Polio eradication

Reaching every child in Afghanistan with polio vaccines

A young girl receives polio vaccine drops at the Torkham border crossing between Afghanistan and Pakistan.
UNICEF Afghanistan/2016/Froutan

The polio challenge

Afghanistan is one of only three countries in the world where polio remains endemic, together with Pakistan and Nigeria. But there is a growing sense of optimism that polio will be the second disease, after smallpox, to ever be eradicated. 

In many ways, the map of polio mirrors the conflict in Afghanistan. The challenge to reach and vaccinate every child is as much diplomatic as it is operational and medical.

Immunization is not a matter of parental refusal – memories of an era when polio was common are still fresh in Afghan minds – but efforts are still needed to dispel myths around the vaccine and to convince families who are afraid of immunization. 

Ongoing conflict and political instability make it difficult to access hard-to-reach areas, and migration along the porous and rugged border between Afghanistan and Pakistan further complicates vaccination efforts, making children on both sides vulnerable to contracting the debilitating disease. This means that polio transmission has become highly localized in pockets in the south and the east of Afghanistan, so eradication efforts focus on planning at the district- and sub-district levels.

For Afghanistan to halt wild polio virus transmission, all children need to be vaccinated. While there has been a near 100 per cent increase in families’ awareness about the importance of polio vaccination in accessible districts, a sizeable number of children are still not being reached.

An Afghan girl shows the purple ink mark on her finger, indicating she has been vaccinated against polio during an immunization campaign in Jalalabad, eastern Afghanistan.
UNICEF Afghanistan/2017/Hibbert
An Afghan girl shows the purple ink mark on her finger, indicating she has been vaccinated against polio during an immunization campaign in Jalalabad, eastern Afghanistan.

Partnering to eradicate polio

UNICEF is a key player in the Global Polio Eradication Initiative – a global public health initiative launched almost two decades ago. In Afghanistan, UNICEF supports the Ministry of Public Health in finding innovative ways to reach children with vaccines and to build demand for and trust in the importance of vaccination campaigns.

Immunization support
During National Immunization Days, nearly 10 million children are targeted for vaccination against polio through a house-to-house approach. This is in addition to a number of sub-national vaccination campaigns in priority districts throughout the year. UNICEF works with the World Health Organization (WHO) to support vaccinators, community mobilizers, monitors, volunteers, campaign coordinators and supervisors to reach every of these children with polio vaccines. 

Women leading the way
Though the focus of most polio campaigns is in Afghanistan’s most conservative areas, a growing number of health workers are women. For many, working for the polio programme is not only their first job, but their first significant experience in the public realm. In that sense the polio programme is not only eradicating the disease, it is an important catalyst for greater rights for women.

Communication and social mobilization
UNICEF works to dispel myths around polio vaccination and to convince families who are afraid of immunization to join the movement to end this deadly disease. The goal is to go beyond raising awareness to make sure communities demand and take ownership of their local polio eradication efforts. Intensive efforts are under way to scale up household and community engagement in priority districts to reduce the number of 'missed children' and build demand for overall immunization.

Infographic: What it takes to reach every child with polio vaccines
UNICEF Afghanistan

Afghanistan’s 2017 polio results 

•    9.9 million children targeted to receive polio vaccines during every national campaign. 

•    10 campaigns, including 4 National Immunization Days and smaller campaigns in priority districts. 

•    More than 65,000 frontline workers deployed, including vaccinators and social mobilizers.

•    111.2 million doses of vaccines procured.

A female social mobilizer in Kandahar, Afghanistan, holds an audio book used to explain the importance of polio vaccinations
UNICEF Afghanistan/2017/Hibbert
A social mobilizer goes house-to-house to explain the importance of polio vaccinations to families in hard-to-reach areas in Kandahar, southern Afghanistan.

Highlights of key interventions to ensure every child is vaccinated against polio

•    Scaling up household and community engagement in hard-to-reach districts to reduce 'missed children' and build demand for immunization. 

•    Mobilizing community leaders, religious leaders, teachers and health staff to raise awareness, knowledge and commitment to immunization.

•    Working with celebrities, including the National Cricket Board, to advocate for polio vaccinations. 

•    Expanding the 'Immunization Communication Network' to educate caregivers who’ve missed or refused vaccination for their children. 

•    Sharing information through national, regional and local media about the importance of immunization, handwashing and exclusive breastfeeding. 

•    Producing original public health service announcements, radio shows, and animated ads for television.

•    Vaccinating children at transit and border crossings to reach children on the move.

•    Strengthening the communication skills of frontline workers, including vaccinators.

•    Sending mobile text messages to promote public awareness and knowledge of polio campaigns prior to each round of vaccination campaigns.

•    Using a 'Ringback Tones' service to share polio messages with callers. 

•    Working with a popular circus troupe to spread health messages in hard-to-reach communities.

A theater show at a camp for internally displaced persons in Kabul, Afghanistan: Two snake puppets representing the polio virus are about to be destroyed by a vaccinator armed with two drops of vaccine.
MMMCC/Bzai
A theater show at a camp for internally displaced persons in Kabul, Afghanistan: Two snake puppets representing the polio virus are about to be destroyed by a vaccinator armed with two drops of vaccine.