© UNICEF HQ01-0628\Shehzad Noorani
Two male health workers give a dose of oral polio vaccine to a baby held by his older brother near the border town of Torkham in Khyber Agency.

Communications and social mobilization activities in Pakistan are focused on ensuring the development of locally appropriate activities to address the challenges unique to high risk areas in the transmission zones of Balochistan, the North West Frontier and Sindh. District communications officers were deployed in the high risk districts in 2007 to support the development of appropriate strategies, including activities to addressrefusals, highly mobile populations and accessibility in security compromised areas.

Although refusal of OPV is not the biggest challenge in Pakistan, there continues to be an increasing trend of opposision to immunization in a few critical districts of the country. The linked table offers information on reasons for missed children in taken from campaign data in early 2008. It demonstrates that overall numbers of missed children are low, usually at about 5% of the total target population, and of that number, refusals remain the lowest reason for missing children at about 5% of the missed children (less than 1% of the entire target population declines immunization outright, however, an additional 1% of the target population was missed due to parents declining vaccine due to child’s age, sleeping or ill, which could be counted as refusal). When refusals are found in blocks, or clusters, they can result in a significant cohort of missed children that can sustain transmission, and thus need to be addressed. 

UNICEF undertook an anthropological study in Baluchistan and the North West Frontier Province to assess reasons why communities are refusing immunization. This data now informs communications planning in 2008. A knowledge, attitudes and practices (KAP) study undertaken at the end of 2007 showed that as the result of ongoing communications efforts there is a high level of awareness throughout communities, with 99% of those surveyed stating they had heard of the polio disease, 96% stating they have heard of the vaccine and 95% considering polio as a priority health issue. In 2007, based on feedback from focus group research where community members indicated that more personalized communication about the tragic effect of polio would motivate people to seek immunization, Polio True Stories were launched in 2007. The stories portray the real lives of polio victims, and reports from the field suggest that these stories have motivated teams to improve performance and conviced community members to accept polio immunization.



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2007 Pakistan polio communication review

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