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Importance of Public Health Education: Polio Immunization in West Africa

1st Annual International conference of the African Science Academy Development Initiative

OPV Safety Controversy, Nigeria Case Study

Background · Polio campaigns suspended in several northern states · Negative media discussion about safety of vaccine in national and international media · Trusted community and religious leaders speak out against polio vaccine · Mistrust in oral polio vaccine leading to nonacceptance

Impact of Negative Communication

OPV controversy

Negative communication about polio vaccine in Nigeria: · Decreased acceptance of vaccine · Increased number of polio cases

100 90 80 70 Number of cases 60 50 40 30 20 10 0 N N N J J J J-02 J-03 J-04 J-05 M M M M M M M M S S S J



Impact of Negative Communication

Negative communication about polio vaccine in Nigeria: Spread of negative vaccine messages to other parts of Africa Spread of polio to polio-free countries from Nigeria

Wild virus type 1 Wild virus type 3

Public health education strategy

Focus: Reaching every child with polio vaccine

·Rebuilding public trust ·Ensuring high political commitment ·Focusing on community/family centered activities ·Sustaining engagement of religious & traditional leaders, civil society ·Increasing media visibility ·Community mobilizers in high risk areas

Use of data for public health education

Source of information in selected states

60.0 50.0 40.0 Kano 30.0 20.0 10.0 0.0 Niger Lagos

No Felt Need Political Difference No care giver consent Religious Belief

Non-Compliance Data

Benue OPV Safety Child Sick

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Unhappy with Immunization personnel Too many rounds Reason Not given


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Key communication elements for building support for immunization

Grassroots Policy Change

Media/ Public Awareness

Intensified Advocacy and partnerships

· Large scale public flag off campaigns · President directs Governors to monitor progress · Engagement of religious and traditional networks · Working with nomadic groups · Working with private sector, including mobile phone companies · High level visits to Governors & religious leaders · Involvement of community leaders

Community education focus

· Community mobilizers in high-risk areas · Visits/revisits to non-compliant homes by mobilizers · Flag-offs at community levels · Engagement of local influencers · Religious statements and announcements · Involvement of traditional media ­ local theatre, mobile cinema, town criers, folk singers · Mass Media ­ radio drama, TV spots, jingles

Media for behaviour change

· Broadcasting in national languages · Special broadcasts to minority groups · Media monitoring generating human interest stories to stimulate adoption of positive behaviours · Folk media including town criers activities stimulating dialogue · Theatre for Development performances followed by community dialogue · Mobile cinema shows followed by community dialogue

Results ­ Increase in acceptance

National Non-compliance Caseload Nov 04 - May 05

100000 No. of Households 97500 95000 92500 90000 87500 Nov 04 Feb 05 May 05

Results ­ increase in coverage

April 04 Community Mobilisers deployed in VHR LGAs, August 2004 October 04

May 05

< 80% reported Cov 80-89% reported Cov > 90% reported Cov

Results ­ Importance of health education

· OPV safety controversy resolved · Increased demand for polio ­ increased coverage during polio campaigns · Increased understanding of importance of immunization · Increased demand for immunization · Increased support for immunization among key stakeholders


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