Papua New Guinea Polio Outbreak Response, 2018

"Trust building and driving demand for vaccination were the key outcomes of the risk communication response for the polio outbreak in Papua New Guinea."

Papua New Guinea confirmed a polio outbreak on June 22 2018 after 18 polio-free years. This World Health Organization (WHO) document summarises the response to the outbreak on the part of the Government of Papua New Guinea, with support from WHO, the United Nations Children's Fund (UNICEF), and other partners. Specifically, it documents activities across 3 components of the comprehensive outbreak response plan: supplementary immunisation activities (SIAs), enhanced surveillance, and communication and social mobilisation (which is the focus of the present summary).

By the end of 2018, there had been 26 confirmed polio cases affecting children in 9 provinces. In addition, 7 of the 27 environmental samples from the National Capital District and Morobe tested positive for poliovirus. The National Emergency Operations Centre (NEOC) was activated on June 27 2018, a day after the Public Health Emergency was declared. The purpose of the NEOC was to connect people for coordinated outbreak response. Throughout the response in 2018, more than 130 international polio experts were deployed to the country to support outbreak management, surveillance, immunisation, risk communication, social mobilisation, cold chain and vaccine management, health operations and logistics, finance, administration, and other roles. Public health measures between Papua New Guinea and neighbouring Indonesia were agreed upon in a cross-border meeting in September 2018.

In addition to organising and coordinating, the NEOC managed information for decision, dissemination, and action. Key updates from the multiple reports the NEOC received daily were synthesised for presentation in morning meetings and are used in decision-making, risk assessment, agreement on action points and weekly situation reports that also become the basis for the development of external communication products such as media releases, web updates, and social media posts.

To keep the public informed, WHO supported the National Department of Health (NDOH) in putting in place a system to engage with media, with spokespersons identified at the national and provincial levels. As part of the outbreak response in 2018, there were 12 press conferences and 2 media orientations held to provide the media with in-depth information on polio and reporting the news.

Communication was a key tool in not only for informing the public but for building trust and creating demand for vaccination. The 8 international communication for development (C4D) consultants who were recruited for the response provided support to the provincial EOCs in the implementation of social mobilisation activities. These included more than 25 advocacy events and over 1,500 "sensitisation" activities across the country. Rumours and occasional reports of misinformation and stigmatisation of children with polio were reportedly immediately addressed in various platforms.

A multi-media approach was used, maximising both traditional media (newspapers, TV, radio, posters, flyers, loud hailers), social media engagement (Facebook, WhatsApp, text messaging), and interpersonal communication through health workers and churches. Some 110,500 posters, 140,000 flyers, 1,750 banners, 1,550 loud hailers, and 40,000 leaflets were deployed. Prior to and during the campaigns, WHO and UNICEF supported the development of polio "jingles" for radio that announced the dates of the campaign rounds in all national and most regional stations. In addition, UNICEF worked with Digicel Telecommunication, which donated SMS (text messaging) "blasts" that reached some 500,000 people.

During the 2018 polio campaign, UNICEF facilitated collection of social data using Global Social Data Collection tools and analysed these data to design the 2019 Polio Outbreak Response Communication Strategy for Papua New Guinea. Focus group discussions were conducted among various stakeholders to ensure evidence-based C4D programming. Collected data helped partners better understand parents' concerns about polio immunisation and to identify some of the behavioural trends in the communities.

World Polio Day was marked with series of activities (October 24 to 28 2018) to further increase awareness of the risk of polio and what can people do to mitigate the risk. One event was a children's painting exhibit at Vision City Mall showcasing schoolchildren's interpretations of how the country can be polio free again.

In all, 5 rounds of the polio vaccination campaign were organised in 2018 in response to the outbreak. A key strategy was the conduct of rapid convenience monitoring (RCM), which finds unvaccinated children missed by the vaccination teams. By the end of that year, polio vaccination coverage in the country reached 97%, with the "majority of the provinces achieving remarkable improvements in coverage compared to before the commencement of the outbreak emergency response."

Looking ahead, the Minister for Health and HIV/AIDS declared 2019 as the Year of Immunization in Papua New Guinea on February 25 2019 in a ceremony attended by representatives from NDOH, WHO, UNICEF, Rotary International, media organisations, and other partners. Parents brought their children for vaccination during the launch.