Communication Lessons Learned in Polio Eradication

This presentation assesses communication programmes for polio eradication through a look at global trends and case studies. First, Silvio Waisbord explores the contributions that communication strategies have made to advocacy, social mobilisation, and information, education, and communication (IEC) programmes. To this end, he discusses specific communication goals that support polio eradication, with a focus on relevant capacity building with regard to personnel, technical, and organisational aspects.

First, Waisbord examines the impact of such programmes on specific communication goals. He organises his thoughts around the following questions:

1. What has been done extensively? What works?
• Large-scale media (television, radio, advertising) has been effective in raising awareness about polio vaccines
• Different media is appropriate in rural and in urban areas
• Local and minority media is particularly relevant
• Print media (posters, newspapers) seems to have had a limited impact
• Interpersonal communication is important - whether between health workers and caretakers, or with traditional and religious institutions and leaders.
• Address rumours before they turn into organised political resistance
2. What could have been done better?
• Explaining and conveying information about oral polio virus (OPV) and other immunisation and health programmes
• Using local forms of communication and culture (e.g., popular theatre or community radio) strategically
• Designing focussed strategies for specific populations
• Maintaining continuity of communication activities
• Identifying hard-to-reach populations earlier
3. What do we still not know? What should we know?
• Causal relation between communication and behavioral outcomes
• Impact of IEC on behaviour: While the links between communication intervention and information have been identified, the links between communication and behaviour remain weak. Evaluation data and control studies are needed.
• Impact of advocacy on behaviour: Knowledge of this impact is currently strong at global and regional levels, but uneven at national levels and weak at local levels. Indicators could be developed to measure achievements of advocacy actions. For example, in measuring government commitment (short- and long-term), indicators might include: participation in ceremonies, raising funds, allocating funds for immunisation, assigning human resources, and persuading other policy-makers.
• Impact of social mobilisation on behaviour: Waisbord indicates that this information is currently inconsistent and last-minute; interventions are often informed by past practices rather than shaped by strategic goals. What is needed, is says, is evaluation of community-based forms of communication (popular theater, songs, puppets).
• Are lessons from campaign-centered interventions applicable to communication for routine immunisation? - Waisbord indicates that most communication for polio eradication has been mobilised around national immunisation days (NIDs) - expecting specific behaviours a few times a year is different from "changing the norm", he stresses.

Second, Waisbord explores the impact of polio vaccination programmes on communication capacity.

• Technical: there has been better planning, but highly uneven quality; there have been advances in message design, but weak strategic thinking; more tools are available
• Personnel: there are more communication staff, but still limited numbers
• Organisational: there is more awareness about the relevance of communication among partners; networks are being formed.

Waisbord indicates that there have been several missed opportunities in terms of capacity building in communication. Among other approaches, he urges that capacity be institutionalised, communication plans be improved, messages be tailored to specific populations and concerns, and a broad perspective and technical expertise in communication be maintained. In addition, he urges that communication strategies be fine-tuned for hard-to-reach communities. He cites specific challenges in this regard: irregular access to health services (due to difficult access and lack of information), insufficient or no access to mass media, living on the move (migrants, refugees, nomads), and marginalised religious and ethnic minorities. In conclusion, he argues that communication programmes that take these factors into account are more likely to contribute to both polio eradication and higher levels of immunisation.

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