TAG Panel Report: Communication for Polio Eradication and Expanded Routine Coverage

This PowerPoint presentation was part of a November 2006 meeting hosted by the World Health Organization (WHO) African Regional Office (AFRO) in Zimbabwe. At this meeting, country-specific presentations were made by communication practitioners in 5 countries which have experienced ongoing cases of wild polio virus (WPV) from 2005 to 2006. The objectives of the meeting included the following:

1. To critically review country communication strategies and activities for polio eradication, routine immunisation and integrated expanded programme of immunisation (EPI)-polio action including progress in implementing the Yaounde 2005 TAG country recommendations.
2. To develop the technical recommendations for each country which, when implemented, would improve polio and routine communication performance.
3. To develop and propose communication indicators that can be effective in measuring the impact of communication strategies for improved polio eradication and expanded routine immunisation.

The mandate of the Technical Advisory Group (TAG) peer review panel is to listen to country presentations, ask questions and provide constructive recommendations. This presentation covered an analysis of the main issues identified during the two-day meeting and outlined recommendations for five African countries: Democratic Republic of Congo (DRC), Nigeria, Angola, Niger and Ethiopia.

The main issues presented by the team from the DRC included:

• 8 new cases of WPV identified in 2006, after 5 years of interrupted transmission.
• Pockets of unreached children remain throughout country (1 in 4 reached).
• Communication sub-committees, including non-governmental organisations (NGOs) and media, are functional only during national immunisation days (NIDs).

The TAG Panel provided seven recommendations for addressing these issues, including using existing data for social/geographic mapping of zero dose/unvaccinated children, to pinpoint their access issues; revising the national Expanded Programme on Immunisation (EPI) communication strategy based on epidemiological and social data; revamping border coordination mechanisms with neighbouring countries and updating the polio response plan.

The main issues presented by the team from Nigeria included:

• Inconsistency of data collection and limitation on the types of indicators used.
• Recent adoption of the immunisation plus day (IPD) strategy places an additional burden on an already limited programme capacity.
• Key social data must be strengthened in order to anticipate problem areas.

The TAG Panel maintained that the IPD should remain the core national strategy for polio eradication, and therefore the strategy needs to be thoroughly and regularly assessed. Recommendations included: creating a tracking list to avoid missing children; strengthening monitoring and regular evaluation; liasing with Niger on a joint communication plan; and developing a measurable advocacy action plan.

The main issues presented by the team from Angola included:

• Under-developed Monitoring and Evaluation Framework for communication in EPI.
• Lack of support for communication in routine immunisation (RI).
• A number of challenges related to communicating with a highly mobile population.

The TAG Panel recommendations included: promoting synchronised campaigns between neighbouring countries; developing a profile of hard-to-reach and mobile populations; and implementing a specific advocacy strategy to influence service delivery planning.

The main issues presented by the team from Niger included:

• Insufficient quality of communication training.
• Increased need for focus on communicating with nomad groups.
• Insufficient synchronisation of national and local efforts at shared border with Nigeria.

The TAG Panel provided four recommendations aimed at strengthening communication strategies. These included: increased monitoring and evaluation; more thorough staffing/training practices; and improving advocacy at a national level.

The main issues presented by the team from Ethiopia included:

• Updating the existing preparedness plan - it needs to reflect the latest international thinking.
• The existing strategy to go beyond polio and pursue RI needs continued active follow-up.
• Giving priority to Somali and Afar regions.

The TAG Panel provided recommendations for strengthening the Somali and Afar regions, conducting more detailed data collection, and assessing how the existing improvements in RI were achieved.

In conclusion, the TAG Panel outlined six major issues pertinent to all countries, resolution of which will greatly aid future immunisation efforts:

1. Apparent need to strengthen in-country communication capacity - identifying technical assistance needs to better support country teams.
2. Need for relevant indicators and measurement of communication impact - 3 main resources can be recommended if interested.
3. Improved understanding of the “fatigue” issue (unsure of what the issue is and how to address it).
4. Improvement in training of vaccinators related to their communication roles.
5. The need for a simple statement, in the context of EPI and RI, of what constitutes communication and its demonstrated added value (across disciplines).
6. The need to technically assist countries in designing communication components for comprehensive multi-year plans.

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