The Drum Beat 811 - Eradicating Polio in Humanitarian and Crisis Contexts

• 1.Making Sense of Apparent Chaos: Health-Care Provision in Six Country Case Studies
  by Enrico Pavignani, Markus Michael, Maurizio Murru, et al.
  In all contexts, the coverage and scope of health services change when the state fails, often due to violence. This paper's 6 country research case studies - Afghanistan, the Central African Republic, the Democratic Republic of the Congo, Haiti, Palestine, and Somalia - examine health service provision in severely disrupted environments. The paper calls for "new and substantially different analytical approaches". For example, informal healthcare providers "will need to be brought into centre stage, in the analysis as well as in the policy discussion". [Mar 2013]
  
   
• 2.The Role of UNICEF's Intervention Programs in Improving Polio Coverage During the Humanitarian Crisis in Yemen
  by Hanan Saleh and Lucy Sebli-Seidelson
  The armed conflict that began in Yemen on March 26 2015 has destroyed pivotal health infrastructures, adversely affecting children who are in need of immunisation against diseases such as polio. This research assesses the major interventions the United Nations Children's Fund (UNICEF) uses to deliver immunisation services, including polio vaccines, to children in Yemen. [Feb 2021]
  
   
• 3.Breathing Space: Vaccination Ceasefires in Armed Conflict
  by Ian Russell, Laura Wise, and Sanja Badanjak
  In February 2021, the UN Security Council adopted Resolution 2565, which demands that "all parties to armed conflicts engage immediately in a durable, extensive, and sustained humanitarian pause to facilitate, inter alia, the equitable, safe and unhindered delivery and distribution of COVID-19 vaccinations in areas of armed conflict". From the Political Settlements Research Programme, this report examines past experiences of using ceasefires to facilitate vaccination campaigns in diverse contexts around the world. In the context of the Global Polio Eradication Initiative, the provision of multiple, similar health services concomitantly, such as vitamin A supplements with polio vaccinations, has been a useful tool for building community trust. Clear and consistent communication is emphasised as vital when implementing vaccination ceasefires. [Sep 2021]
  
   
• 4.Case Study: Innovations in Emergency Disease Responses
  by Ben Ramalingam
  This paper draws out some of the emerging findings on the nature and condition of the "innovation ecosystem" in infectious disease responses. For example, though operational humanitarian knowledge is essential at all stages of the innovation process, it is not always well supported or integrated into innovation management efforts. The paper seeks to better understand the ecosystem by reviewing both positive examples, where innovations have emerged and been successful (e.g., the response to polio outbreaks in Syria), and more challenging examples, where innovations have not happened or have not been successful. [May 2015]
  
   
• 5.Certifying the Interruption of Wild Poliovirus Transmission in the WHO African Region on the Turbulent Journey to a Polio-Free World
  On August 25 2020, the Africa Regional Commission for the Certification of Poliomyelitis Eradication declared that the World Health Organization (WHO) African region had interrupted transmission of wild poliovirus (WPV). Among the setbacks that occurred along the way: 2 years after the most recent WPV case was reported in Nigeria, 4 cases of infection with WPV1 were detected in a remote and security-challenged area of Borno State. In response, political, military, traditional, and community leaders were engaged; communities were mobilised; and information and communication technology was used. [Sep 2020]
  
   
• 6.Vaccine Hesitancy in Migrant Communities: A Rapid Review of Latest Evidence
  by Akhenaten Siankam Tankwanchi, Brett Bowman, Michelle Garrison, Heidi Larson, and Charles Shey Wiysonge
  Although vaccination is often required for immigration and refugee resettlement, many immigrant communities experience lower immunisation rates and higher burden of vaccine-preventable diseases than host populations. This rapid review examines evidence of vaccine hesitancy within migrant communities in the context of increased human mobility, anti-immigrant sentiment, and xenophobia. [Jun 2021]
  
   
• See also:
  Report on the Meeting of the Technical Advisory Group for the Eradication of Poliomyelitis in Afghanistan [2021, March]
  Breaking the Inertia in Coverage: Mainstreaming Under-utilized Immunization Strategies in the Middle East and North Africa Region
  

• 7.Polio Outbreak Investigation and Response in The Horn of Africa: 2013-2016
  by Samuel Okiror, Abraham Mulugeta, Iheoma Onuekwusi, Fiona Braka, Sylvesta Malengemi, John Burton, Rustam Haydarov, et al.
  Political instability, insecurity, and recurrent natural disasters are major drivers of population movements within the Horn of Africa (HoA). Due to these crises, children in difficult terrains and security-compromised areas are not given the required immunisation services. This article reviews the epidemiology, risk, and programme response to the 2013-2014 poliovirus outbreaks, including the 5 main strategies (with examples) of the outbreak communication plan: advocacy, mass media/promotion, community engagement/social mobilisation, behaviour change/participatory communication, and capacity building. [Apr 2021]
  
   
• 8.Oral Cholera Vaccination Coverage in an Acute Emergency Setting in Somalia, 2017
  by Mutaawe Lubogo, Ahmed M. Mohamed, Abdullahi H. Ali, et al.
  During the 2016/17 drought season, a cholera outbreak was declared in 55 districts of Somalia, and the Ministry of Health implemented an oral cholera vaccine campaign. "Even when insecurity may have been perceived as a major obstacle..., the use of accepted community volunteers and community leaders within areas that were not accessible to humanitarian agencies, the vaccinators targeting IDP [internally displaced person] camps where majority of the target population lived having been displaced by drought, helped achieve the high coverage rates." [Jan 2020]
  
   
• 9.Are Children on Track with Their Routine Immunization Schedule in a Fragile and Protracted Conflict State of South Sudan? A Community-based Cross-sectional Study
  by Israel Oluwaseyidayo Idris, Janet Tapkigen, Germaine Kabutaulaka, et al.
  The South Sudanese civil war has affected health-related outcomes, including immunisation timeliness. This study assessed if children aged 0-23 months in the rural communities of the 4 counties in the former Western Lakes State were on track with their immunisation schedule and identified predisposing factors that affected immunisation status. One finding: A child who did not attend a church that discussed immunisation importance was more than 2 times more likely to be off track with immunisation than children who went to a church that did, and a child whose community leaders did not discuss immunisation importance was more than 3 times more likely to be off track than a child whose community leader did. [Mar 2022]
  
   
• 10.Humanitarian Led Community-based Surveillance: Case Study in Ekondo-titi, Cameroon
  by Alain Metuge, Lundi-Anne Omam, Elizabeth Jarman, and Esther Omam Njomo
  Community-based surveillance (CBS) - the systematic detection and reporting of events of public health significance by community members - has been used in many situations to strengthen existing health systems, as well as in humanitarian crises. The 2016 "Anglophone Crisis" of Northwest Southwest regions of Cameroon led to collapse of surveillance for outbreak-prone diseases. This paper discusses a project incorporating CBS for timely emergency response to displaced communities in hard-to-reach areas. The CBS generated a higher number of alerts than traditional outbreak reporting used in the region and had timely investigations and, if appropriate, responses. According to Reach Out NGO, the use of community health workers living as part of the displaced communities increased community acceptance and engagement in mass immunisation services, even at short notice. [Mar 2021]
  
   
• 11.Towards People-Centered Epidemic Preparedness and Response: From Knowledge to Action
  by Kevin Bardosh, Daniel de Vries, Darryl Stellmach, et al.
  During an epidemic, day-to-day decision-making takes place in a context of uncertainty, complexity, fear, and stress. An epidemic response of global concern typically involves an array of local and national government bodies supported by the UN, humanitarian non-governmental agencies, donors and funders, civil society groups including the media, militaries, and other partners. In this context, social science can support the quality, course, and timeliness of key information flows and knowledge synthesis necessary for decision-making. The report outlines a set of 17 priority recommendations, which are part the total list of 38 key recommendations organised across 3 domains. [Jun 2019]
  
   
• See also:
  Improving The Response To Covid-19: Lessons From The Humanitarian Sector Around Communication, Community Engagement And Participation
  Conducting Public Health Surveillance in Areas of Armed Conflict and Restricted Population Access: A Qualitative Case Study of Polio Surveillance in Conflict-affected Areas of Borno State, Nigeria
  

• See also:
  Gender in Challenging Contexts - The Drum Beat 803
  Rapid Gender Analysis of Ukraine
  

• 12.Realist Evaluation of the Early-Stage Implementation of a Smartphone-Based Disease Surveillance Project in Two Armed-Conflict Communities in Nigeria
  by Bashir M. Mustapha and Samuel C. Avemaria Utulu
  A growing body of literature focuses on how mobile phones can help eradicate some of the challenges that hamper quality healthcare services in communities experiencing armed conflicts in developing economies. This paper investigates the early-stage implementation of a smartphone-based acute flaccid paralysis surveillance project in 2 rural communities experiencing armed conflicts in Northern Nigeria. "The advantage of involving local community members in security-constrained areas who understand the terrain and various routes to avoid direct encounters with insurgents has been crucial to the project's success." [Nov 2021]
  
   
• 13.Real-time Monitoring of a Circulating Vaccine-Derived Poliovirus Outbreak Immunization Campaign using Digital Health Technologies in South Sudan
  by Isah Mohammed Bello, Sylvester Maleghemi, Melesachew Ferede, Godwin Ubong Akpan, et al.
  Although there is documented use of mobile and geographical information systems (GIS) technologies to support, guide, and monitor polio immunisation campaigns across different geographical settings, limited studies take place in complex and humanitarian settings such as South Sudan. A tool to monitor and evaluate vaccination campaign processes in real time using open data kits (ODKs) was deployed during vaccination campaigns conducted in response to a circulating vaccine-derived poliovirus (cVDPV) type 2 outbreak declared in South Sudan on September 18 2020. This article evaluates the impact of the tool on the timeliness and completeness of data reporting, as well as its ability to provide real-time information to stakeholders at all levels so they can take informed action while increasing transparency and accountability. [Dec 2021]
  
   
• 14.Scaling the Children Immunization App (CIMA) to Support Child Refugees and Parents in the Time of the COVID-19 Pandemic: A Social Capital Approach to Scale a Smartphone Application in Zaatari Camp, Jordan
  by Yousef S. Khader, Wadih Maalouf, Mohammad Abu Khdair, et al.
  To support Syrian refugee parents and caregivers in Jordan's Zaatari camp during the COVID-19 pandemic, the United Nations Office on Drugs and Crime developed a leaflet on caregiving that was delivered using an existing smartphone app called the Children Immunization App (CIMA). A team of 2 nurses from the local population and 2 volunteers from the camp introduced parents to CIMA during household visits. The organisers explain they "created the values of the app through the active participation of both the clinic staff and the parents. This collaborative work between all stakeholders, as active participants in the process of the health promotion was a key ingredient..." in building trust in the tool. [Jan 2022]
  
   
• See also:
  Leveraging Polio Geographic Information System Platforms in the African Region for Mitigating COVID-19 Contact Tracing and Surveillance Challenges: Viewpoint
  

• 15.Core Commitments for Children in Humanitarian Action [CCCs]
  The CCCs are UNICEF's core humanitarian policy and framework for humanitarian action. In addition to serving as a mandatory policy for all UNICEF personnel, the CCCs guide external stakeholders, including governments and civil society organisations, in designing their humanitarian action and in setting and meeting standards for respecting, protecting, and fulfilling the rights of children in crisis. UNICEF promotes the participation of children, adolescents, women, and affected populations, as well as those who advocate for the centrality of their rights and voices. [Oct 2020]
  
   
• 16.Collective Communication and Community Engagement in Humanitarian Action
  From the CDAC Network, this is a guide for those implementing communication, community engagement, and accountability in humanitarian action. It suggests practices to support an active role for communities in humanitarian services and decision-making, to improve access to information, and to keep people connected to support their own ways of coping. It emphasises a collective approach where humanitarian actors coordinate, collaborate, and are held accountable for their actions. [2019]
  
   
• 17.Managing Misinformation in a Humanitarian Context
  by Viviane Lucia Fluck
  Internews works to amplify the voice of those affected by disasters and conflict, to make the humanitarian system more accessible and accountable, and to provide technical expertise in Communicating with Communities (CwC). As part of this work, since 2014, Internews has implemented rumour tracking as a way to address misinformation during humanitarian crises in numerous countries and contexts. Informed by that work, this 3-part manual offers case studies, practical instructions, and a template library to implement the Internews Rumour Tracking Methodology. [Jul 2019]
  
   
• 18.Behavioral Communication Strategies for Global Epidemics: An Innovative Model for Public Health Education and Humanitarian Response
  New York University's School of Global Public Health, UNICEF, Anthrologica, and Common Thread designed a course that brings together UN professionals, government staff, and students to design social and behaviour change communication strategies that address disease outbreaks and humanitarian challenges around the world. By the culmination of the course each year, participants develop tangible and implementable strategies to bring back to UNICEF country and regional offices. In 2019, the field challenges included chikungunya in Sudan, monkeypox in Nigeria, Ebola in the Democratic Republic of Congo, and destroyed health systems in Iraq, Syria, and Yemen. Teams were required to demonstrate the value of their proposal, how it met the need of the local community, and how it would change behaviour.
  
   

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