|© HQ04-0728/Mudi Yahaya|
|Nigeria: Two health workers from a mobile immunization team register children during the NIDs campaign against polio, in Kwachiri.|
Communication interventions in Nigeria have proven to be a vital part of the polio eradication effort. In the past two years, communication activities have adopted new strategies and have contributed greatly to the 80% reduction in the number of WPV cases from the 2006 level. Success of the polio communication efforts can be verified by the reduction in missed children due to non-compliance by 12%, as well as increases in overall coverage through targeted social mobilization.
For example, thousands of children in the highest risk states were reached in Koranic schools, as well as through child-to-child and youth outreach participation programmes. A series of community dialogues, in partnership with the Federation of Muslim Women Association of Nigeria (FOMWAN) mobilized 313 schools, sensitizing 685 teachers and also played a role in 76 ceremonial events that reached 4,831 women. In the ensuing house to house IPD mobilization, over 72% of the non-compliance cases were resolved.
The communication efforts were developed based on the results of the 2006 desert survey, which identified numerous key factors affecting immunization rates:
The data provided insight into how to develop and deploy effective communication initiatives that reached specific communities.
Five interpersonal communication modules were developed and deployed beginning in July, 2007. By end November three hundred ward focal persons and over 1500 vaccinators from the 30 highest risk Local Governance Authorities (LGAs) in the six highest risk states had improved inter-personal communication skills to counsel non-compliant families. According to an EU assessment (November 2007) vaccinators explained issues correctly to caregivers, ward leaders were actively participating in polio activities and traditional chiefs and village elders visibly supported the programme.
Community dialogues have become an integral part of the proactive strategy to better engage communities. Dialogues are a form of community meeting, facilitated by local leaders and health workers, in order to create a two-way stream of communication that informs communities and health workers of each other's concerns. These forums provide answers to participant questions, offer facts about campaigns, and record concerns raised which can then be re-programmed into communication messages and strategies.
A community dialogue audit was conducted between June and September 2007 to assess the quality of the process, content of discussions, impact of the dialogues and perception of communities of the approach. The audit showed that community dialogues for polio eradication were facilitated by traditional and religious leaders, including ward heads at least 50% of the time, and Imams facilitated 10% of the observed activities. The provision of interpersonal skills for ward focal persons helped improve their participation in facilitating dialogues as opposed to previous times when their roles were restricted to logistics.
In November 2007 recording and monitoring forms used during polio immunization activities were revised to provide additional communication data. One of the modifications was made to provide information on the reasons for why children were absent from the home, which was the main reason for children being missed during polio campaigns. Human resistance analysis proved to be central to effective deployment of resources.
This information helped guide operational and communication interventions whose goal is to increase overall coverage in the highest risk areas. In the spring of 2008, both national and state-specific social mobilization plans were developed and implemented to increase media coverage and the community leader involvement.
Simultaneously, the documentation and evaluation processes continue to be improved with the goal of ensuring that all communications interventions are based on epidemiological and programme data and that they demonstrate patterns in refusal, source of information about campaigns and other indicators of low coverage that will help pinpoint areas and issues requiring priority attention.
Data tables and graphs used in this article:
Fight against polio in Nigeria focuses on community involvement, Febuary, 2007.
2007 Nigeria polio communication review