Engaging Communities in Immunisation

This presentation was part of the 12th meeting of the Expert Review Committee on polio eradication in Nigeria, the
first to be held in the country following the global Urgent Stakeholder Consultation on Polio Eradication in Geneva in February 2007.
The meeting reviewed progress made on recommendations since the previous 11th ERC meeting, held in December 2006,
in all major areas of Nigeria's polio eradication and routine immunisation programmes. In attendance were members from the National
Primary Health Care Development Agency (NPHCDA), the World Health Organization (WHO), the Government of Nigeria, and members from the "Very High Risk" (VHR)
states of Kano, Katsina and Jigawa.



This presentation examines community involvement and social mobilisation in Nigeria's immunisation programme.
It takes a look at the progress made against the 11th ERC meeting recommendations, provides an update on the
outcomes of 2007 Immunisation Plus Days (IPDs), key challenges facing the programme, new initiatives and ways forward through the remainder of this year.

The 11the ERC meeting provided the following four major recommendations in the area of Social Mobilisation in Nigeria:



Recommendation 1: Assess the impact of community dialogues.

Status: Acheived and ongoing - data from Kano and Katsina states reflect a positive trend in reduction
of zero dose children in areas with active community dialogues.

Recommendation 2: Update the communication workplans of the six high risk states.

Status: Achieved and ongoing - guidelines for workplans developed and shared in December 2006.
Currently under implementation.

Recommendation 3: Systematically engage local, traditional and religious leaders.

Status: Achieved and ongoing - through a number of workshops, Quranic school teachers initatives,
media engagement and community activities.

Recommendation 4: Refine communication indicators and rapidly analyse and utilise data.

Status: Achieved - social mobilisation tools and indicators reviewed and revised by the Monitoring
and Evaluation Working Group (MEWG), electronic databases generated to collate information at the state level,
and non-compliance data used to inform community dialogues and distribution of supplies.



Monitoring data from the March 2007 IPDs shows a reduction from 9.6% to 6.2% in missed children since the
November 2006 rounds. Similarly, non-compliance percentages for households in the six high risk states reduced
from 40,554 to 28, 225 during the same time frame.


Activities by women's groups and traditional birth attendents (TBAs) were undertaken between
rounds at a much higher intensity than the previous year. In addition, megaphone and mosque announcements, as
well as print media were employed to supplement activities between rounds.

New initiatives undertaken by Nigeria's social mobilisation programme in 2007 include:

• Partnerships with Quranic teachers to reach children in Islamic schools.
• Religious leaders initiating community dialogues to address challenges.
• Branding of immunisation activities and embarking on a multi-media campaign.
• Facilitation of vaccination tean training on ethics by religious leaders in certain states.
• Provision of resources for purchase of incentives for IPDs by local communities.

The main challenges currently facing the programme are the high turnover of vaccinators, persistent
loss of interpersonal communication skills (IPC), and the financial burden of sustaining engagement of
religious leaders and multimedia strategies. To move forward, the presenters suggest that the programme:
rapidly engage new political leadership through high-level advocacy; work with religious groups to develop and
disseminate their own messages to the grassroots level; and hold Technical Advisory Group (TAG) Country
Communication Reviews to guide future communication planning and implementation.



In conclusion, the presenters asked the following question of the ERC:



What additional communication intervention can be implemented to increase the contribution of communication
to the campaign?