In Nigeria, one of the last battlegrounds in the fight against polio, unfounded rumours in the predominantly Muslim northern region about the safety of the oral polio vaccine stopped the immunization campaign, threatening to undermine the entire global eradication effort. UNICEF and other agencies worked closely with religious leaders to address their own communities to counter the rumours and get the campaign back on track. Support included high-level advocacy, with UNICEF Egypt requesting the Grand Shiekh of Al Azhar to issue a statement on the importance of vaccination that could be used to engage and mobilize religious leaders in Nigeria to support the vaccination programme.
At the local level, community dialogues were the core strategic approach to promote ownership and participation in immunization services. These involved identifying the more vulnerable communities, briefing the Mai Angwa (traditional leader) who chaired and facilitated the dialogue, then ensuring that women, religious leaders and local organizations were represented. Local service providers supported factual responses to questions and created space for community advocates to respond to concerns raised as they could make the link to local norms and proverbs that complemented proposed behaviours. Polio survivors were often given the opportunity to talk about the challenges they faced. The dialogues ended with the group agreeing on key action steps to be implemented, which were supported by the UNICEF health team.
An assessment of the programme revealed a 16 per cent increase in the number of children immunized in 89 communities with monitored dialogues and a 60 per cent reduction in the number of non-compliant households in 54 communities with monitored dialogues in the most high-risk states. Within a year of its introduction, Community Dialogues became the primary approach to increase social learning, participation and ownership as well as to initiate steps towards more equity in information sharing and participation in communities.
One of the key lessons learned identified in the assessment was that purposefully engaging local networks, especially traditional and religious leaders as advocates, expands the dissemination of knowledge and skills to families and communities and overrides any behaviours of adults seen to be harmful to ‘our’ children and community.
Source: United Nations Children’s Fund, ‘Nigeria’, 2009