Meeting the challenge of
Communication & Social Mobilization
in an India with no cases
Structure of the presentation
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•
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•
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Social Mobilization Network and Communication
Guarding against complacency in an India without cases
Media & Advocacy
Emergency Preparedness
Questions for the IEAG
The impact of the
Social Mobilization Network
UNICEF HR SUPPORT IN POLIO HIGH RISK AREAS,
UTTAR PRADESH, 2011
UNICEF CMC – 4931
CORE – 1319
*Data as on 1st Feb 2012
Source: Form A
SMNet strength in Kosi & Bihar, 2012
Source: PDSCL
% Female
44%
24%
591
(246)
2010
(616)
2011
Rest of Bihar
Kosi
390
391
827
628
526
236
264
165
87
252
2007
500
2008
917
2009
1018
2010
1418
2011
High levels of knowledge and trust for
OPV
Strong acceptance of need to immunize
against polio
Average OPV doses through RI & SIA to infants,
41 HR blocks, CMC areas
Doses
A child at one year
of age has an
average of 10 OPV
doses in SMNet
blocks of Bihar
Age (Months)
Source: CMC Fieldbook
Guarding against complacency
in an India with no cases
Respondents believe that Polio can affect
children in their household
Trust is not as strong for Routine
Immunization in the general population
Communication materials
promoting routine immunization
RI Handbill distributed to parents by polio
teams to remind them of RI days and
schedule
RI poster:
“Lay the Foundation for a healthy
future today. Protect your child
against six life-threatening diseases
with timely Routine Immunization
vaccination and polio
immunization in every round.”
Bottlenecks in Monitored RI sessions, 41 HR Blocks
Bihar Mar-Dec 2011
Sessions =
Monitored
429
445
N=6095
485
642
714
639
637
673
671
760
Source: RI Monitoring: SM net
Need to sustain MOMENTUM.
Need to sustain IMMUNITY.
Indian parents and caregivers need to understand that they must
protect their child against a disease that is no longer a direct
threat, and against all other five vaccine-preventable diseases.
There is a significant opportunity to use the momentum and trust
generated in the SMNet to promote routine immunization, which
acts as our best buffer to ensure high levels of immunity, in
addition to other convergence activities.
Routine Immunization improves in areas with SMNet
Target (80%)
DPT coverage in Infants: Jan to Dec 2011
Bihar HR Blocks Vs. Non HR Block
41 HR Block Yearly Target <1 Ch= 256836
Monthly Target <1 Ch= 21403
Non HR Block Yearly Target <1 Ch= 1272500
Monthly Target <1 Ch= 106042
Source: Block Coverage GoB
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THE SOCIAL MOBILIZATION OPPORTUNITY
Children from 80% of refusal families in Howrah
remain unvaccinated in RI
9% of children in Howrah are fully immunized
18% of children are delivered at an institutional
facility.
Exclusive Breastfeeding rates are low
ACTION (IF SUPPLY LINES ARE HEALTHY): LARGE-SCALE
RI COMMUNICATIONS CAMPAIGN – media buys,
communication campaigns and sustained community
mobilization, awareness and advocacy — that can
transition into broader areas of child survival and
development
SMNet convergence for other child survival interventions
West Bengal
Families reached with convergent activities in
West Bengal, Oct 11 - Jan 12
123189
97058
79458
71865
67070
65363
Nov 11
57707
Dec 11
46553
47262
43532
Jan 12
36010
24472 25661
29439
9255
HandWashing
Oct 11
Toilet Use
Breast Feeding
Routine
Immunisation
IPC
Learning Needs Strategy
• Communication Training
• Five convergence areas
• Underserved Strategies Training
• Data-based planning Training on interventions
• Training of trainers
• Sub-Regional Training Coordinators
• BMC level
• Management training
• Supervisory level of staff
Focus on supporting training for Front-Line Workers
Continuous risk assessment for
communication
107 block-level profiles
reviewed monthly
Media Tonality
Monitoring reports
State Polio Convergence Taskforce Meetings
State Polio Partners Meetings
National Social Mobilization Working Group meetings
Communications Review
PLANNED STUDIES FOR 2012
1. Mega KAP 3 for HRA and HRG in UP and Bihar
2. Migration patterns and KAP on Polio among
HRGs of Punjab, Haryana, Maharashtra, West
Bengal and Delhi
3. Impact evaluation of RI activities in west UP
4. Impact in SMNet v non-SMNet areas for
initiatives under convergence
Maintaining community
support + tackling
remaining resistance
Community’s engagement in Polio Programme
Continued decline in resistant households in CMC areas
Uttar Pradesh, 2007 – 2012 (Jan)
4.00%
3.70%
3.40%
3.00%
2.50%
2.40%
2.00%
1.60%
1.00%
0.70%
0.00%
2007
2008
2009
2010
2011
2012 (Jan)
Source:Tallysheet
Local influencer visiting all X houses with the teams, UP
N=9269
100%
97%
N=10040
N=14775
94%
95%
N=8117
N=15446
N=12310
97%
96%
91%
80%
60%
9%
7%
8%
8%
3%
20%
12%
40%
0%
April
May
June
CMC Area
August
September
November
Non CMC Area
Source :SMNet & Partners
Subregionwise % XS Houses
Refusal to immunize due to
child sick is still an issue in
some areas
Uttar Pradesh, Jan 2012
12%
10%
8%
Gorakhpur
Varanasi
Agra
4.4%
5.6%
Allahabad
2.4%
Aligarh
Ghaziabad
2.3%
Kanpur(Nagar)
3.5%
1.9%
Moradabad
Lucknow
1.4%
Meerut
SIA round partially covered Gorakhpur, Alllahabad, Varanasi,
Lucknow data is updated as on Sep 11 for the same & rest of the
updated where SIA held on Jan 2012
3.4%
1.1%
State
0%
Badaun
2.5%
2%
Bareilly
4%
8.6%
7.6%
11.3%
6%
Source:Tallysheet
REASONS FOR OPV Refusal
Congenital issues
7%
Misconception including
‘OPV causes infertility’
31%
Others
5%
Non receipt of Govt.
services 57%
% of mosque where announcements happened in West Bengal
99% refusal families in West Bengal belong to
the Muslim community.
Source-FV data
INTERVENTIONS
• IEC/IPC to address misconception such as vaccine safety
• Private doctors, Rural Medical Practitioners and non-registered
medical practitioners mobilized
• Mobile health teams visit houses during rounds
PLUS
• Trend analysis to identify persistent passive resistance
• Identify pockets of resistance and develop strategic response
• redistribution of staff to highest-resistant areas
• 2 x PRI Workshop with 350 participants each
• Rotary plastic balls in highest-resistance areas
• Health camps in Howrah, South 24 Parganas, Kolkata and
Murshidabad
Media and Advocacy
New polio campaign
launch by UNICEF
Goodwill Ambassador
for Polio
Media Tonality, last quarter
15%
44%
41%
Positive
Neutral
Negative
Coverage has been
predominantly positive (418
stories) and neutral (393
stories) across the reporting
period covering 13 January.
Significant positive coverage
also resulted due to WHO
taking India off from the list
of polio-endemic countries.
Mass Media campaigns
Extensive roll out of media campaign for programme visibility &
reinforcement key messages to diverse target audience.
1533 TV spots on 21 satellite channels
and cable
2030 spots on 9 radio channels
IEC for Polio Immunisation NIDs
Posters:
973,370
Rally flags 685,000
Sun visors 537,550
Rally banners 9,000
Whistles
1,088,000
Making polio advocates of media
114 radio announcers and presenters
trained on polio and RI in 2011
15 print & electronic media workshops held
in key high-risk Areas: Indo-Nepal border,
Nasik-Malegaon, Howrah-West Bengal
(pictured), Agra and Varanasi in UP and
block-level media in Bihar.
Field visits by national & international media
around important events – 13 Jan milestone,
NIDs and SNIDs.
Key Media Challenges & Strategies
Key Challenges:
• The risk of AFP being misreported as ‘Polio’ & VDPVs being
highlighted in a zero WPV scenario.
• Having media report accurately in the event of WPV importation
Key Strategies:
 Updated standard responses on AFP/VDPV shared with
spokespersons, officials & partners to effectively respond to
media to prevent inaccurate reports.
 In addition to media workshops, media trainings for
spokespersons & key partner representatives to effectively
handle media.
 When AFP is reported as polio, information on the lab results
shared with media for further coverage, by highest authority.
 Ensuring EPRP media plans are in place in all states for timely
media engagement and response for accurate coverage.
Recent Events
Bowl Out Polio with India,
West Indies teams
Australia v India Test in Perth
Polio advocacy by F1 world champion
driver Fernando Alonso.
Advocacy events & material
WB CM Mamata
Banerjee polio
posters
Prime Minister Dr Manmohan Singh
launches GOI/Rotary Summit
Bihar CM Nitish Kumar polio banner
Advocacy events & material
Advocacy with PRI elected
representatives in high-risk
districts of Howrah and 24
South Parganas in West
Bengal and Mewat in
Haryana.
From 200,000 to Zero:
The journey to a polio-free India
Preparing for Emergency Response
Emergency Kits developed in seven languages
Each kit has 20,000 emergency posters, 3,000 FAQs,
500 Green advocacy booklet, 500 IPC flip books,
artworks of dated and undated posters, emergency TV
and radio spots and CDs with mike announcements.
Rapid Response Teams
Six orientation workshops held
for Rapid Response Teams –
trained on responding
to media, oriented on
social mobilization in
the event of a polio case.
Each state to develop Communication and Media Plan
and identify spokesperson to respond to media.
Questions for the IEAG
1. How does the IEAG perceive the development of the Road
Map for all aspects of polio eradication in India, including:
 Social Mobilization to maintain strong community
support, tackle complacency, and promote RI/other
convergence interventions
 Continuous interaction with the media and advocacy at
all levels
 Readiness to rapidly respond to any case
2. How does the IEAG perceive
 Planning for the mainstreaming of the polio
infrastructure in India for other child survival
initiatives?
 The future of the SMNet in India and replication of
certain elements of the SMNet in other high-risk areas?
Questions for the IEAG
3. The IMB has requested that India document and
share its lessons learned/best practices. How does the
IEAG suggest the polio programme move forward on
this recommendation?
4. In light of continued resistance in pockets of West
Bengal, does the IEAG support sustained focus on
tackling resistance in that state, despite the absence
of cases? What about resistance in other areas?
Towards a polio-free India