IEC and Media Engagement - Uttar Pradesh

This PowerPoint presentation was part of a March 2007 United Nations Children's Fund (UNICEF)-hosted meeting dedicated to examining polio communication efforts, in the context of the final global push towards polio eradication. State-specific presentations for India's polio-endemic states (Uttar Pradesh and Bihar) were given by in-country communication and health practitioners. These were assessed by an external Technical Advisory Group (TAG) panel of experts who provided communication strategy recommendations based on evidence presented and data gathered on field-visits to endemic states. Communication strategies presented at this meeting were primarily focused on:

1. Analysing the results of programmes implemented to March 2007.
2. Detailing activities on national and sub-national levels, specific to social mobilisation, community engagement, underserved areas and media and political advocacy strategies.
3. Suggesting a planned communication programme for the next 6- to 12-month period, designed to support India's polio eradication efforts in the event of a resurgence of cases or population/programme fatigue.

This presentation identified innovations and approaches to information, education and communication (IEC) materials supporting polio eradication and wider child health development issues, current efforts for district level media management, and media monitoring framework.

The communication for polio eradication message base has expanded significantly from the initial focus on oral polio vaccine (OPV) and supplementary immunisation activity (SIA) participation. It has grown to include routine immunisation, complementary child health issues, localised ownership and leadership, National Rural Health Mission (NRHM) communication and encouraging health-seeking behaviours through the work of accredited social health activists (ASHAs) and other community bridge-builders.

To facilitate an approach to IEC materials and media engagement, the intended audiences within Uttar Pradesh (UP) were grouped accordingly:

1. General Public - Date notification of important immunisation activities achieved through out-of-home extension of electronic media (i.e.: posters, banners, billboards, etc.) and community mobilisation (i.e.: rallies, special events, engagement of older siblings).
2. Caregivers (Low Risk of Non-Compliance) - In this group, maintaining sustained participation (i.e.: answering concerns over repeated rounds), risk perception and communication (i.e.: IEC materials evolved to heighten the perception of risk in 2006 during the outbreak), and add-ons are seen as effective strategies.
3. Caregivers (High Risk of Non-Compliance) - Community specific materials, leveraging of community networks, events and leaders.

A research study undertaken by Jamia Millia Islamia (JMI) found persistent gaps in the reach and effectiveness of IEC materials, most notably:

• Negative perceptions and misconceptions impact the family’s decision to immunise more strongly in rural areas than urban.
• Common myths are still in circulation (i.e.: that polio vaccine causes infertility, it should not be given to sick children, is contaminated, etc.)
• News media are increasingly identified as the main sources for rumours.
• IEC material reach is particularly poor in rural areas.

Challenges presented by the media to the polio communication campaign were exacerbated by an increase in negative media coverage following the 2006 outbreak. These stories are seen to be politicised, often lacking in accuracy and focusing on Muslim rejection of OPV, poor vaccine efficacy, programme failure and an emphasis on the growing number of cases. A detailed analysis of the tonality of polio media story content between 2006-2007 reflects a general decrease in negative reporting, and an increase in neutral reporting.

Several steps have been initiated to deal with these challenges, including:

1. Systematic content analysis of all vernacular press in critical districts of western UP.
2. A media plan to engage with identified daily press to positively position the programme.
3. Group/partner coordination on this media plan.
4. Positive messages given to media by district administration during polio briefings.
5. One-to-one interactions with editorial staff from main media houses in critical states to determine the content, tonality, headlines and placement of stories.

The impact of these efforts have resulted in a reduction in negative stories in the daily media that was directly engaged, an increase in positive and balanced stories and accurate reports that positively position the programme.

The challenges that remain in 2007 include the following:

• Sustaining media support for the programme.
• Capacity building of field management staff to engage with media and reinforce critical messages periodically.
• Creating or identifying focal points in critical districts to engage with local media and to provide authentic information.
• Strategic planning to sustain constructive media interest.

In conclusion, the TAG panel was asked the following questions:

1. Is the present balance between IEC materials and activities for general date notification and for addressing specific local issues appropriate?
2. What methodologies would the TAG suggest to predict and measure the impact of IEC materials and activities on immunisation-seeking and compliance behaviours?

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