Engaging Communities for Polio Eradication in Nigeria - Review of the National Communication Strategy

This PowerPoint presentation was part of a June 2007 United Nations Children's Fund (UNICEF)-hosted meeting dedicated to examining polio communication efforts, in the context of the final global push towards polio eradication. State-specific presentations for Nigeria’s polio-endemic states were given by
in-country communication and health practitioners. These were assessed by an external Technical Advisory Group (TAG) panel of experts who provided communication strategy recommendations based on evidence presented and data gathered on field-visits to endemic states. Communication strategies presented at this meeting were primarily focused on:

1. Analysing the results of programmes implemented to June 2007.
2. Detailing activities on national and sub-national levels, specific to social mobilisation, community engagement, data monitoring and media and political advocacy strategies.
3. Suggesting a planned communication programme for the next 6- to 12-month period, designed to support Nigeria’s polio eradication efforts in the event of a resurgence of cases or population/programme fatigue.

This presentation gives an overview of the communication environment in Nigeria and the key components and results of the current polio communication strategy. It outlines the supplementary immunisation activity SIA) calendar and provides an update on TAG recommendations from previous meetings held in Zimbabwe and Cameroon. It concludes with overall observations and issues, and the proposed way forward for 2007.

As of June 18 2007, there were a total of 96 wild poliovirus (WPV) cases in Nigeria. Approximately 75% of these cases were of the WPV Type 3 strain, as compared to 25% which were WPV Type 1. The national non-polio Acute Flaccid Paralysis (AFP) rate was 8.0 in 2007 compared to 5.1 in 2006. All states achieved a non-polio AFP rate of >2 in the first quarter of 2007, as compared to 92% in same period of 2006.

The programme has secured sustained national commitment, and expanded inter-sectoral collaboration. Communities no longer display block rejection of vaccination, and are beginning to address their own challenges at the community level. This is facilitated by increased support from traditional and religious leaders. Unfortunately, wavering political commitment at the state and legal government area (LGA)levels, as well as pockets of rejection by households or families, still pose significant challenges.

Positive strides have been seen on a national level in the media environment - the programme has witnessed a high reach of mass and traditional media, increased air time on both radio and television stations, and a new trend of interactive phone-in media. Partnerships with media chief executives and good human interest stories profiling community engagement have also strengthened this aspect of the programme.

The core platforms of Nigeria's national polio communication strategy include:

• Community dialogue involving traditional and religious leaders.
• High level advocacy in partnership with key policy makers and influentials.
• Building alliances with traditional and religious leaders and the mass/ traditional media for effective community mobilisation.
• Participatory microplanning, social mapping and research.

The following five objectives for 2007 were outlined:

1. Non-compliant households reduced to < 50% of the 2006 level.
2. That 90% of heads-of-households agree that multiple doses of oral polio vaccine (OPV) are safe.
3. At least 95% of parents have had their children under the age of five immunised with OPV during the last round of immunisation plus days (IPDs).
4. 50% of parents who can state the number of diptheria, pertussis and tetanus (DPT) doses a child requires before their first birthday.
5. 75% of eligible children receive three doses of DPT.

The main challenges currently facing the programme include: media costs and limited media time; poor interpersonal communication (IPC) skills of vaccination teams; and population fatigue and fear regarding multiple doses. To address these issues, the programme plans to utilise existing radio programmes, undertake IPC training for health service providers and involve the public in interactive media and community dialogue sessions.

The communication model undertaken by the programme is based on Communication for Behavioural Impact and Social Change (CBSC). This model places an emphasis on empowering communities to have greater control over their own actions, offers incentives to recommended behaviours and attempts to engage at all levels of the community.

A detailed discussion followed this which described Nigeria's update on the 2005 TAG Recommendations from Cameroon, as well as the 2006 TAG Recommendations from Zimbabwe. The programme has made strides in addressing concerns at all levels of the programme, from data monitoring and child tracking to community engagement. Still pending is the formulation of a joint communication plan and approaches for border issues, towards creating a system for routine synchronisation of plans for shared borders.

Ways forward for Nigeria's communication programme include:

• Strengthening active community involvement in microplans.
• Synchronisation of communication interventions and operational services during IPDs and between rounds.
• Maintening the gains of traditional and mass media.
• Strenthening institutional and human capacity.
• Periodic assessment and monitoring to ensure that targets are met.

In conclusion, the team asked the following question of the Technical Advisory Group:


What are the priority communication gaps to be bridged in the next 6 months to help break the transmission of the virus in the identified hard-to-reach, border LGAs and non-compliant families?

Click here to download the full PowerPoint presentation as a PDF document.

Click here to open or save a Word document that was used to brief the TAG team before they went to the field.