|© UNICEF/HQ07-1074/ Noorani|
|A health worker vaccinates a boy through the open window of a car at a roadblock in the southern city of Kandahar.|
A strategic shift made towards data driven communication was further consolidated in 2007 and 2008. The primary communication objective for PEI in Afghanistan was for targeted communication and social mobilization efforts to reach caregivers of repeatedly missed children in 70 high-risk clusters in 17 high-risk districts of southern and eastern Afghanistan.
High-risk clusters were identified through a series of epidemiological, social and operational indicators, including 1) evidence of polio transmission in the past year, 2) high population density, 3) mobile or transit populations and 4) coverage during polio campaigns reported at under 95%. Though refusals to polio immunization are not widespread, data collected from a recent UNICEF-supported knowledge, attitudes and practices (KAP) study using a sample size of 440 respondents from four provinces including Kandahar and Nangarhar, shows that knowledge about polio and the eradication effort is limited and pockets of refusals exist, particularly in areas of the south.
Since more than half of the respondents (55.5%) got their knowledge from local, interpersonal sources, community mobilization efforts were intensified in 2007, with the recruitment of Mullahs (religious leaders), teachers, village elders and community health workers (CHW) to act as conduits of credible information to families and to negotiate a safe context in which vaccinator teams can operate to deliver OPV.
In addition, a ‘women’s courtyard’ strategy was initiated in the Eastern Region to reach female caregivers at home and immunize newborns and very young children. Recent workshops under the lead of the MoPH have helped to identify indicators to measure process, outcome and impact of the community mobilisers. A vigorous media outreach strategy was also recently implemented with a focus on local radio stations and TV channels in the transmission zones in the south and the east.