Achieving polio eradication: A review of health communication evidence and lessons learned in India and Pakistan

Article (PDF Available)inBulletin of the World Health Organisation 87(8):624-30 · September 2009with51 Reads
DOI: 10.2471/BLT.08.060863 · Source: PubMed
Since 1988, the world has come very close to eradicating polio through the Global Polio Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Polio Eradication Initiative communication strategies have become increasingly research-driven and innovative, particularly through the introduction of sustained interpersonal communication and social mobilization approaches to reach unreached populations. This review examines polio communication efforts in India and Pakistan between the years 2000 and 2007. It shows how epidemiological, social and behavioural data guide communication strategies that have contributed to increased levels of polio immunity, particularly among underserved and hard-to-reach populations. It illustrates how evidence-based and planned communication strategies - such as sustained media campaigns, intensive community and social mobilization, interpersonal communication and political and national advocacy combined - have contributed to reducing polio incidence in these countries. Findings show that communication strategies have contributed on several levels by: mobilizing social networks and leaders; creating political will; increasing knowledge; ensuring individual and community-level demand; overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and marginalized populations. The review concludes with observations about the added value of communication strategies in polio eradication efforts and implications for global and local public health communication interventions.
    • "PEI resources contribution has gone beyond disease specific approach toward health system strengthening approach in respect to the International health regulation core capacity in order to improve preparedness and response to outbreak in the AFRO region [16] . Polio infrastructure is used in any epidemic preparedness and response [17,18] activities, Marburg, measles, Cholera, Anthrax, Shigelloses, Dengue and EVD affecting the country over the past 20 years as described in Angola. In Ethiopia, technical support of WHO officers is contributed to the improvement of the health system in general. "
    [Show abstract] [Hide abstract] ABSTRACT: Introduction: The continuous deployments of polio resources, infrastructures and systems for responding to other disease outbreaks in many African countries has led to a number of lessons considered as best practice that need to be documented for strengthening preparedness and response activities in future outbreaks. Methods: We reviewed and documented the influence of polio best practices in outbreak preparedness and response in Angola, Nigeria and Ethiopia. Data from relevant programmes of the WHO African Region were also analyzed to demonstrate clearly the relative contributions of PEI resources and infrastructure to effective disease outbreak preparedness and response. Results: Polio resources including, human, financial, and logistic, tool and strategies have tremendously contributed to responding to diseases outbreaks across the African region. In Angola, Nigeria and Ethiopia, many disease epidemics including Marburg Hemorrhagic fever, Dengue fever, Ebola Virus Diseases (EVD), Measles, Anthrax and Shigella have been controlled using existing polio Eradication Initiatives resources. Polio staffs are usually deployed in occasions to supports outbreak response activities (coordination, surveillance, contact tracing, case investigation, finance, data management, etc.). Polio logistics such vehicles, laboratories were also used in the response activities to other infectious diseases. Many polio tools including micro planning, dashboard, guidelines, SOPs on preparedness and response have also benefited to other epidemic-prone diseases. The Countries' preparedness and response plan to WPV importation as well as the Polio Emergency Operation Center models were successfully used to develop, strengthen and respond to many other diseases outbreak with the implication of partners and the strong leadership and ownership of governments. This review has important implications for WHO/AFRO initiative to strengthening and improving disease outbreak preparedness and responses in the African Region in respect to the international health regulations core capacities.
    Full-text · Article · Jul 2016
    • "But the accuracy of this survey is questionable in the northern parts of the country [2]. The ambiguity about the failure of achievement of Global Polio Eradication Goals in Pakistan has remained unsolved in minds of many people [3]. Major among the proposed causes of this menace are Military-Talban Nexus [4], State Imposed Religion, Biomedical and religious Illiteracies, Lack of Trust in US [5] and extremist factions versus innocents. "
    [Show abstract] [Hide abstract] ABSTRACT: The ambiguities about the failure of achievement of Global Polio Eradication Goals in Pakistan have remained unsolved in the minds of many people. A plethora of reasons has been documented to explain Polio uptake in Pakistan, which have carried this issue further on con-fusion scales. The present study is focused on the analysis of anatomy of genesis of Polio Vaccination Hindrance Syndrome (PVHS) in the light of Quranic Verses, Hadiths (saying of Prophet) and their interpretations done by the local clerics at the times of their weekly sermons (Khotbat). Along with these, the medical aspects of vaccination are also taken under consideration. It is concluded from this analysis that in true teachings of Islam, there is nothing against Polio Vaccination and related medication irrespective of its source, if reproductive health of children is not at stake. The main epidemic stems in lack of education, deprivation from basic human rights, lack of trust in international agencies and the perception of vaccination at lower levels of society, as a real threat to their family growth. This and related issues would be tackled by the initiation of development projects, by winning the trust of people and through strengthening the hold of state in remote areas of Pakistan.
    Full-text · Article · Mar 2016
    • "Political motivation was another prompter of public health concern as in the case of polio vaccination boycott in Northern Nigeria, where marginalised communities were mobilized to challenge government-driven initiatives [4]. In spite of taking rigorous measures to interrupt the rapid transmission of polio virus in Pakistan [5] , the success is far from reach. Security risks to healthcare workers, false religious and traditional beliefs, and limited access to hard-to-reach communities have severely hampered the progress of 'End Polio from Pakistan' campaign [6]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background Despite the efforts of national and international organizations, polio has not been eradicated from Pakistan. The prevalence of polio in Pakistan is exceptional in global context. Quetta and Peshawar divisions are amongst the most affected regions hit by polio in Pakistan. This study was carried out to assess the knowledge, attitudes and perceptions towards polio immunization among residents of Quetta and Peshawar divisions in Pakistan. Methods A descriptive, cross-sectional study involving 768 participants was conducted from August to December, 2014 in Quetta and Peshawar divisions in Pakistan. Multistage sampling technique was used to draw a sample of residents from each division. A pre-tested, self-administered questionnaire was used to collect the data from eligible participants. Descriptive and logistic regression analyses were used to express the results. Results A total of 38.8 % participants exhibited good knowledge about polio. Mean knowledge score of the participants was 7.35 ± 2.54 (based on 15 knowledge questions). Older age (p < 0.001), low qualification (p < 0.05), rural locality (p < 0.05) and Quetta division (p < 0.001) were significantly associated with poor knowledge of polio. A large proportion of participants displayed negative attitudes towards polio immunization (84.8 %), with a mean score of 19.19 ± 2.39 (based on 8 attitude statements). Lack of education (p < 0.001) and rural residence (p < 0.001) were significantly associated with the negative attitudes of participants towards polio immunization. False religious beliefs (39.06 %), lack of knowledge (33.7 %), fear of infertility by polio vaccines (32.16 %) and security issues (29.42 %) were reported by the participants as the main barriers towards polio immunization. Conclusion The findings of this study showed poor knowledge and negative attitudes of participants towards polio immunizations. Religious beliefs and lack of knowledge about polio immunization were reported as the major barriers towards polio immunization.
    Full-text · Article · Nov 2015
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