PEI Communication: Progress & Challenges - Afghanistan
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PEI Communication: Progress & Challenges - Afghanistan TAG 1- 2 June 2009, Cairo Presentation Outline Implementation of last TAG Recommendations Evidence-based communication - what does the data tell us? Strategic shifts & communication objectives

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Presentation Transcript

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Presentation Outline

  • Implementation of last TAG Recommendations

  • Evidence-based communication - what does the data tell us?

  • Strategic shifts & communication objectives

  • A dynamic mix of communication interventions

  • Outcome

  • Challenges

  • Way forward

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What Does Data Tell Us?

Social & Epidemiological Analysis

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Social Data – KAP Study Jan 2008

If we want caregivers to get children immunised with OPV, what do they need to know, feel and believe? Is awareness enough?

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Knowledge Gaps

Low knowledge of specifics, regarding polio as a disease or OPV




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Low perceived threat—few people believe polio is an untreatable disease, which indicates low threat perception

Low perceived OPV efficacy, which might be linked to poor knowledge



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Missed Children Distribution 2009 – Children Absent or Silent Refusal?









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Communication Variables Silent Refusal?


Communication Objectives

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Communication Variables to Increase Demand Silent Refusal?

Knowledge of intervention


Threat (susc / sev)

Child gets OPV

Intent to immunize child

Perceived norms

Perceived personal efficacy

Perceived efficacy of intervention

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Communication objectives Silent Refusal?

Raise awareness and fill specific knowledge gaps about polio and routine immunisation

Improve access to children in HRAs with targeted, data-driven community mobilisation

Communicate with and through women to reach newborns, sleeping & sick children with OPV

Address campaign fatigue and improve motivation of families and vaccinators

Reduce % share of ‘absent children’ among children missed in SIAs

Integrate communication planning and implementation into the SIA micro planning.

Build IPC skills of vaccinators, especially in HRAs

Improve cross-border communication – social mapping, common messaging and reaching mobile populations

Improve communication data collection management & utilisation

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A Dynamic Mix Silent Refusal? ofCommunication Interventions Focus - High Risk Districts

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Community Mobilisation Supporting ‘Option Three’ Silent Refusal?

Southern Region:

Kandahar – Panjwai, Maiwand, Shahwalikot, spinboldak, Daman, Kandahar urban

Hilmand – Nade Ali, Nauzad, Musa Qala, Sangin, Kajaki, Washer, Garamsir & Bust

Urozgan – Tirinkot, Dehrewood, Shahedehesas

Eastern Region:

Ningarhar - Jalalabad

Laghman – Mehterlam

Kunar – some border clusters

Western Region:

Farah – Bakwa, Balabaluk,

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Local Inaugurations at Sub-district Level Silent Refusal?

Local level ownership & community engagement:

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‘Cluster Jirgas’ with Elders and Mullah Silent Refusal?

Local level advocacy: using credible voices to influence families

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Address Campaign Fatigue: Silent Refusal? District & Sub-district Motivational events

Cricket, football and volleyball matches held in Kandahar, Khox and Nangarhar & Laghman – generating good coverage in local media

Special Events:

Above – Cricket Match for the

May NID in Jalalabad

Right – Cricket Match in Khost

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Communication With Women, By Women Silent Refusal?

Visibility events




Visibility events



Community Elders

Women Courtyard


Posters and Banners



Women Courtyard


Community Elders

Posters and Banners



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Risk Communication: Metherlam, Laghman perceived susceptibility & severity of threat

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Post-campaign Community Mobilisation Reviews – Ongoing Process

Cluster focal points’ review meeting March 2009:

Mawlawi Nazeer, Cluster focal point of B3 during reporting of his cluster

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Improved Communication Data Management Process

  • Communication indicators added to PCA and ICM checklists

  • Data collection tools standardised

  • Training provided to national and provincial communication Focal Points in data entry, analysis and report generation using Epiinfo – STOP Team Volunteer

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Cross Border Communication Process

High visibility to border vaccination posts

Use of local Pashto media channels – BBC Pashto Service, local and community media channels, Shamshaad TV

Community based social mapping of border clusters in ER to identify spheres of influence & channels of communication to access them better

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Coordination in ER: Process

Number and % of CM undertaking Joint house visits with vaccinators during Jan 2009 NID




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Missed Children Reduced in CM Districts during Jan 2009 NID Process


due to insecurity

Districts with Social Mobilization

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Result indicator in SR: Comparison of Refusal in CM districts by rounds Oct 08 – Jan 09Data Source PCM

Zero refusals

New Families Repatriated from Pakistan

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Women Courtyard in SR ER – visits to health centres

  • 787 meetings attended by 6,578 women*

  • Women discussed with women & shared information about polio immunisation - 12,136 neighbourhood houses mobilized

  • Space created for women to dialogue with women on survival and health of children – including of course polio and routine imunisation

  • 68 refusal and not interested families ‘converted’ during mobilization

  • Courtyard Women accompanying male vaccinator teams in ER to open access into homes

    * Q 3 & Q 4 of 2008

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Media Outreach ER – visits to health centres

  • National Media:

  • Regular briefings

  • Polio Express brought out by MoPH

  • PSAs produced and broadcast in the field

  • Partnership with BBC World Trust: Produce and broadcast episodes in the highly popular TV drama serial ‘New Home, New Life

  • Local media:

  • Local radio, community radio, local TV channels

    For e.g. Azadi radio, Equal Access community radio, BBC Pashto service, Shamshad TV

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Challenges ER – visits to health centres

  • IPC Skills of vaccinators need continuous strengthening

  • High turnover of trained vaccinators – limits training gains

  • Ongoing training of monitors to collect communication data

  • Communication data collection and transmission from sub-district and provincial level

  • Inadequate documentation in the field of innovations & lessons learned

  • Difficulties in conducting micro surveys, KAPs and similar resarch due to modest technical capacity and ongoing insecurity

  • Develop relevant partnrships to reach mobile and nomadic populations

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Next Steps ER – visits to health centres

  • Strengthen partnerships including with NGOs, YICC (youth), pvt media and women’s groups in KDH, Hilmand and Farah

  • Strengthened monitoring of Integrated community mobilisation in HRAs (SR, ER & WR)

  • Implement Research Plan

  • Hold national Polio Communication Review in October 2009

  • Long term IPC capacity building of vaccinators

  • Strengthen communication data management and standardise reporting

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Research Plan ER – visits to health centres

  • Micro survey to track ‘absent children’ : members in order to analyse trends among 'missed children', esp 'absent' or 'not at home’

  • Post training evaluation- Interviews- Field observations- Interviews with families- Role play

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Thank you ER – visits to health centres