In June 2004, a group of independent communication and epidemiological experts met in New Delhi, India to present to each of the polio-endemic countries their recommendations for improving the effectiveness of its polio social mobilisation/communication programmes. (Click here to access documents from this meeting.) In early 2004, Egypt's Ministry of Health and Population (MOHP) had approved a national, UNICEF-supported communication plan for polio; the experts reviewed the effectiveness of the strategies implemented so far, their linkage to epidemiological data, and next steps (both within the following 6 months and until the end of 2005). Their key recommendations for Egypt were:

1. "Conduct, if not available, an assessment of the profile of the missed children, misconception and refusals' reasons and [Knowledge, Attitudes and Practices] KAP gaps in order to refine the strategies applied and messages used. TIME: Immediately
2. Strengthen the institutional capacity / skills and staffing within MOHP both on the central and local levels: TIME: Within one month
3. Refine the community strategy for high risk areas based on the above activities. TIME: within 2 months".

This 27-page review presents a revision of the MOHP's polio social mobilisation plan, based on these recommendations. To begin, the author lists revised objectives toward the overall goal of supporting the interruption of virus transmission. These objectives include identifying and profiling children who have been "missed" (not immunised) and articulating the reasons for vaccination refusals. The MOHP will also strive to maintain a high level of public awareness of the National Immunization Days (NIDs) at current rates (above 95%) and to maintain current positive attitudes and practices toward immunisation during NIDs (above 95%). Finally, organisers will work to maintain and improve the positive motivation of caretakers in specific regions of Egypt (e.g., both upper socio-economic status areas and slum areas of Greater Cairo, as well as those in pockets of virus circulation) with children between the ages of 0 and 5 years to immunise their children during the NIDs.

This paper also presents an updated list of priority activities and a number of annexes that detail specific communication strategies for carrying out these activities. In sum, these activities are to include:

• Strengthening partnership - activating the Interagency Coordinating Committee (ICC) Social Mobilization Committee to work together on various action points to the end of effectively carrying out advocacy events such as the launch of the NID by the First Lady.
• Developing a research agenda - conducting analysis and evaluation in an effort to better understand the situation (e.g., why children are being missed) and to move forward more strategically (i.e., by developing clear and specific indicators concerning advocacy, community mobilisation, public mobilisation, and training and capacity building).
• Galvanising mass media - making immunisation a visible social cause by - for example - involving celebrities, airing spots on strategic channels, developing creative press ads before each campaign, erecting strategic billboards, and offering social club events.
• Improving the Interpersonal Communication (IPC) skills of vaccinators - tailoring training to each groups' needs, which might include handling resistance, refusals, misconceptions, and rumours; defining community needs; building awareness among caretakers about the NID; community networking; and emergency communication plans on the district level.
• Conducting community outreach in high-risk areas - mapping and defining needs of the various communities and available resources. Then engaging non-governmental organisations (NGOs) and coordinating with health offices. Third, conducting training of NGO awareness volunteers. Fourth, implementing pre-campaign awareness activities such as mapping the areas, conducting home and group visits, using megaphones, and hosting community meetings/local launches. Finally, motivating volunteers by organising an award event to reward the best performing team/district.
• Providing institutional support to the MOHP - hiring additional staff (detailed in the annexes).
• Synthesising private physicians in collaboration with the medical syndicate.
• Printing of information, education, and communication (IEC) materials (a fact sheet and a Q&A brochure) and reprinting of posters, register books, and stickers (house marks).