This 9-page report shares details from the 14th Expert Review Committee for Polio Eradication and Routine Immunization, which took place in Jos, Plateu State, Nigeria, March 12-13 2008. The analysis of Nigeria's strategy to eradicate polio provided here features descriptions of, and recommendations gleaned from, several communication components of the national effort.

As explained here, the meeting convened at a time when optimism engendered by what the organisers describe as "remarkable" progress towards polio eradication in Nigeria throughout 2007 was tempered by a resurgence of wild poliovirus type 1 in several states during the 6 months preceding the meeting. "The ERC noted with some alarm that of the 4 remaining polio endemic countries in the world, Nigeria now accounts for nearly 90% of the type 1 cases, reporting 40 cases by 11 March 2008, compared with just 1 in India, 2 in Pakistan and 3 in Afghanistan." That said, the ERC highlighted that more than 50% of these cases are in just 3 states (Kano, Jigawa, Sokoto) and, in all infected areas, the upsurge reflects a failure to reach and immunise all children, rather than any fundamental problem with the eradication strategy.

One of the approaches evaluated here is the use of Supplementary Immunization Activities (SIAs). The theme of community engagement is apparent in this excerpt: "The ERC is satisfied that the mix of monovalent and trivalent OPV rounds in 2007 and early 2008 has been appropriate, and has been optimal for achieving high levels of population immunity to the circulating poliovirus serotypes....The ERC also notes the increasing ownership of polio eradication activities by states, LGAs [local government associations] and local communities, including traditional and religious leaders. Activities to mobilize and engage local communities are being widely conducted across all northern states. However, there remain many LGAs with significant coverage problems....[I]n high risk areas many children are still not reached during immunization activities..."

One of the recommendations to addressing this issue involves participation amongst various groups. The ERC suggests that LGA Chairmen in the identified very high and high risk LGAs should be convened for special review meetings immediately prior to each immunisation for preventable disease (IPD) round in order to provide a platform for reviewing past performance, identifying problems, and formalising solutions. The ERC indicates that these meetings should be convened by the state Health Commissioner and Commissioner of Local Government, and that a full report should be made to the State Governor following each meeting.

A second communication-related approach explored here involves social mobilisation and communications for polio eradication: "The ERC noted progress made towards implementing recommendations previously made for social mobilization and communications. The programme is increasingly using data to drive activities, in particular with respect to community dialogues, the expansion of engagement of local traditional and religious leaders, the expansion of engagement of Quranic school teachers, both male and female, and other innovations."

With regard to this aspect of the effort, the ERC recommends continuing efforts to engage communities and community leaders (religious, traditional, and political), with attention to documenting and evaluating these efforts to assess impact. In addition, "[s]tates should develop data-based strategic plans to ensure appropriate social mobilization interventions are targeted to...high risk communities." Along these lines, the ERC stresses that, at state level, government and partners should ensure that the capacity exists to collect, analyse, and incorporate epidemiological and programme data while developing social mobilisation and communications interventions, and while assessing the impact of these activities through monitoring and evaluation processes.

The role of the media in sharing information and sparking action is also highlighted in this report: "At national and state level a process of engaging and re-vitalizing mass media should be undertaken, to highlight polio eradication activities and the importance of immunization."