Transcript Afghanistan Polio communication Review recommendations

Communication Strategies
for Polio Eradication
Background and Progress to 2007
 Enormous gains have been made against difficult and constantly evolving
conditions since polio eradication activities began in 1994.
 In 1999 there were 45 cases; this has been reduced to 10 cases as of
September 2007.
 Circulation has been restricted since 2004 primarily to the South and East with
only three sub-clusters (1 P3 and 2 P1).
 Good overall AFP surveillance established, with some concerns regarding
accessibility.
 Overall good coverage in accessible areas. Gaps remain due to security.
 A national PEI system through which government works with donors and
partners such as UNICEF, WHO and a range of NGO’s has delivered good
results in difficult circumstances over the past decade.
 Urgent need to review communication strategies in this last push towards
eradication
Communication and Social
Mobilisation Activities
 Strong political commitment exhibited
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Presidential Task Force, Polio Eradication National Steering
Committee, Polio Action Group
Activation of IEC department for polio eradication
SIA inauguration ceremonies at national and provincial levels
 Involvement of religious and community leaders
 Branding and national awareness campaign
 Enhancement of social mobilization activities in high
risk areas
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Development and use of social mobilization materials
 Stronger focus on cross-border immunization
activities
Communication Challenges
 Gaps in communication strategy at national and
provincial levels
 Insufficient human resource capacity to implement
polio SM/C strategies
 Limited programme data related to communication
and limited use of existing data
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Lack of communication baseline data
 Poor levels of monitoring and supervision especially
(but not exclusively) in high risk areas
 Gaps in inter-sectoral collaboration at sub-national
level
Communication Challenges
 Continued and increasing security restrictions
impeding access to many areas in the South and
East
 Cross border population movement (internal and
external)
 Difficulties accessing households and reaching
child caregivers directly
Recommendations
Strategic Approach to
Communication Activities
Previous
Communication
Interventions:
Training of CHW,
Meeting with Mullahs,
Community Leaders,
Courtyard women
Analyze to
identify reasons
& patterns of
missed children:
•Inaccessibility (to
area/household)
•Performance of teams
(fighting, IPC)
Surveillance
data
EPI
SIA data
(control room, PCA)
over time
•Refusals
(perceptions, misinformation, demand)
Locally
appropriate
strategy
identified
Implement and
measure
communication
strategy (s)
(DC, CHW/CHS,
Elders, Mullah,
Teachers,
women’s
groups)
Implement
program
activity
•Impact of previous
interventions
Collect Data
Communication Strategy
 Develop a comprehensive communication strategy for
national and provincial levels using data to identify high
impact activities
(Oct 2007)
 Ensure development of indicators and updated social
mobilization microplans at district and sub-district levels to
address local challenges
(Nov 2007)
 Focus on high risk districts: Eastern and Southern region, areas with
recent WPV, high insecurity/inaccessible/refusal, low-coverage
 National media programme: ongoing (TV, radio, billboards,
posters)
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Baseline data is urgently required: immediate need for KAPB
(Nov 2007)
Utilize Pashtu news services for polio message delivery: BBC, Azadi
(immediate)
Polio Communication:
National Level Capacity
Polio Action Group:
 Improve inter-sectoral involvement and coordination at the national level
(Ministry of Women’s Affairs, Education, Religious Affairs, Rural Rehab and Dev,
Def)
 Translate this commitment into action at the provincial and district level
Implementing NGOs:
 Specify polio activities (SIA/Surv) as part of one of the 7 components of BPHS and
ensure allocation of adequate resources
 Hold a national meeting with NGO representatives (contracting and noncontracting ) to ensure their buy-in. Disseminate decision to provincial/district
level
(Nov 2007)
 Update NGO contract upon renewal to include provision of polio activities
(2008)
 Formally incorporate polio component into CHW training
(Nov 2007)
 Incorporate NGO representation within national and provincial level polio
committees
(Oct 2007)
Polio Communication:
National Level Capacity
Strengthen IEC department within MoPH
 Assign a polio communication focal point (IEC)(Oct 2007)
 Regular refresher training of MoPH/NGO communication staff
(Nov 2007)
 Immediately recruit a qualified full-time polio
communication officer to provide support in
implementation at the national level (International post
through partner agencies)
(Nov 2007)
Polio Communication:
Provincial Level Capacity
 Ensure all high risk provinces have an assigned polio communication
focal point
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(Nov 2007)
Work in concert with provincial health team and report back to the
national IEC polio focal point
Responsible for leadership, coordination and monitoring of SM/C activities
Receive immediate and regular communication training by IEC polio focal
point supported by partner agencies
(Dec 2007)
 Establish provincial inter-sectoral polio communication committees
for high risk provinces:
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(Dec 2007)
Membership: Include other line departments, NGOs
ToR: Review and oversee provincial communication strategy and plan
and monitor implementation at district level
Polio Communication:
District Level Capacity
 Ensure all high risk districts have a district
communication coordinator working in concert with
polio district team
(Dec 2007)
 Trained by and report to the provincial
communication focal point
 ToR:
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Develop SM/C micro-plans appropriate to the local
challenges
Coordinate and monitor communication activities
Polio Communication:
District Level Capacity
Currently identified network categories: Elders, Mullahs, Teachers, CHW
 Enhance community involvement:
 Community Development Council/ Shura
 Local inauguration ceremony for key polio related events (community
leaders/mullahs)
 Enhance involvement of women
(immediate)
 Women’s courtyard: develop materials, strategy and indicators
 Female CHW : reaching homes and dissemination messages through service
delivery
(next SIA)
Training: SM/C training materials recently developed and distributed
 Review and update training materials with focus on local adaptation
(Nov 2007)
What does this look like?
Polio Communication
Officer
Polio Focal Point
Nat’l Inter sectoral
IEC Department
Committee
Provincial Polio
Communication Focal Point
Provinicial Inter
Prov Health Team
sectoral Committee
Training:
Revise IPC
module
District Communication
Coordinator
NGO/Community
NGO, CDC,
Shura,Schools,
mosques etc
NGO/CHWs:Health Facility
CORE TEAM
6 Community Activists per
CHS
Elders
Mullah Imams
Teachers
CHWs
Data
Family
Women
Courtyard
Monitoring Process
 Ensure the use of updated social mobilization
campaign monitoring tools in all provinces
(Next SIA)
 Ensure communication monitoring data is collected
and analyzed regularly and used to modify activities
(Next SIA)
Security
Tremendous efforts being made at district
levels (e.g. focused district strategy (FDS),
access negotiators)
 Recent successes especially in accessing 2 high
risk districts and obtaining support for polio
from local communities
 Active fighting still ongoing and some clusters
within districts are either inaccessible or
difficult to verify quality and performance.
Security
 Need to map inaccessible populations/areas at sub-district
levels
(Immediate)
 Intensify Coordination at higher level between GoA, ISAF,
and other parties involved
(Next SIA, ongoing)
 Assess and expand successful strategies: e.g. access
negotiators
(Immediate)
 Pilot using community monitoring to assess the quality of
campaigns in hard to reach areas: require adequate training
(Dec 2007)
 Using alternative social networks at community levels to
gain access
(On-going)
Cross Border Issues and Mobile Populations
Efforts are being made in tracking and vaccinating mobile and
border-crossing populations
Good collaboration between Pakistan and Afghanistan and
synchronizing SIAs:
 Continue regular meetings between provincial level teams
 Ensure better coordination at local level to implement agreed-
upon decisions regarding vaccination strategies for bordercrossing populations
 Coordinate sharing of common communication materials,
messages, and initiatives in border areas
(Nov 2007)
 Ensure appropriate location, visibility and shelter for vaccination
posts (especially permanent ones)
(Next SIA)
Follow-up to communication
activities
 Hold regular (every 2 months) national-level meetings
attended by provincial communication focal points to
review progress.
(Nov 2007)
 Expand mandate of TAG to include substantial component
of communication:
 Include communication expert on the TAG
 include updates by the national polio focal point regarding progress
in the high risk provinces
(Sept 2007)
 A time-bound action plan should be developed by the MoPH
and partners to ensure implementation of these
recommendations
(Oct 2007)
Summary
 Incredible strides have been made against great odds and it is
critical to sustain the achievements of the program as we move
into this final phase of eradicating polio.
 Communication has to play a central role in what comes next.
 The recommendations focus on quickly building polio
communication capacity through:
 Strengthening current communication structures and capacity
 Reinforcing the current focus on high risk districts and locally
tailored strategies
 Utilizing program data to focus on the highest impact activities
 Monitoring and follow-up for all SM/C activities
 And enhancing cooperation with Pakistan to ensure that the
areas of circulation are covered.
Thank You