Polio: The Art & Science of Communicating for Eradication

This presentation examines UNICEF's communication for development (C4D) strategy for reaching the last remaining children with the oral polio vaccine (OPV) globally. A case study of its application in Pakistan, one of the few polio-endemic countries (where 88% of the global cases were found in 2014), is explored in more depth. Shifting from a focus on individual behaviour change and an emphasis on building trust in OPV, UNICEF's approach has broadened to include a greater exploration of social dynamics, politico-religious dynamics, and insecurity as critical variables impacting vaccine uptake, and the interaction of these dynamics with individual perceptions of trust in healthworkers, vaccine, and the health system delivering OPV. Data shared in the slides explain the rationale for a strong focus on trust: in a 2014 poll, only 26% of caregivers surveyed in the Federally Administered Tribal Areas (FATA) of Pakistan said they trust vaccinators a great deal, as compared to 61% of those in other provinces. That number is 34% among internally displaced persons (IDPs) from North Waziristan. The percentage of caregivers saying vaccinators seemed to care about well-being of their child a great deal was 27% in FATA, compared to 53% in other provinces, and 45% among IDPs from North Waziristan. The percentage of caregivers saying they heard at least one destructive rumour about OPV was 48% in FATA compared to 18% in other provinces. This trend was consistent in nearly all areas where polio still thrives, pointing to deep issues of trust in the final reservoirs of polio.

Elements of the response at this time reflect attention to communication-related components such as community engagement, mass communication, media relations, access and security (especially in light of polio-related murders), and social mobilisation and advocacy. Two pillars of the global communication strategy include:

Promote vaccination (including polio) as a social norm ("we are all intertwined" campaign). Demonstrating this shift in Pakistan, communication has moved beyond showing paralysis and risk towards a new brand for vaccinators: "Guardians of Health", and images that portray frontline workers as heroic and serving the community. A global frontline worker training guide (see above) has been produced to ensure the communication strategy is promoting reality on the ground. The training provides a global standard curriculum to enhance the efficacy of frontline workers to reach every child in all polio-affected countries. It includes a regionalised comic book and flash cards to communicate more effectively with low-literacy vaccinators and portray them as heroic in all training materials and methods. As explained here, there are over 6,500 Continuous Community Protected Volunteers (CCPV) newly recruited in the highest-risk areas of Pakistan who are: selected by local communities, female, permanent (to build trust), paid on time, supervised by an independent structure, and tasked with promoting other health services beyond OPV.

Next, the presentation explores Rhizome, UNICEF's website to be launched in February 2016 to support teams in the field with best practice C4D resources and tools that is accessible, easy to digest and effective in low-connectivity environments. "Rhizome supports the design of data-driven communication strategies that help vaccinate every missed child. Inside, you will find a selection of the best C4D tools, case studies and guidance that will help finish off polio for good." Also described is a soon-to-be-released guide titled "Polio Communication Global Guide: A How-to Manual for the Art and Science of Maximising Immunisation Rates through Communication."

Click here for the 35-slide PowerPoint presentation.