Social Mobilization for Polio Eradication - Uttar Pradesh 2006-2007

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 looked specifically at the Indian state of Uttar Pradesh (UP), and provides an overview of key strategies for engaging communities in high-risk districts, innovations in tracking the immunisation status of children, training and monitoring modalities for polio communication workers, and outcomes in terms of maximising family/community participation in response to the accelerated supplementary immunisation activity (SIA) schedule.


The core elements of UP's Communication and Social Mobilisation Campaign from 2006-2007 included the following:

• Intensive interpersonal communication
• Underserved strategy
• Engagement of formal stakeholders
• IEC
• Mass media
• Editorial media management
• Celebrity endorsements

In response to the 2006 outbreak, the government of Uttar Pradesh took many steps to strengthen the state's health infrastructure. This included integrating Health and Family Welfare Departments for more effective control, engaging almost 2,000 new doctors, filling all vacant Medical Officer positions and appointing over 110,000 health support workers. It also introduced a range of polio-specific initiatives, such as shortening gaps between house-to-house activities, tracking of newborns, identification of high-risk areas (HRAs), and using large public events to immunise children. The government has also taken a role in monitoring of the programme by senior level officers, and actively engages with the press through regular conferences to enhance the coverage of rounds.

The Social Mobilisation Network (SMNet) in UP has seen a 23% increase in deployment in response to the 2006 outbreak. UNICEF and [spell this out here] CORE community mobilisation coordinators (CMCs) in 2007 now cover 95% of the HRAs in western UP.

These CMCs are seen as an integral part of the polio communication campaign - they are responsible for tracking the immunisation status of every child in the campaign under age 5, ensuring the ‘birth dose’ of oral poliovirus (OPV), generating detailed child and area maps of communities and, most importantly, promoting behaviour change in avoidant or resistant (X) families. They receive induction, on-the-job and refresher training which has been proven to effectively increase their understanding of poliovirus transmission. By February 2007, a survey of 9 districts in UP showed that 90% or more of the families in these areas had been contacted by CMCs. Likewise, an increase in the proportion of newborns receiving the birth dose and higher child immunisation at booths is seen in areas where CMCs are active. Despite significant gains made through incorporation of CMCs into the network, operational challenges (such as vaccination teams not asking all relevant questions to the family or not making adequate efforts to locate and vaccinate all available children) still hinder overall programme performance in CMC areas.

Other mobilisation activities within the SMNet have included Muslim influencers accompanying vaccination teams during house-to-house rounds, inauguration of vaccination booths by influencers and celebrity endorsements in HRAs.

In conclusion, the following key questions were addressed to the TAG panel:

• Are we playing a powerful and helpful enough role in ensuring that the youngest children are receiving more OPV doses more quickly?
• How do we make our system sensitive enough to catch 'hidden resistance' and respond effectively and in time?

Click here to download the full PowerPoint presentation as a PDF document.