Pakistan Polio Eradication Initiative Support to the COVID-19 Response

PEI personnel are offering technical support for the coordination of the RCCE working group for the COVID-19 response, utilising behavioural research by the polio eradication programme assets to determine the direction of interventions for risk communication and preventive behaviours. The PEI anthropologist is designing and fielding tools through phone interviews with key informants to collect information on awareness, key concerns, rumours and misconceptions, major influencers and sources of information, and care-seeking behaviours. This informs the national RCCE strategy and communication materials.

At the provincial level, PEI personnel are offering technical support for the coordination of provincial RCCE working group. The provincial, district, and community PEI personnel are also implementing COVID-19-related RCCE.

The following are among the key contributions of PEI towards RCCE:

• The "Sehat Tahaffuz" (Protection of Health) Helpline (1166): The helpline, which provides polio and other health information, was co-opted by the government to support the COVID-19 response. Both technical and human resource capacity was boosted (from 55 to 250 personnel) to receive and address the additional COVID-19 call load. All 250 helpline agents were trained on COVID-19 information and support. In addition, 16 doctors address issues and questions. Cumulatively, 1,820,408 calls had been received on the helpline as of April 18 2020, and 313,485 questions had been answered since January 31 2020, when the helpline started receiving COVID-19 calls. The limited capacity in the number of agents at the beginning of the pandemic limited the number of calls answered. As of April 23 2020, over 60% of received calls are answered and assisted. Most calls are related to questions about symptoms and/or precautions/treatments.
• Social media reach and overcoming misinformation: Over 3 million people have been reached through the PEI social media cell: PEI social media accounts - Facebook and Twitter - posted 236 COVID-19-related awareness messages, including statements of celebrities/religious leaders. Steps are also underway to block or limit dissemination of misinformation posts. As of this writing, 25 links had been blocked, and others have been reported to the telecommunication authorities and Facebook for action.
• Using polio frontline worker networks (community-based vaccinators (CBVs), ComNet), about 5,402 videos have been recorded, as of this writing, with celebrities and local influencers and shared on multiple local WhatsApp groups engaging high-risk populations.
• Influencer engagement and social mobilisation: 25,357 religious leaders and 203,481 other influencers have been engaged through existing polio alliances. Religious leaders have been mobilised at different levels (national, provincial, district, union council (UC) level), especially to promote social distancing and praying at home. The National Islamic Advisory Group and Islamic Advisory Group met under the leadership of the World Health Organization (WHO) Regional Director, Regional Office for the Eastern Mediterranean (EMRO), guiding development of messages before Ramadan. The provincial religious support networks met virtually to discuss and share experiences on community engagement related to social distancing. Religious leaders have given video messages and offered their social pages for dissemination of materials and messages.
• Mapping of mosques by the polio programme: Mosques remain central for information dissemination, so this venue has been utilised to reach out imams (e.g., who can offer mosque announcements). In addition, public address systems mounted on motorbikes and rikshaws are being utilised to disseminate information. It is estimated that 173,976,363 (cumulative figure; multiple attenders may have been counted more than once) have been reached through mosque announcements alone.
• Engagement of journalists and bloggers: Orientations have been conducted with 3,500 journalists and bloggers to counter negative media and COVID-19 myths. Existing good will associated with the polio eradication programme has been utilised with the journalists to access their social pages.
• Leveraging of polio partnerships: The PEI entered several partnerships to disseminate COVID-19 messages and get support of key industries and business communities. The most notable among these is with Daraz.pk, an online retailer in Pakistan that has distributed COVID-19 information, education, and communication (IEC) materials along with its parcels throughout Karachi, with a plan to extend the same service in Punjab. Daraz also shared an animated video (Allahyaar) on their social media pages. Partnerships are also being pursued with the stock exchange and industrialists, as Pakistan moves towards the relaxation of the lockdown. Capacity building through online platforms was planned in upcoming weeks.

Health

Pakistan reported its first case of COVID-19 on February 26 2020. As of April 24 2020, the country had confirmed over 10,000 cases and over 200 deaths.

In addition to the RCCE activities described above, other contributions of the PEI to the COVID-19 response in Pakistan, include, in part:

• Improved data management system through gathering and entering available data on COVID-19 in the Integrated Disease Information Management System (IDIMS) for real-time analysis and display to support the response's decision-making.
• Facilitated the establishment of quarantine camps in Quetta, Sukkur, and Dera Ismail Khan districts.
• Provided ongoing support for investigations, screening, interviewing, and filing of risk assessment and data forms.
• As of April 24 2020: Traced 16,915 contacts, identified and isolated 1,946 symptomatic travellers, investigated 3,277 suspected COVID-19 cases, and facilitated sample collection from 4,102 suspected cases.