The Drum Beat 433 - Communication for Polio Eradication

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The global eradication of polio continues to present communication challenges and opportunities to share strategies. Diverse and ongoing communication responses and interventions described in this issue of the Drum Beat include, for example: personal experiences of volunteer immunisation team members; an analysis of parental beliefs on immunisation; and campaigns of polio survivors. This issue provides summaries of approaches to overcoming obstacles, social marketing initiatives and thinking, regional and international planning documents, and immunisation campaign strategies.

If you would like your organisation's polio communication work or research and resource documents to be featured on The CI websites and in The Drum Beat newsletters, please contact Deborah Heimann dheimann@comminit.com

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Please make sure to visit our Polio theme site - where we focus on communication and media as central elements in efforts to eradicate polio.

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OVERCOMING OBSTACLES

1.Obstacle Course to Global Health: In Worldwide Campaigns, Rumors Trump Science
by Laura Ofobike
This article illustrates what it describes as a seldom-acknowledged issue facing global health campaigns: rumours. In addition to lack of funding, political will, and scientific progress rates, public perception is seen here as playing a huge role in the success of most health initiatives. In particular, immunisation campaigns are here portrayed as vulnerable to misinformation, which may result in large segments of the population refusing to participate in the programmes. The case of the 2003 polio vaccination boycott in northern Nigeria is used to exemplify this point. Political leaders in the upper states barred polio immunisation on the grounds that Western powers were using the vaccine to sterilise children, thereby controlling the Muslim population. The impact of this vaccination ban on disease transmission was almost immediate, and within 2 years Nigeria accounted for almost half of the poliovirus cases in the world. Additionally, over a dozen previously polio-free countries became re-infected as a result of viral importation from Nigeria.

2.Parental Beliefs and Decision Making About Child and Adolescent Immunization: From Polio to Sexually Transmitted Infections
by Lynne A. Sturm, Rose M. Mays, and Gregory D. Zimet
This article presents a review of research on the role of United States (US) parental attitudes and beliefs in decision making about child and adolescent immunisation. It describes the historical context of vaccine-related decision making research. The potential influences on vaccine decision making studied are social-environmental and parent-specific personal factors. Social-environmental issues discussed include media coverage of vaccines, perceived social norms, and the persuasive influence of peer groups. Personal factors addressed include parental health beliefs, attitudes, and knowledge related to vaccine preventable diseases and immunisation, as well as elements of the decision making process. The article suggests that when parents contest the need for or safety of vaccines for children, practitioners may find it productive to open a discussion with parents on their concerns about immunisation and to inquire into cultural, religious, and personal history issues that might contribute to their uncertainty.

3.Importance of Public Health Education: Polio Immunization in West Africa
This presentation, from the 1st annual African Science Academy Development Initiative (ASADI) conference held in Nairobi in November 2005, described the comprehensive public-health education strategy that was critical to rebuilding public trust and increasing advocacy for polio immunisation in West Africa following a 12-month period during which Nigerian officials were refusing to administer the vaccine. In order to regain trust in polio vaccination programmes, the public health education strategy focused on sustaining engagement of traditional and religious leaders, attaining high political commitment, and increasing media visibility. Additional components included deploying community mobilisers in high-risk areas and leveraging community- and family-centred activities. The results of these interventions indicated a drastic decrease in the number of non-compliant cases in Nigeria from February to May of 2005.

4.Polio True Stories - Pakistan
Launched in 2007, this initiative uses the medium of documentaries - broadcast on television - to help viewers understand what it is really like to be affected by polio, to raise awareness, and to challenge rumours and misunderstandings that might cause parents to refuse or fail to pursue or complete routine immunisation before their child(ren) reached the age of one year. "Polio True Stories" is a 13-part series of 4.5-minute episodes that were produced and directed by Sharpcut Films as part of Pakistan's Polio Eradication Campaign. Each episode tells a personal story of what is it like to live with polio in Pakistan; the testimonials are aired on television stations across Pakistan ahead of polio immunisation campaigns to draw public attention to the ongoing dangers of the poliovirus and to encourage compliance with eradication efforts.
Contact: Tauseeq Haider tauseeq@yahoo.com

SOCIAL MARKETING

5.Pakistani and Indian Cricketers Immunise Children Against Polio
by Anupam Srivastava
This article describes the "Bowl Out Polio" campaign, which was launched in India to support the Polio Eradication Initiative (PEI) and encourage polio vaccination in the general public. In an effort to boost participation in the November 2007 immunisation rounds, top cricket players from India and Pakistan made appearances at vaccination booths and administered oral polio drops (OPV) to children. As cricket is the favourite sport in the country, it is hoped that strategies such as this one will help deliver positive polio immunisation messages to an audience of millions by reaching the fans attending the sporting event. The cricketers have been influential at both the national and sub-national levels, most importantly within the high-risk polio states of Uttar Pradesh and Bihar. As part of the ongoing crusade, they are speaking publicly about the importance of polio vaccination, making television announcements during cricket matches, and participating in field and other various immunisation activities.

6.WE'RE STILL HERE! Campaign - Global
Post-Polio Health International (PHI) is a United States-based non-profit organisation using education, advocacy, research, and networking in an effort to enhance the lives and independence of polio survivors and home ventilator users. In October 2007, PHI launched a campaign with the goal of inspiring polio survivors in every country, state/province and city/town, in the world to write a "Letter to the Editor" or an "Op-Ed" newspaper item, or to participate in a radio, television, or internet interview or blog. The purpose of this participatory media effort was to call for support and assistance to those people worldwide who are struggling with post-polio syndrome and to encourage those in a position to help to do everything possible to eradicate polio wherever it exists in the world.
Contact: Joan L. Headley, PHI info@post-polio.org

7.Role of Marketing in Polio Eradication
by Rahul Goswami
This article describes the Global Polio Eradication campaign as requiring sustained political advocacy and mass community mobilisation, together with strong management and supervisory processes. The article explores "an integrated approach for polio eradication, emphasising the role of marketing by various stakeholders..." Focusing on marketing as a way to create demand, it emphasises advocacy, community participation, and community ownership of immunisation and surveillance programmes as keys to success and it reviews a number of strategies in detail. The author concludes that the public health community has an obligation, as well as a major opportunity, to harness the value of marketing in the polio eradication programme by involving civil society and the private sector in the marketing effort.

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Please VOTE in our current POLIO POLL:

Which is the biggest threat to polio eradication today?:

• The increased number of Type 3 polio cases.
• Religious and political refusals.
• Insecurity and conflict.
• Too few newborns being vaccinated.
• Burnout from too many door-to-door campaigns.
• Not enough local ownership of the campaigns.
• Poor health care services and infrastructure.

VOTE and COMMENT - Top Right side of the website.

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REGIONAL and INTERNATIONAL PLANNING

8. Poliomyelitis Eradication in Eastern Mediterranean Region - Progress Report 2006
This document reports on the Eastern Mediterranean Region (EMR) countries, which in 1988, with the exception of Kuwait, reported cases of polio. The report states that by the end of 2006, polio incidence had been reduced and was limited primarily to endemic countries. The report details the current (2007) situations in these countries, discussing the emergence of the wild polio virus, cross-border infection, and geographic containment in polio endemic countries. Communication aspects detailed in the document include immunisation campaigns, cross-border cooperation and strategy planning, campaigns in insecure areas, increased preparation measures regarding importation of the virus, and surveillance measures.

9.Research Report: Impact of National Immunization Days on Polio-related Knowledge and Practice of Urban Women in Bangladesh
by Md. Abdul Quaiyum, Cristobal Tunon, Abndullah Hel Baqui, and Jahanara Khatun
This article analyses the reasons behind the success of the first 2 National Immunization Days (NIDs) held in Banagladesh in 1995 as part of that country's goal to eradicate poliomyelitis by the turn of the century. The paper assesses the impact of these 2 polio NIDs in terms of the immunisation coverage and change in knowledge about the disease among women living in Dhaka city, the capital of the country. A large motivation campaign was developed to support the vaccination drive: organisers found that knowledge of polio as a vaccine-preventable disease increased after NIDs among both slum and non-slum women. In addition, the knowledge gap between the 2 groups was significantly reduced. Field workers were the main source of information for women living in slums, while television was cited as the most important source of information by non-slum women.

IMMUNISATION CAMPAIGN STRATEGIES

10.Community Leaders, Women Help Curb Polio in West Bengal
by Rajdeep Datta Roy
This article describes the successful social mobilisation efforts of West Bengal's polio eradication programme. In order to address concerns in the predominantly Muslim communities of Murshidabad district that the polio vaccine is not halal (or 'permissible under Islam'), the programme strategy has relied on advocacy from community and religious leaders in order to gain access to these areas. During an intensification of polio vaccination efforts in 2003 onwards, despite the high threat of the virus, polio workers encountered severe resistance from citizens at vaccination booths. The programme responded by enlisting support of religious leaders such as Madrassahs, Qazis, and seminary heads, in order to augment the ongoing community meetings and outreach activities that aimed to raise polio awareness. These leaders have incorporated positive polio vaccination appeals into regular prayer schedules to reach the Muslim community. This strategy has been regarded as successful, as the 4 vaccination rounds held in 2007 witnessed a dramatic increase in voluntary attendance to 80% at immunisation booths.

11. Burma Mobilizes To Protect 7M Kids Against Polio
This article describes the social mobilisation and immunisation activities undertaken in order to vaccinate Burmese children against polio in 2007, after the first polio cases in 5 years were reported in Burma. The polio eradication initiative planned the following activities:

• Deployment of 10,000 mobile vaccinators who move from house to house.
• White banners hung to display positive immunisation messaging around the country.
• Use of megaphones by town criers and health workers to disseminate messages within towns.
• Establishment of fixed vaccination posts at health centres and other public areas in the community.
• Targeting of children who were missed at the fixed posts by the above-mentioned mobile vaccinators.

12. Polio Immunization Drive Reaches Children in Koranic Schools of Northern Nigeria
by Christine Jaulmes
This article describes the success of Nigeria's Polio Eradication Initiative (PEI)'s outreach programme in mobilising religious leaders to advocate for polio vaccination. During the April 2007 Immunisation Plus Days, Koranic schools in Zaria allowed vaccinators into the classrooms to administer oral polio drops (OPV) to all children under the age of 5 years. Just 1 year prior to this, these institutions were resistant to the idea and their unwillingness to approve of OPV had an influence throughout the community. In order to build trust for immunisation amongst religious leaders and institutions, Nigeria's PEI has held community dialogues throughout the region. Those leaders who support immunisation are going on to make announcements at mosques and public gatherings; this has led to a much greater public acceptance of the vaccine. These efforts resulted in a total of 30,000 Koranic schoolchildren being vaccinated during the April 2007 immunisation campaigns in Kaduna state alone.

13.Babille Story [India's National Polio Eradication Programme]
by Irene Babille
As a student at the American International School in New Delhi, India, Irene Babille participated in the November 2007 National Polio Eradication Programme immunisation rounds as part of a community outreach programme coordinated by the United Nations Children's Fund (UNICEF). During her 2-day field visit, she was involved in community mobilisation efforts as well as polio immunisation booth activities. Irene's notes provide a personal perspective of her observations and impressions as both a participant in campaign activities and a supporter of the National Polio Eradication Programme in India.

14.Anti-Polio Campaign Targets Four Million Children
This article describes a 3-day national anti-polio campaign in Yemen that began on December 15 2007. The date was chosen to coincide with the Hajj pilgrimage, during which over 2 million Muslims from across Africa and the Middle East travel to Mecca, Saudi Arabia's holy city. Yemen's Ministry of Health was hoping to minimise the threat of poliovirus transmission amongst pilgrims by vaccinating all children under the age of 5 within the country. In order to accomplish this feat, 18,000 mobile vaccination teams were tasked to travel door-to-door to 2.5 million homes across the country, and another 2,000 teams were set to work in fixed vaccination centres. In addition to the vaccination rounds, Yemen's polio eradication initiative distributed posters, leaflets, and banners throughout the country. At the date of publication of this article, Yemen had maintained its polio-free status for 22 months.

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Please make sure to visit our Polio theme site - where we focus on communication and media as central elements in efforts to eradicate polio.

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This issue of The Drum Beat was written by Julie Levy.

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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.

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