Polio Project: Missed Opportunities for Polio & Other Immunizations in Urban Poor Communities in West Africa

This presentation explores the Applied Research on Child Health (ARCH) West African Polio Project, which was part of the United States Agency for International Development (USAID) Child Health Research Project (CHR) consortium. CHR identified, tested, and evaluated new technologies, approaches, and interventions to reduce the major causes of morbidity and mortality in children under five. The ARCH Polio Project included the following research components, undertaken in The Gambia, Ghana, Mali, and Benin: household survey of mothers, qualitative research involving consumers and providers, and a community profile: agents for social mobilisation. Included here are details about the percentage of eligible children vaccinated against polio, etc.

Selected communication-related findings include:

• Partnerships between researchers and programme managers work - for example, in facilitating simple, inexpensive, periodic surveys of sub-populations with low immunisation coverage to estimate progress toward the elimination of polio. These partnerships have led to findings that, according to ARCH, will make the routine Expanded Programme on Immunization (EPI) and the National Immunization Days (NIDs) more effective.
• Tailor-made messages and approaches are important.
• Careful thought needs to be given to the factors that lead to the exclusion of selected groups from the public health services.
• Instruct health staff to be more respectful of mothers, however ill-informed they may seem, and ensure that a few key messages are clearly communicated to all mothers or guardians, such as: NIDs are free; re-vaccination is recommended; one round is not enough; and come this year even though you came last year.
• With regard to communication and social mobilisation: Good information and ready accessibility make a difference; full participation of the community helps build ownership; some prior contact with the health services means that people return for additional services later; many mothers heard indirectly from family members about NIDs, not through the radio or television - so local and informal methods of communication need to be encouraged.
• Focus group discussions (FGD) with mothers revealed communication insights such as: "We expect the nurses to sometime congratulate us for looking after our child very well...so it will boost our morale, but they do not." and "All mothers mentioned a number of sources including radio, information vans, posters, Muslims announced in the mosque, volunteers go from house to house, family members and people living on the same compound..."
• In-depth conversations with health personnel revealed insights such as: "T-shirts should be an integral part of the remuneration...volunteers were very happy and it helped in identifying volunteers. It contributed to the success of the program." and "Important to tell people one month before NID so they will not forget."

Suggested future work related to communication described here includes: forging alliances, strengthening the capacity to do competent social science research in the field, and developing effective and sustainable ways in which cases of disease can be reported to the health authorities for suitable response and follow-up.

For more information, contact:

Jonathon Simon

Chair, International Health; Director, International Health, Center for International Health; Professor, International Health

Boston University School of Public Health

Boston, MA

United States

Tel: 617 414 1260

jonsimon@bu.edu