25th Meeting of the Expert Review Committee (ERC) on Polio Eradication & Routine Immunization in Nigeria

This document shares the results of the Expert Review Committee (ERC) on Polio Eradication and Routine Immunization in Nigeria, which took place in Abuja, Nigeria, from March 19-20 2013. It includes background, discussion of strategy (including communication strategies), and 31 recommendations that were developed at this gathering.

In brief, the ERC asserts that Nigeria (one of the few remaining polio-endemic countries) has made "tremendous progress" in reaching more children, even those in very high-risk (HR) areas, with polio immunisation. Collaboration among the government and Global Polio Eradication Initiative (GPEI) partners is one factor discussed here as contributing to that progress. In particular, the ERC points to the oversight, on the part of the Presidential Task Force, of the implementation of the National Emergency Action Plans (NEAP) for 2012 and 2013, as well as the task force's efforts to monitor the Abuja Commitments through new tools for monitoring the implementation of NEAP activities. Also cited here are the information gathering and analysis functions performed by the new Emergency Operations Centre (EOC). The use of geographic information system (GIS) technology has contributed to the new household-based microplanning process, helping to reach more children. As part of the household-based communications strategy in HR wards, expansion of the network of Volunteer Community Mobilizers (VCM) is continuing, and "there is already some evidence of the impact of this strategy in reducing missed children" in HR communities. Reportedly, much work has been done to identify and track underserved communities to ensure that they are included in planning and that they are reached with vaccine. A new training package for vaccinators, which focuses on enhancing team performance, has been developed. This package includes a module on interpersonal communication (IPC) skills; the ERC recommends that this module be strongly emphasised in the roll-out of the training process.

However, as noted here, serious challenges remain that could derail polio eradication in Nigeria, which had reported over half of all cases worldwide in the 6 months prior to this ERC meeting. Several reasons for this are described in the report; one communication-related reason concerns the re-appearance of well-organised anti-immunisation propaganda, which "requires a coherent and effective response". The ERC suggests: positively concluding ongoing engagement with anti-immunisation groups, intensifying activities to refute false allegations, and creating demand for immunisation services by undertaking a systematic programme to engage religious leaders in HR states, local government associations (LGAs), and wards as part of the process of building community ownership.

The report offers a number of recommendations going forward. It is noted that a review of the VCM network had, as of this writing, just been completed; the results will influence future communications planning. For example, the programme should continue the planned roll-out of the VCM network to HR communities, per the review, yet also set up operations at the LGA and ward levels in order to be able to engage communities on a broader scale and, in particular, to build local ownership and acceptance for immunisation. The importance of informing programme actions through tracking and monitoring is highlighted; for instance, the ERC suggests polling and systematic investigations of chronically missed children as well as exploring the impact of the work that has been undertaken to ensure the systematic involvement of religious leaders in addressing the propaganda. Also proposed: proactive media programming to highlight the gains of the eradication programme, working together with community leaders, and engaging in low-key dialogue with those behind the propaganda to provide data that counters their incorrect information.

One strategy for achieving broader immunisation goals is to prepare an annual activity plan, beginning in 2013, that covers all immunisation activities and draws on the synergies between them, including by aligning activities such as training and communications.

Click here for the 13-page report in PDF format.