The Drum Beat 826 - Polio Outbreaks: Communication Insights

• 1.Curbing an Outbreak of Circulating Vaccine Derived Poliovirus Type 2 in Dollo Zone, Somali Region, Ethiopia
  by Legesse Kidanne, Filimona Bisrat, Mohammud Mohammed, and Negussie Deyessa
• Conducted in Bokh woreda, Dollo Zone, Somali Region, Ethiopia, this study describes the response to a cVPDV type 2 (cVPDP2) outbreak declared on June 9 2019 in Dollo Zone, Somali Region, Ethiopia. Responders addressed difficulties in coordinating teamwork, communication, and stakeholders' engagement in a pastoralist setting. For example, the team encouraged parents to vaccinate their children through Jummah prayer at the mosques, use of megaphones, and house-to-house mobilisation by trained community volunteers. The latter strategy was the preferred one to achieve the objective of reaching all children. Data indicate that the immunisation campaign, which started through rapid response vaccination within 14 days of the laboratory-based verification, covered "a substantially high proportion of children." [May 2022]
   
• 2.Strategies to Reach Nomadic Children During Polio SIAs: Experience in Dadaab and Fafi Sub-Counties of Kenya after the 2013-2014 Polio Outbreak
  by Abdi H. Ahmed, Gedi Mohamed, Joseph Okeibunor, et al.
• During the 2013 polio outbreak in Garissa County in Kenya, 50% of the confirmed cases were among nomads, even though they comprise less than 20% of the total population in the county. Thus, starting 8 months after the last confirmed case, the Ministry of Health (MOH) and partners reached out to the nomadic community to involve them in reporting suspected acute flaccid paralysis (AFP) cases. Experienced community health volunteers were assigned to each listed nomadic settlement to sensitise the identified leaders and contact persons on the lay case definition and how to report a suspected AFP case. As an indication that more nomadic children were reached in the campaigns using the new strategies, 100% of the AFP cases reported from nomadic settlements in 2014 and 2015 had received at least one dose of oral polio vaccine (OPV). [Nov 2020]
   
• 3.Polio Vaccination Activities in Conflict-affected Areas
  by Chukwuma Mbaeyi
• Polio outbreaks spreading from reservoir countries into once polio-free countries have been and remain a threat to the progress achieved by the Global Polio Eradication Initiative (GPEI). Within the context of armed conflict, the emergence of these outbreaks is often driven by the destabilising effects of war on healthcare systems or compromises to security and access for the conduct of vaccination activities. This article examines the implementation of polio vaccination activities in settings of war and other armed conflict with an aim to understand the approaches that have been adopted in these settings. One consideration: "Establishment of community-based vaccination programs, where feasible, would provide an avenue to actively engage resistant communities and build the necessary trust needed for polio vaccinators to operate in areas that would otherwise be treacherous." [Jul 2023]
   
• 4.Poliovirus Outbreak in New York State, August 2022: Qualitative Assessment of Immediate Public Health Responses and Priorities for Improving Vaccine Coverage
  by Ben Kasstan, Sandra Mounier-Jack, Tracey Chantler, et al.
• In July 2022, a confirmed case of paralytic polio in an unvaccinated young adult without a relevant travel history for poliovirus exposure was reported in New York, United States. Vaccine uptake among Haredi (Jewish) populations, where this outbreak was concentrated, is influenced by a range of issues, including access and convenience challenges due to larger families, a preference for delayed acceptance (vs. broadscale refusal), and targeted activism and misinformation campaigns. Efforts to increase vaccination uptake and sanitation behaviour involved infographics and other print material due to the cautious use of the internet among Haredi populations. Three priorities for strengthening vaccine programme activities going forward include: (i) maternal engagement, (ii) communication to counter misinformation, and (iii) vaccine policy and data management. [Jul 2023]
   
• See also:
  * Standard Operating Procedures for Responding to a Poliovirus Event or Outbreak, Version 4
  * The Mozambique Response to the WPV and cVDPV Outbreaks [Presentation from the Sharing Learning from Polio SBC Side Event at the 2022 SBCC Summit]
  * Establishment and Use of Polio Communication Network in Response to Polio in Outbreak Countries of the Horn of Africa: 2013-2014

• 5.The Experiences of Using Polio Outbreak Simulation Exercises to Strengthen National Outbreaks Preparedness and Response Plans in Sub-Saharan Africa
  by Daudi Manyanga, Brine Masvikeni, and Fussum Daniel
• This paper shares the results of a cross-section qualitative study to review 8 countries that conducted polio outbreak simulation exercises (POSEs) in East and Southern Africa from 2016 to 2018. The main objective was to assess the capacity and level of preparedness of the MOH and key partners in responding to a polio event or an outbreak to contain it within 120 days as indicated in the GPEI's polio outbreak Standard Operating Procedures (SOPs). Having assessed that the POSEs "contributed to the overall improved communication and coordination for outbreaks in these countries", the researchers indicate that they should be conducted at least every 3-5 years for improved preparedness and response. [Aug 2020]
   
• 6.Simulation Exercises To Strengthen Polio Outbreak Preparedness in The Horn of Africa: Experiences and Lessons Learnt
  by Samuel Okiror, Chidiadi Nwogu, Obianuju Igweonu, Rustam Haydarov, et al.
• Between 2013 and 2014, there was a series of outbreaks of WPV type 1 (WPV1) in the Horn of Africa. In response, WHO and United Nations Children's Fund (UNICEF) held 7 tabletop POSEs to explore national planning and coordination. This paper reviews and summarises these experiences and lessons learned therein, with a focus on country readiness to respond to a polio outbreak in line with the existing plan. Overall, "The exercises helped familiarize participating countries with each other's preparedness plans and practices and promoted better understanding and cooperation between countries and international organizations..." [Nov 2020]
   
• 7.Building Local Capacity for Emergency Coordination: Establishment of Subnational Public Health Emergency Operations Centres in Nigeria
  by Oyeronke Oyebanji, Fatima Ibrahim Abba, Oluwatosin Wuraola Akande, et al.
• Public health emergency operations centres (PHEOCs) provide a platform for multisectoral coordination, collaboration, and communication to enhance the efficiency of outbreak response activities and enable the control of disease outbreaks. The earliest use of EOCs in Nigeria was with the national polio response. PHEOCs enable health leaders to receive information from multiple sources, coordinate decision-making, communicate across levels and sectors, and mobilise rapid response teams and resources. This paper shares the experience and importance of establishing PHEOCs at national and subnational levels in Nigeria and the lessons learned, which can be used by other countries considering the use of PHEOCs in managing complex emergencies. [Oct 2021]
   
• 8.Community-Based Surveillance of Infectious Diseases: A Systematic Review of Drivers of Success
  by Catherine R. McGowan, Emi Takahashi, Laura Romig, Kathryn Bertram, et al.
• Community-based surveillance (CBS), which involves engaging community members to detect and report events of public health significance within their own communities, is intended to complement facility-based systems, particularly in rural areas within low-resource settings. Communication and engagement were the most frequently cited success factors of CBS. For example, in Ethiopia, CBS workers organised village coffee ceremonies at which they were able to ask for reports of AFP and to discuss signs, symptoms, and reporting. "[D]eveloping CBS preparedness is more likely to be both successful and sustainable within communities that are actively engaged in designing and implementing a range of co-produced public health solutions." [Aug 2022]
   
• See also:
  Real-time Monitoring of a Circulating Vaccine-Derived Poliovirus Outbreak Immunization Campaign using Digital Health Technologies in South Sudan

• You may also be interested in:
  The Drum Beat 811 - Eradicating Polio in Humanitarian and Crisis Contexts

• 9.Drivers of Routine and Outbreak Vaccination Uptake in the Western Democratic Republic of Congo: An Exploratory Study in Ten Health Zones
  by Laurene Peckeu-Abboud, Patrick Mangoni, Kaouther Chammam, Papy Kwete, Patrick Mutombo Lupola, Veerle Vanlerberghe, Jepsy Yango, Marie Meudec, Christian Ifufal, Marianne A.B. van der Sande, Joule Madinga Ntwan, and Placide Mbala
• This study aimed to identify determinants of routine and outbreak vaccination that could either promote or hamper uptake among different stakeholders in 10 health zones in 4 western provinces of the Democratic Republic of Congo, an epidemic-prone country with limited resources but with considerable experience in outbreak control. Sample findings: Vaccine acceptance was lower for outbreak vaccinations (57%) than for routine vaccinations (90%), especially if there was no direct experience with the outbreak. Vaccine acceptance for outbreak vaccination was lower among people with incorrect knowledge or who felt insufficiently informed on vaccination. Gathering data as in the present study may enable agile, targeted interventions by public authorities to optimise the uptake of vaccinations when aiming to prevent and control outbreaks. [Jul 2022]
   
• 10.Exploring Public Perceptions of Vaccine-Derived Poliovirus and a Novel Oral Polio Vaccine in the Democratic Republic of the Congo, Kenya, and Nigeria
  by Lara Lorenzetti, Rustam Haydarov, Emily Namey, Anna Lawton, Hayon Nam, Muhamad Ridwan Hasan, Claude Monj, Surangani Abeyesekera, Maria Amina Kabwau, and Ross McIntosh
• In November 2020, the GPEI introduced novel OPV type 2 (nOPV2) to address cVDPV2. Although nOPV2 is a more genetically stable vaccine than monovalent OPV type 2 (mOPV2), communities and health workers may not initially trust it due to its novelty, potential side effects, and introduction under an Emergency Use Listing (EUL). This paper explores how nOPV2 introduction might be perceived by stakeholders and identifies communication barriers related to nOPV2 hesitancy. Across stakeholder groups and sites, respondents believed that acceptability of nOPV2 hinged upon information, including content and source of messages. The researchers suggest that ensuring alignment of messaging among health officials, community leaders, traditional media, and social media will be important for maintaining caregiver acceptance of nOPV2. [Jul 2022]
   
• 11.National Emergency Action Plan 2023: Polio Eradication Initiative Afghanistan
• The WPV-endemic Afghanistan has also had outbreaks of cVDPV. Inconsistent vaccination coverage, especially in the South, poses a significant, ongoing threat to eradication. The National Emergency Action Plan 2023 holds that, in consultation with community groups and polio health workers at the forefront and based on understanding of local norms, community initiatives should aim to address lack of motivation/fatigue with regard to polio eradication activities, while making any polio outbreak visible and a national concern. Such initiatives could include a radio drama series focusing on polio prevention in the context of daily life in communities and families, development of a national/local model to promote polio messages at household and community level, and efforts to promote UNICEF's Aisha character as a means of fighting polio in Afghanistan. [Jun 2023]
   

• 12.cVDPV2 Outbreak Response in the Midst of COVID-19 in Ghana: Key Lessons Learned from Communication and Social Mobilisation Strategies and Activities
  by Anastasiya Nurzhynska, Berhanu Abebe, and Charity Nikoi
• Although the last confirmed polio case in Ghana occurred in 2008, in July and August 2019, the country confirmed 3 events of cVDPV2. From the onset of the outbreak, the MOH/Ghana Health Service (MOH/GHS) declared a public health emergency of national concern; consequently, massive house-to-house vaccination campaigns were carried out by GHS and the GPEI in various regions. UNICEF, a GPEI partner, was one of the key actors in supporting social mobilisation and community engagement in all rounds of the response. In this document, UNICEF Ghana shares key learnings in the area of social mobilisation and community engagement in Ghana's cVDP2 response - especially in light of the fact that it took place in the midst of COVID-19. [Dec 2020]
   
• 13.How Has Guinea Learnt from the Response to Outbreaks? A Learning Health System Analysis
  by Tamba Mina Millimouno, Bruno Meessen, Willem Van De Put, et al.
• Learning is a key attribute of a resilient health system and, therefore, is central to health system strengthening. The main objective of this study was to analyse how Guinea's health system has learned from the response to successive and parallel infectious disease outbreaks, such as cVDPV2, between 2014 and 2021. Notably, "achieving knowledge translation into action requires an exchange of knowledge among key stakeholders, starting with cultivating appropriate relationships and establishing a shared understanding of what knowledge to action means and why it is crucial..." [Feb 2023]
   

• 14.Communication for Development Guidance for cVDPV2 Outbreak Response Including the Use of Novel OPV2 (nOPV2)
• The purpose of this guidance is to assist GPEI field communication professionals in planning and executing high-quality communication responses to cVDPV2 outbreaks, including response with nOPV2. Part 1 provides an overview of - with links to - various communication resources for cVDPV2 outbreaks in accordance with revised GPEI SOPs for outbreak response. Part 2 focuses on specific guidance for the use of nOPV2 vaccine in the response, including rationale, communications challenges, objectives, and tactics (e.g., how to implement monitoring and evaluation (M&E) and rumour tracking). [Oct 2021]
   
• 15.Communicating with Communities in Epidemics & Pandemics: Risk Communication and Community Engagement (RCCE) Readiness Kit - Strengthening Preparedness to Respond to Outbreaks in Humanitarian Settings
• Funded by the United States Agency for International Development (USAID) and produced by the READY initiative, this kit is designed to help national and international non-governmental organisations respond to public health emergencies, especially in humanitarian settings, by systematically listening to communities and tailoring response interventions accordingly. After outlining risk communication and community engagement (RCCE) roles and responsibilities, the resource guides readers through a series of readiness actions, linking to practical tools that support their implementation. These steps cover the various stages of an outbreak, including pre-crisis, early onset, mitigation, suppression, and recovery. [Jun 2022]
   
• 16.Early Warning Alert and Response in Emergencies: An Operational Guide
• Populations affected by emergencies are continually at risk of outbreaks of epidemic-prone diseases and other public health hazards. Developed jointly by 69 experts from more than 20 organisations from global level to country level, this operational guidance from WHO aims to guide decision-making on when and how to implement and strengthen early warning alert and response (EWAR) in preparation for and response to emergencies. Chapter 15, which focuses on communication and dissemination of EWAR information, stresses that EWAR is only as good as the information that is communicated effectively between all partners who contribute to the system. [2022]
   
• 17.A Guide for the Media on Communicating in Public Health Emergencies
  by Genevieve Hutchinson and Jacqueline Dalton
• In a health crisis, effective communication can help to prevent or reduce the spread of disease and guide those affected towards health services and treatment. Featuring case studies and links to various online resources, this manual provides tips for media practitioners on how to help audiences during health emergencies. It was created by BBC Media Action for the International Federation of Red Cross and Red Crescent Societies in the framework of the Community Epidemic and Pandemic Preparedness Programme. [Dec 2018]
   
• 18.How to Build an Infodemic Insights Report in 6 Steps
  by Tina Purnat and Elisabeth Wilhelm
• An infodemic is defined as an overabundance of information, accurate or not, in the digital and physical space accompanying an acute health event such as an outbreak or epidemic. Infodemic insights are developed through a compilation of narratives across various data sources, often using social listening, and they are shared in the form of "insights reports". In response to the need to understand the health information environment and help health workers better communicate and engage with the public to encourage healthy behaviours, WHO and UNICEF created this manual and accompanying tools for analysts who conduct social listening to develop infodemic insights reports. [Jul 2023]
   
• See also:
  Rapid Social Data Collection Tools: Rapid Polling and Rapid Qualitative Research for Polio Outbreak Response

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