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

Importance of Public Health Education: Polio Immunization in West Africa

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 non-acceptance

Impact of Negative Communication

0

10

20

30

40

50

60

70

80

90

100

J-02 M M J S N

J-03 M M J S N

J-04 M M J S N

J-05 M M J

Num

ber o

f cas

es

WPV1 WPV3

OPV controversy

Negative communication about polio vaccine in Nigeria:

• Decreased acceptance of vaccine

• Increased number of polio cases

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

•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

Focus: Reaching every child with polio vaccine

Use of data for public health education

Source of information in selected states

0.0

10.0

20.0

30.0

40.0

50.0

60.0

Town C

rier

Radio TVMosqu

e/ChurchHealth

Work

erTraditio

nal Instit

ution Other

Not Aware

of the C

ampaign

KanoNigerLagos

Benue

OPV Safety

Child Sick

Religious Belief

No Felt Need

Political Difference

No care giver consent

Unhappy with ImmunizationpersonnelToo many rounds

Reason Not given

Non-Compliance Data

Key communication elements for building support for immunization

Grassroots

Media/Public Awareness

Policy Change

• 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

Intensified Advocacy and partnerships

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

87500

90000

92500

95000

97500

100000

Nov 04 Feb 05 May 05

No.

of H

ouse

hold

s

Results – increase in coverage

< 80% reported Cov

80-89% reported Cov

> 90% reported Cov

April 04 Community Mobilisers deployed in VHR LGAs, August 2004

October 04

May 05

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