Meeting the challenge ofCommunication & Social Mobilization

in an India with no cases

Structure of the presentation•Social Mobilization Network and Communication•Guarding against complacency in an India without cases•Media & Advocacy•Emergency Preparedness•Questions for the IEAG

The impact of the Social Mobilization Network

*Data as on 1st Feb 2012

UNICEF HR SUPPORT IN POLIO HIGH RISK AREAS, UTTAR PRADESH, 2011

UNICEF CMC – 4931CORE – 1319

Source: Form A

2007 2008 2009 2010 2011

87

264

526

628

827

165

236

391

390

591

Rest of BiharKosi

SMNet strength in Kosi & Bihar, 2012

252 500 917 1018 1418

Source: PDSCL

High levels of knowledge and trust for OPV

Strong acceptance of need to immunize against polio

Age (Months)

Average OPV doses through RI & SIA to infants, 41 HR blocks, CMC areas

A child at one year of age has an

average of 10 OPV doses in SMNet blocks of Bihar

A child at one year of age has an

average of 10 OPV doses in SMNet blocks of Bihar

Source: CMC Fieldbook

Guarding against complacency in an India with no cases

Respondents believe that Polio can affect children in their household

Trust is not as strong for Routine Immunization in the general population

RI poster:“Lay the Foundation for a healthy future today. Protect your child against six life-threatening diseases with timely Routine Immunization vaccination and polio immunization in every round.”

Communication materials promoting routine immunization

RI Handbill distributed to parents by polio teams to remind them of RI days and schedule

Bottlenecks in Monitored RI sessions, 41 HR BlocksBihar Mar-Dec 2011

Source: RI Monitoring: SM net

429 445 485 642 714 639 637 673 671 760Sessions = Monitored

N=6095

Need to sustain MOMENTUM.

Need to sustain IMMUNITY.

Indian parents and caregivers need to understand that they must protect their child against a disease that is no longer a direct threat, and against all other five vaccine-preventable diseases.

There is a significant opportunity to use the momentum and trust generated in the SMNet to promote routine immunization, which acts as our best buffer to ensure high levels of immunity, in addition to other convergence activities.

DPT coverage in Infants: Jan to Dec 2011 Bihar HR Blocks Vs. Non HR Block

Source: Block Coverage GoB

Target (80%)

41 HR Block Yearly Target <1 Ch= 256836 Monthly Target <1 Ch= 21403

Non HR Block Yearly Target <1 Ch= 1272500 Monthly Target <1 Ch= 106042

Routine Immunization improves in areas with SMNet

THE SOCIAL MOBILIZATION OPPORTUNITY •Children from 80% of refusal families in Howrah remain unvaccinated in RI•9% of children in Howrah are fully immunized•18% of children are delivered at an institutional facility.•Exclusive Breastfeeding rates are low

ACTION (IF SUPPLY LINES ARE HEALTHY): LARGE-SCALE RI COMMUNICATIONS CAMPAIGN – media buys, communication campaigns and sustained community mobilization, awareness and advocacy — that can transition into broader areas of child survival and development

SMNet convergence for other child survival interventions

West Bengal

Learning Needs Strategy •Communication Training

• Five convergence areas • Underserved Strategies Training• Data-based planning Training on interventions

•Training of trainers• Sub-Regional Training Coordinators• BMC level

•Management training • Supervisory level of staff

Focus on supporting training for Front-Line Workers

Media Tonality Monitoring reports State Polio Convergence Taskforce MeetingsState Polio Partners MeetingsNational Social Mobilization Working Group meetingsCommunications Review

PLANNED STUDIES FOR 2012•Mega KAP 3 for HRA and HRG in UP and Bihar•Migration patterns and KAP on Polio among HRGs of Punjab, Haryana, Maharashtra, West Bengal and Delhi•Impact evaluation of RI activities in west UP•Impact in SMNet v non-SMNet areas for initiatives under convergence

107 block-level profiles reviewed monthly

Continuous risk assessment for communication

Maintaining community support + tackling

remaining resistance

Community’s engagement in Polio Programme

0.70%

1.60%

2.40%2.50%

3.40%

3.70%

0.00%

1.00%

2.00%

3.00%

4.00%

2007 2008 2009 2010 2011 2012 (Jan)

Continued decline in resistant households in CMC areas Uttar Pradesh, 2007 – 2012 (Jan)

Source:Tallysheet

97%94% 95% 97%

91%96%

3%

8% 8%

12%

7% 9%

0%

20%

40%

60%

80%

100%

April May June August September November

CMC Area Non CMC Area

Local influencer visiting all X houses with the teams, UP

Source :SMNet & Partners

N=9269 N=10040 N=14775 N=15446N=8117 N=12310

2.5

%

1.1

%

1.4

%

1.9

%

2.3

%

2.4

% 3.4

%

3.5

% 4.4

% 5.6

%

7.6

% 8.6

%

11

.3%

0%

2%

4%

6%

8%

10%

12%

Sta

te

Ba

da

un

Me

eru

t

Mo

rad

ab

ad

Ka

np

ur(

Na

ga

r)

Alig

arh

Ba

reill

y

Lu

ckn

ow

Gh

azi

ab

ad

Alla

ha

ba

d

Ag

ra

Va

ran

asi

Go

rakh

pu

r

Subregionwise % XS Houses Uttar Pradesh, Jan 2012

Source:TallysheetSIA round partially covered Gorakhpur, Alllahabad, Varanasi, Lucknow data is updated as on Sep 11 for the same & rest of the updated where SIA held on Jan 2012

Refusal to immunize due to child sick is still an issue in

some areas

REASONS FOR OPV Refusal

% of mosque where announcements happened in West Bengal

Source-FV data

99% refusal families in West Bengal belong to the Muslim community.

INTERVENTIONS•IEC/IPC to address misconception such as vaccine safety•Private doctors, Rural Medical Practitioners and non-registered medical practitioners mobilized•Mobile health teams visit houses during rounds

PLUS•Trend analysis to identify persistent passive resistance•Identify pockets of resistance and develop strategic response•redistribution of staff to highest-resistant areas•2 x PRI Workshop with 350 participants each•Rotary plastic balls in highest-resistance areas•Health camps in Howrah, South 24 Parganas, Kolkata and Murshidabad

Media and Advocacy

New polio campaign launch by UNICEF Goodwill Ambassador for Polio

Media Tonality, last quarterCoverage has been

predominantly positive (418 stories) and neutral (393

stories) across the reporting period covering 13 January.

Significant positive coverage

also resulted due to WHO taking India off from the list of polio-endemic countries.

Extensive roll out of media campaign for programme visibility & reinforcement key messages to diverse target audience. 1533 TV spots on 21 satellite channels

and cable2030 spots on 9 radio channels

IEC for Polio Immunisation NIDsPosters:      973,370Rally flags   685,000Sun visors   537,550Rally banners   9,000

Whistles     1,088,000

Mass Media campaigns

Making polio advocates of media

114 radio announcers and presenters trained on polio and RI in 2011

15 print & electronic media workshops held in key high-risk Areas: Indo-Nepal border, Nasik-Malegaon, Howrah-West Bengal (pictured), Agra and Varanasi in UP and block-level media in Bihar.

Field visits by national & international media

around important events – 13 Jan milestone,

NIDs and SNIDs.

Key Challenges: •The risk of AFP being misreported as ‘Polio’ & VDPVs being highlighted in a zero WPV scenario.•Having media report accurately in the event of WPV importation

Key Strategies: Updated standard responses on AFP/VDPV shared with spokespersons, officials & partners to effectively respond to media to prevent inaccurate reports.In addition to media workshops, media trainings for spokespersons & key partner representatives to effectively handle media.When AFP is reported as polio, information on the lab results shared with media for further coverage, by highest authority.Ensuring EPRP media plans are in place in all states for timely media engagement and response for accurate coverage.

Key Media Challenges & Strategies

Recent Events

Bowl Out Polio with India, West Indies teams

Australia v India Test in Perth

Polio advocacy by F1 world champion

driver Fernando Alonso.

Advocacy events & material

Bihar CM Nitish Kumar polio banner

Prime Minister Dr Manmohan Singh launches GOI/Rotary Summit

WB CM Mamata Banerjee polio posters

Advocacy events & material

Advocacy with PRI elected representatives in high-risk districts of Howrah and 24 South Parganas in West Bengal and Mewat in Haryana.

From 200,000 to Zero:The journey to a polio-free India

Preparing for Emergency Response

Emergency Kits developed in seven languages

Each kit has 20,000 emergency posters, 3,000 FAQs,

500 Green advocacy booklet, 500 IPC flip books,

artworks of dated and undated posters, emergency TV

and radio spots and CDs with mike announcements.

Rapid Response Teams

Six orientation workshops held

for Rapid Response Teams –

trained on responding

to media, oriented on

social mobilization in

the event of a polio case.

Each state to develop Communication and Media Plan and identify spokesperson to respond to media.

1.How does the IEAG perceive the development of the Road Map for all aspects of polio eradication in India, including:

Social Mobilization to maintain strong community support, tackle complacency, and promote RI/other convergence interventions

Continuous interaction with the media and advocacy at all levels

Readiness to rapidly respond to any case

2.How does the IEAG perceive 1. Planning for the mainstreaming of the polio

infrastructure in India for other child survival initiatives? 2. The future of the SMNet in India and replication of

certain elements of the SMNet in other high-risk areas?

Questions for the IEAG

3. The IMB has requested that India document and share its lessons learned/best practices. How does the IEAG suggest the polio programme move forward on this recommendation?

4. In light of continued resistance in pockets of West Bengal, does the IEAG support sustained focus on tackling resistance in that state, despite the absence of cases? What about resistance in other areas?

Questions for the IEAG

Towards a polio-free India