The Drum Beat 795 - Resuming and Ramping Up Polio Activities Toward Eradication

• 1.A Qualitative Analysis of Vaccine Decision Makers' Conceptualization and Fostering of 'Community Engagement' in India
  by Tapati Dutta, Beth E. Meyerson, Jon Agley, Priscilla A. Barnes, Catherine Sherwood-Laughlin, and Jill Nicholson-CrottyCommunity engagement (CE) is a strategy for facilitating transparent vaccine communication between communities and decisionmakers and supporting efforts to address inequities in vaccination coverage, especially among under-reached and underserved populations. These researchers interviewed Indian vaccination decisionmakers to derive a shared understanding of the evolving conceptualisation of CE in the context of India's Universal Immunization Program. [Oct 2020]
   
• 2.Lessons Learnt from the Polio Program Communication Activities in Eastern Afghanistan
  by Anpuj Panchanan Achari, Shafiqullah Bashari, Zahra Mosaiby, Wazir Khan, and Tamara Abu ShamWhat lessons have been learned from using communication/communication for development (C4D) to increase vaccine acceptance and CE for polio eradication in eastern Afghanistan? This case study looks back at the United Nations Children's Fund (UNICEF) Afghanistan polio programme's C4D activities from 2017-2020, with a focus on the role of the Immunization Communication Network, the CE arm that addresses polio vaccine acceptance amongst Afghanistan's caregivers. It also describes the Interface Dialogue Communication Strategy, which involves face-to-face discussion to negotiate access to children for vaccination. [Jul 2020]
   
• 3.Impacts of Engaging Communities Through Traditional and Religious Leaders on Vaccination Coverage in Cross River State, Nigeria
  by Angela Oyo-Ita, Xavier Bosch-Capblanch, Amanda Ross, Patrick Hanlon, Afiong Oku, et al.In Nigeria, previous studies have shown that engaging traditional and religious leaders (TRLs) as agents of change to tackle misguided parental norms about polio vaccination improved uptake. This study, funded by the International Initiative for Impact Evaluation (3Ie), evaluated a multi-component intervention that involved training TRLs to engage communities in the planning, implementation, and monitoring of immunisation services in Cross River State, Nigeria. The authors conclude that the TRLs are a form of untapped resource in the community who have the capacity to influence and support vaccination uptake. [Jul 2020]
   
• See also:
  Engagement of Community Structures in Polio Campaigns in Kasai and Kasai Central Provinces, Democratic Republic of Congo
  

• 4.Capacity Development and Community Engagement to Overcome Misinformation About Vaccination
  Based on social data collected in 2019, UNICEF Ukraine developed a C4D response to confront low immunisation rates in the country and the misinformation that can contribute to the problem. Applying behavioural science to create solutions, the organisation has been engaging (including on social media) with children, health professionals, fathers, and communities to increase their loyalty towards immunisation. For example, UNICEF Ukraine addressed fathers with a series of creative communication products shared via digital media activation. The social media campaign reached 217,999 people, with 2,693 clicks to the Ministry of Health website.
   
• 5.When Celebrities Speak: A Nationwide Twitter Experiment Promoting Vaccination in Indonesia
  by Vivi Alatas, Arun G. Chandrasekhar, Markus Mobius, Benjamin A. Olken, and Cindy PaladinesThis nationwide Twitter experiment was conducted in Indonesia with 46 high-profile celebrities and organisations who agreed to let the researchers randomly tweet or retweet content promoting immunisation from their accounts. In sum, there is evidence that celebrity endorsements actually may affect a combination of offline knowledge about facts and the knowledge of health status and health-seeking behaviour by one's neighbour, friend, and relative network members. [Feb 2019]
   
• 6.Using Social Media for Vaccination Promotion: Practices and Challenges
  by Maryke S Steffens, Adam G Dunn, Julie Leask, and Kerrie E WileyVaccination misinformation is prevalent on social media and has potential to decrease public confidence or trust in the safety and effectiveness of vaccines. This research aimed to understand and analyse the experiences of Australian vaccine-promoting organisations on social media, including how they use it and the challenges they face. Among the recommendations for these organisations: Commit to the participatory nature of social media by joining conversations and interacting authentically. [Nov 2020]
   
• See also:
  Twitter Conversations and English News Media Reports on Poliomyelitis in Five Different Countries, January 2014 to April 2015
  

• 7.In Vaccines We Trust? The Effects of the CIA's Vaccine Ruse on Immunization in Pakistan
  by Monica Martinez-Bravo and Andreas StegmannConfidence in vaccines is vulnerable to rumours and misconceptions. In July 2011, the Pakistani public learned that the United States' Central Intelligence Agency (CIA) had used a vaccination campaign as cover to capture al Qaeda leader Osama Bin Laden. The Taliban leveraged this information and initiated anti-vaccine propaganda to discredit vaccines and vaccination workers - trust in whom is key to vaccine acceptance. This paper quantifies the negative impact of using health services as covert for espionage by evaluating the effects of these events on immunisation rates for the polio and measles vaccines. [Oct 2019]
   
• 8.Why Vaccine Mistrust Is a Relationship Problem
  In this TEDMED talk, Heidi Larson, anthropologist and founding Director of The Vaccine Confidence Project, argues that the problem of vaccine hesitancy is due not to misinformation per se but, rather, to the lack of relationships around trusted health information. While working across the globe on polio eradication, Larson has noticed the consequential impact of vaccine distrust and medical rumours. She believes we can inspire trust in medicine by building a health system that is empathetic and reciprocal. This involves investigating people's confidence in vaccines before there is a crisis and listening with empathy, kindness, and understanding.
   
• 9.Building Trust Within and Across Communities for Health Emergency Preparedness
  The central reason trust is so important in emergencies is that preparedness and response rely on whole-of-society buy-in and cooperation. We have seen in past crises that low institutional trust and belief in misinformation hampers the adoption of prevention behaviours, including vaccines. This report from UNICEF and the International Federation of Red Cross and Red Crescent Societies (IFRC): examines the impact of mistrust, explores values and strategies for building an atmosphere of trust, and offers recommendations for leaders. [Jul 2020]
   
• See also:
  Conversations to Build Trust in Vaccination: A Training Module for Health Workers
  

• 10.Developing a Three-Dimensional Narrative to Counter Polio Vaccine Refusal in Charsadda
  by Sheraz Ahmad Khan, Muhammad Ashfaq, Ayaz Ayub, et al.The Global Polio Eradication Initiative (GPEI) faces numerous challenges in polio-endemic Pakistan. This is especially the case in the Pashtun belt, where district Charsadda, an active hub of nationalist politics and religious ideologies, has seen violence against polio vaccinators, and ethnic mistrust has created a public-versus-state mindset. Instead of trying to establish a credible image and creating active demand for vaccines, the government has started to arrest parents for refusing vaccination; the study's interviews reveal that the use of force is counterproductive and further maligns this ethnic group. In addition, the informal Hujra and Jirgah institutions are being replaced with social media, where malicious messages are spreading at an exponential rate. The researchers recommend that the Polio Eradication Initiative (PEI) take steps to foster open discussion to dispel myths, such as those around infertility and gender ratio related to oral polio vaccine (OPV). Simultaneously, the PEI and Expanded Programme on Immunisation (EPI), along with their partners, should use social media to disseminate accurate information to the public. [Oct 2020]
   
• 11.Exploring the Muslim-Focused Cultural Sensitivity in Polio Vaccination Communication Campaign in Northern Nigeria
  by Gambo Ibrahim Ahmad, Mohd Khairie Ahmad, and Joyce Cheah Lynn-SzeRumours and misconceptions about the safety of OPV led Islamic clerics to reject OPV, resulting in the suspension of polio programmes from 2003-2004 in the Muslim-populated Kano state and 5 other states of northern Nigeria. Four themes emerged to guide the PEI in connecting with community stakeholders in the future: Incorporate Qur'an and hadith in message design; prioritise Muslim communities for intensive education on the polio vaccination campaign, using native languages; create Islamic information, education, and communication (IEC) materials for behaviour change; and call on clerics as community mobilisers. [May 2019]
   
• 12.Reach Every District (RED)/Reach Every Community (REC) Strategy Evaluation Pakistan (2014-18)
  UNICEF commissioned this evaluation to assess the extent to which the RED/REC strategy strengthened the delivery of routine immunisation services in Pakistan by improving access to marginalised and vulnerable communities. Activities feature, for example, the participation of community outreach/lady health workers (LHWs), who work at the grassroots level to promote healthy behaviours and provide basic curative services for children without any discrimination. In this sense, the strategy empowers females (e.g., LHWs) to act as agents of change. In brief, the evaluation revealed that an increase in vaccination coverage validated the effectiveness of RED/REC strategy in terms of improvement in childhood morbidity and mortality. [Jan 2020]
   
• See also:
  Breaking the Inertia in Coverage: Mainstreaming Under-utilized Immunization Strategies in the Middle East and North Africa Region
  

• 13.Strengthening Routine Immunization in Papua New Guinea: A Cross-sectional Provincial Assessment of Front-line Services
  by Christopher J. Morgan, Olga P.M. Saweri, Nicholas Larme, et al.Low routine immunisation coverage in Papua New Guinea has contributed to disease outbreaks such as the polio that re-appeared after a 20-year hiatus in 2018. This paper reports on a cross-sectional health services assessment investigating government efforts to improve routine immunisation, with a focus on modifiable aspects of frontline services, including a stretched health workforce. Examples include: supportive supervision linked to refresher training including good communication, and stronger, formalised involvement of local leadership, possibly with the deployment of trained lay health workers. Such community resources can also help register and track children needing vaccination. [Jan 2020]
   
• 14.Interpersonal Communication for Immunization: Training for Front Line Workers - Facilitator Guide and Participant Manual
  by Robert Karam, Waverly Rennie, and Stephanie ClaytonUNICEF contends that front line workers (FLWs) are critical influences on caregivers' immunisation behaviour; building trusted relationships with caregivers and community members can increase the likelihood that children will receive recommended vaccines on time. To that end, this training package is meant to help FLWs identify and address their own biases and misconceptions and to equip them with the essential knowledge, skills, and attitudes they need for positive and meaningful interpersonal communication in the context of immunisation. Although materials and examples in the training package are tailored to the contexts of Bosnia and Herzegovina and Serbia, the content can be adapted and applied elsewhere. [Nov 2019]
   
• 15.Evaluating the Impact of Interventions to Improve Full Immunisation Rates in Haryana, India
  by Abhijit Banerjee, Arun Chandrasekhar, Esther Duflo, et al.In Haryana, India, rates decline rapidly from the initial vaccines in the immunisation schedule to the final vaccines. As part of a 3-pronged initiative to address this issue across 2,359 villages, the programme built a common information infrastructure leveraging an mhealth software application (app), known in Hindi as Teekakaran Protsahan Karyakram (Immunisation Encouragement Programme). It was used by Auxiliary Nurse Midwives (ANMs), who were trained to record details of every child who was immunised at an immunisation camp in the study sample. The tablets seemed to have raised the self-esteem of many ANMs, who expressed confidence about their potential to harness technology, learn something new, and impress both caregivers and their own families. [Jun 2020]
   
• See also:
  Challenges Facing Vaccinators in the 21st Century: Results from a Focus Group Qualitative Study
  

• 16.Establishing and Utilizing Strategic Partnerships for Vaccine-Preventable Diseases: Best Practices in Haiti
  by Paul Adrien, Jeannot Francois, Dana M. Parke, et al.This article summarises the presentations and conclusions of a March 2016 conference in Port-au-Prince, Haiti, that brought together Ministry of Health officials, researchers, clinicians, academics, public health professionals, and others to discuss vaccine programmes and policies in Haiti. They suggested that characteristics of effective partnerships include those where stakeholders have a shared vision of success and collaborate to achieve a compelling goal, where innovation is encouraged, where resources and rewards align with desired results, where results are measured and transparent, and where information is shared and learning occurs. [Mar 2018]
   
• 17.Civil Society Organization Platforms Contribute to National Immunization Programs
  From 2011-2018, Gavi, the Vaccine Alliance funded Catholic Relief Services (CRS) to establish and support civil society platforms for immunisation in 24 countries. This diverse group is made up of over 4,000 CSOs from around the world who are actively involved in working with governments to shape services, to reach communities that would otherwise be missed, and to counter the myths that make people hesitant to vaccinate their children. This document shares those platforms' best practices - e.g., around coordination. [Feb 2019]
   
• 18.Global Immunization Systems Strengthening through Pediatric Societies: The Promise of Private-Public Partnerships in Indonesia
  by Tina Q Tan, Hartono Gunardi, Sherri Smith, et al.This article describes and evaluates an initiative to build the capacity of Indonesia's paediatricians and national paediatric societies to strategically advocate for improved immunisation services across both public and private sectors. [Dec 2019]
   
• See also:
  Why We Need More Collaboration in Europe to Enhance Post-marketing Surveillance of Vaccines
  

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