The Drum Beat 421 - Communication for Polio Eradication

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The challenge of eradicating polio highlights many of the overall strengths, opportunities, and difficulties for effective development communication; for that reason we have provided regular insights from polio-focused practitioners and researchers. The strategic thinking and evaluation summaries included below were recently posted within The Communication Initiative's Polio Theme Site in response to recent polio-specific meetings held in Pakistan and Afghanistan.

This issue of The Drum Beat focuses largely on these 2 meetings which had the shared objectives of reviewing in-country progress on polio eradication and formulating recommendations on accelerated strategies to ensure interruption of wild poliovirus transmission (WPV). Please click here for summaries of and links to the full presentations from the Polio Communication Technical Advisory Group (TAG) meeting, held in Islamabad, Pakistan, September 17-19 2007. For summaries and presentations from Afghanistan's Polio Communication TAG meeting, held in Kabul, Afghanistan, from September 25-27 2007, click here. This meeting included a specific section on cross-border polio communication strategies, which are also detailed within this issue. Finally, we include a few recent news articles and reports that further highlight polio eradication efforts in these 2 countries.

We welcome information about your polio-related activities, materials, thinking pieces, and evaluations. Send details to Deborah Heimann at dheimann@comminit.com To join The Communication Initiative's online polio discussion forum please contact Kiyuri Naicker at knaicker@comminit.com

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Please visit The CI's Polio Theme Site - providing a specific focus on the information related to polio on The CI website.

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Presentations from the Polio Communication Technical Advisory Group (TAG) Review in Islamabad, Pakistan

This meeting was hosted by the United Nations Children's Fund (UNICEF) and attended by major implementing and supporting organisations involved in the Polio Eradication Initiative (PEI). The series of 6 presentations, summarised below, included comprehensive updates on the epidemiological situation and national polio communication activities in Pakistan. Provincially specific presentations followed, led by communication practitioners in the 3 endemic provinces - the Northwest Frontier Province (NWFP), Sindh, and Balochistan - which have experienced ongoing cases of wild poliovirus (WPV) from 2006 to 2007. The meeting concluded with a report of programme recommendations given by the Technical Advisory Group panel.

1.Epidemiological Update - Polio Eradication Pakistan
This presentation provided a general review of epidemiological and virological data related to poliovirus in Pakistan to date. Achievements in eradication from 1994-2007 were discussed, and cases reported within the last year were documented in detail. Special attention was given to the need for coordinating and synchronising immunisation activities along the Afghan border, accompanied by an explanation of virus transmission trends across this zone. Several strategies to strengthen the programme over the next year were suggested in closing, including improving routine immunisation and leveraging the PEI infrastructure more fully, as well as sustaining communication activities in this area.
Click here for a summary.
Click here for the full presentation in PDF format.
Contact Dennis King dking@unicef.org or Rustam Haydarov rhaydarov@unicef.org, UNICEF Pakistan

2.National Polio Communication Update [Pakistan]
Pakistan's Polio Eradication Initiative has outlined a polio communication strategy at the federal level for 2007. This presentation provided an update on the overarching communication platforms and objectives that comprise this strategy, and related communication activities that have been implemented at the federal, provincial, and district levels in the hopes of increasing WPV immunisation coverage. Notably, the effectiveness of these polio communication interventions over time was documented. A strong focus was given to media engagement and social mobilisation activities.
Click here for a summary.
Contact Dennis King dking@unicef.org or Rustam Haydarov rhaydarov@unicef.org, UNICEF Pakistan

3.Northwest Frontier Province (NWFP) - Immunisation [Pakistan]
This presentation was given by the provincial teams working in Pakistan's Northwest Frontier Province (NWFP) and Federally Administered Tribal Areas (FATA). It consisted of 2 extensive discussions, the first of which looked at strategies for addressing rumours and building community acceptance for immunisation in these areas. The second addressed the challenge of reaching the high-risk mobile population and the very young. Social mobilisation and advocacy activities were emphasised as important facets in moving polio communication programming ahead in both of these areas.
Click here for a summary.
Contact Dennis King dking@unicef.org or Rustam Haydarov rhaydarov@unicef.org, UNICEF Pakistan

4.International Communication Review of Polio Activities in Pakistan [Sindh]
This presentation was given by the PEI team working in Sindh, who discussed the challenges specific to polio vaccination in this province of 39.3 million people. An overview of surveillance strategies and statistics, routine immunisation (RI), polio-specific communication, and social mobilisation strategies in the region were detailed by them. The 6 reported WPV cases reported in 2007 were documented in detail. The team described an immunisation strategy that focuses on communication and social mobilisation activities in the high-risk areas, especially when dealing with nomadic populations and garnering political advocacy.
Click here for a summary.
Contact Dennis King dking@unicef.org or Rustam Haydarov rhaydarov@unicef.org, UNICEF Pakistan

5.Strategies for Addressing Rumours and Building Community Acceptance for Immunisation (Balochistan)
This presentation was given by a team of polio communication practitioners from Balochistan, a province that has seen 2 WPV cases to date in 2007. Social mobilisation activities at the community level were given particular attention by the team, most notably in response to addressing rumours regarding immunisation and polio vaccine refusal. Increasing the focus on interpersonal communication skills (IPC) for practitioners and social mapping at the district levels were seen as important ways forward for Balochistan's PEI programme into 2008.
Click here for a summary.
Contact Dennis King dking@unicef.org or Rustam Haydarov rhaydarov@unicef.org, UNICEF Pakistan

6.Pakistan Recommendations Report
This series of slides was presented by the expert panel at the conclusion of Pakistan's polio communication review meeting, and provided a set of recommendations to strengthen communication activities over the upcoming 12 months. Specifically, the panel addressed the areas of: maintaining achievements; focus strategies in high-risk areas; strategic approach to communications; training; human resources; and follow-up to communication activities.
Click here for a summary.
Click here for the full presentation in PowerPoint format.
Click here for a detailed report in MS Word format.
Contact Kiyuri Naicker, The Communication Initiative, knaicker@comminit.com

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Please VOTE in the current Polio Poll:

Is polio a more difficult challenge than small pox?

• Absolutely - more aware/engaged population.
• Maybe - more cultural and religious dimensions.
• Basically the same - just another disease.
• No way - easier in a more advanced world.
• None of the above.

VOTE by clicking here.

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Presentations from the Polio Communication Technical Advisory Group (TAG) Review in Kabul, Afghanistan

This meeting was convened shortly after the Polio Communication TAG Review in Pakistan, and addressed similar issues facing the Polio Eradication Initiative (PEI) in Afghanistan. The series of six presentations included comprehensive updates on the country's case situation, surveillance and programme issues, as well as communication activities and challenges. Regional presentations followed, led by communication practitioners in Afghanistan's Southern and Eastern Regions, both of which have experienced ongoing cases of wild poliovirus (WPV) from 2006 to 2007. A set of recommendations in response to these detailed programme overviews was then presented by the Polio Communication TAG expert panel.

7.Polio Situation in Afghanistan (Epidemiological Data, Surveillance and Programme Issues)
This presentation was delivered by the national PEI team in Afghanistan, and provided an overview of trends in WPV transmission, supplementary immunisation activities, cross-border activities, political advocacy, and obstacles to polio eradication within the country. In particular, the team discussed a range of innovative polio communication activities recently implemented, including: synchronised vaccination of border communities; specialised vaccinator training; and periods of security in conflict areas to facilitate immunisation activities.
Click here for a summary.
Click here for the full presentation in PowerPoint format.
Contact Savita Naqvi, UNICEF Afghanistan, snaqvi@unicef.org

8.Polio Communication Challenges [Afghanistan]
This presentation was also prepared by Afghanistan's National PEI team, and focused specifically on the communication challenges surrounding polio immunisation in the country. In particular, the team detailed the communication environment and social mobilisation framework, and the steps that could be taken to resolve various communication issues (e.g., misconceptions and refusals). To conclude, the team synthesised a list of 7 crucial barriers to eradication currently present within Afghanistan's PEI programme, including a lack of strong communication indicators and advocacy at the local level.
Click here for a summary.
Click here for the full presentation in PowerPoint format.
Contact Savita Naqvi, UNICEF Afghanistan, snaqvi@unicef.org

9.Afghanistan Polio Communication Overview
This presentation described how the structure of Afghanistan's polio communication programme has been refined to fulfill the polio eradication Milestone requirements outlined by the World Health Organization (WHO) in Geneva in February 2007. The main strategic components and their impact were discussed, and focused on areas such as: vaccinator and supervisor training; campaign branding; advocacy and partnerships; and use of media.
Click here for a summary.
Click here for the full presentation in PowerPoint format.
Contact Savita Naqvi, UNICEF Afghanistan, snaqvi@unicef.org

10.Programme Communication On Polio Eradication, Eastern Region [Afghanistan]
Afghanistan's Eastern Region consists of 43 densely populated districts and a shared border with Pakistan, factors which have presented a range of difficulties to polio immunisation campaigns. This regional presentation discussed how social mobilisation and communication strategies are being used to address issues of nomadic population movement and security in areas of conflict, among others. Challenges facing the PEI particular to the Eastern Region include a lack of social mobilisation materials, insufficient numbers of female community health workers, and difficulty in communicating with household women.
Click here for a summary.
Contact Savita Naqvi, UNICEF Afghanistan, snaqvi@unicef.org

11.Afghanistan Polio Communication, Southern Region
Afghanistan's Southern Region had 7 documented cases of WPV by late September 2007. This presentation outlines vaccine coverage rates by area, current human resource capacity for the polio vaccination and social mobilisation networks in the region, and recent successful strategies that have resulted in improved quality of vaccination campaigns. The major remaining challenges to eradicating polio in the South include compromised access due to security issues, insufficient planning and monitoring of communication interventions, and high population movement.
Click here for a summary.
Contact Savita Naqvi, UNICEF Afghanistan, snaqvi@unicef.org

12.Afghanistan Polio Communication Review Recommendations (Communication Strategies for Polio Eradication)
After deliberating upon the national and regional presentations discussed above, the Afghanistan Polio Communication TAG panel presented this set of recommendations, designed to strengthen the polio communication programme in the key areas of: strategic approach to communication activities; communication strategy; national-level capacity; provincial-level capacity; district-level capacity; monitoring process; security; cross-border issues and mobile populations; and follow-up to communication activities.
Click here for a summary.
Click here for the full presentation in PowerPoint format.
Click here for a detailed report in MS Word format.
Contact Kiyuri Naicker, The Communication Initiative, knaicker@comminit.com

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See the NEW Polio Theme Site - where communication and media are central to the eradication of Polio - Click here!

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Presentations from the Polio Communication Technical Advisory Group (TAG) Review in Kabul, Afghanistan - Cross-Border Review

In the interest of addressing a major area of concern for the PEI in both countries, a joint review of immunisation activities and issues along the Pakistan/Afghanistan border was held following the Afghanistan-specific presentations. Teams working on either side of the shared border presented during this half-day review.

13. Cross-Border Coordination between Afghanistan and Pakistan
This presentation was delivered by a representative of the Pakistan PEI team, and gave a detailed account of virus-sharing between the two countries, challenges presented by the border, and how collaboration between implementing parties in the 2 countries hopes to address these issues. A synchronised schedule of supplementary immunisation activities (SIAs) on either side of the border was seen as key in effectively covering populations that travel frequently between the 2 countries.
Click here for a summary.
Click here for the full presentation in PowerPoint format.
Contact Dennis King dking@unicef.org or Rustam Haydarov rhaydarov@unicef.org, UNICEF Pakistan

14. Cross Border Presentation - Eastern Region [Afghanistan/Pakistan]
This presentation addressed polio communication issues along the Eastern portion of the border. The Afghani team illustrated the major transit points along the Pakistan border and discussed monthly trends in population movement. A schedule for cross-border meetings with the Pakistan team was shared, as well as outcomes of the most recent of these meetings. It was suggested that finalising the standardised monitoring and coverage checklists and sharing of information related to refusals and low coverage areas would be helpful to the cross-border teams in the future.
Click here for a summary
Click here for the full presentation in PowerPoint format.
Contact Savita Naqvi, UNICEF Afghanistan, snaqvi@unicef.org

15. Cross Border Communication - Southern Region - Afghanistan
The Southern border region is composed of 111 target villages for immunisation on the Afghan side and another 126 falling on the Pakistan side. This presentation detailed activities in high-risk areas such as Killah Abdulla and Spin Boldak, which are identified points of entry into each country. Cross-border communication activities conducted in this region include the sharing of communication plans 10 days before each round, contacting religious leaders on either side of the border, and weekly updating with the Balochistan team from Pakistan.
Click here for a summary.
Click here for the full presentation in PowerPoint format.
Contact Savita Naqvi, UNICEF Afghanistan, snaqvi@unicef.org

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For presentations from other TAG meetings, please see:

The Drum Beat Issue #407 "Nigeria: Communication for Polio Eradication"
Presentations from the Technical Advisory Group (TAG) Meeting, June 28-29 2007 in Abuja, Nigeria.

The Drum Beat Issue #398 "India: Communication for Polio Eradication"
Presentations from the Technical Advisory Group (TAG) Meeting, March 27-28 2007 in New Delhi, India.

The Drum Beat Issue #383 "Communication for Polio Eradication"
Presentations from the Annual Meeting of the TAG on Communication for Polio Eradication, held in Harare, Zimbabwe, November 8-10 2006; and presentations from the India Expert Advisory Group (IEAG) meeting, held in New Delhi, India, December 11-12 2006.

The Drum Beat Issue #320 "Communication for Polio Eradication"
Presentations from the Annual Meeting of the TAG on Communication for Polio Eradication (convened jointly by UNICEF and WHO), held in Yaounde, Cameroon, June 22-24 2005.

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The following media stories and reports further highlight recent developments in polio communication and the PEI campaign in Pakistan and Afghanistan.

16. Drive Against Polio Hit by Rumours, Litigation
by Ashfaq Yusufzai
August 17 2007
Public concerns regarding the reliability and safety of oral polio vaccine (OPV) in Pakistan have been heightened recently, according to this article. Rumours that the vaccine causes impotency and is contaminated by estrogen reached Peshawar's High Court system, following a petition filed by a resident of the city who sought closure of the programme. Representatives from the Polio Eradication Initiative (PEI) were concerned that these rumours would increase resistance in religious groups and other populations, and potentially spark a vaccine boycott similar to the one witnessed in Nigeria in mid-2003.

17. Moot Discusses Polio Eradication
October 23 2007
A high-level meeting was convened in the city of Peshawar to discuss polio eradication strategies for Pakistan's PEI programme. The National Polio Officer for the World Health Organization, Senior Surveillance Officer, Assistant Director for the Expanded Programme on Immunisation (EPI) and UNICEF Polio Focal Person, among others, gathered to discuss social mobilisation and communication strategies. Of particular interest, the group noted the powerful and effective role of the electronic media in message dissemination, and stressed the need for special talk shows on polio, involving experts, religious scholars, and those afflicted by the disease. In order to sensitise reporters more effectively, it was decided that the PEI would deploy these individuals to witness field activities during polio immunisation campaigns.

18. Sindh Committed to Eradicating Polio by Year's End
September 17 2007
This article discusses the renewed commitment of the government of Sindh to eradicating polio, and details the initiative's efforts at increasing involvement of public and private health practitioners across the province. Through a range of social mobilisation and awareness activities the province hopes to be polio-free by the end of 2007.

19. Report: Technical Consultation on Polio Eradication in Afghanistan and Pakistan (Muscat, Oman)
October 1-2 2007
A regional technical consultation on polio eradication progress in Afghanistan and Pakistan was held in Oman from October 1-2 2007. This review focused largely on epidemiology, surveillance, and service delivery, and also included a communication component. It was noted that WPV transmission is currently focal in Pakistan's Northwest Frontier Province (NWFP) and Federally Administered Tribal Areas (FATA), and the corridor for mobile populations between Southern Afghanistan to Balochistan and Northern Sindh in Pakistan. The consultation stated that the immediate communication priorities in these areas should address young children, mobile populations, and issues related to refusals.

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This issue of The Drum Beat was written by Kiyuri Naicker, Polio Coordinator, The Communication Initiative.

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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.

Please send material for The Drum Beat to the Editor - Deborah Heimann dheimann@comminit.com

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