Nine west and central francophone African countries (Benin, Burkina Faso, Cameroon, Chad, Cote d’Ivoire, Guinea, Mali, Niger, and Central African Republic - RCA) participated in the Consultative Technical Committee Meeting on communication for poliomyelitis eradication that took place in Yaounde from June 22nd to 24th 2005. Please click here for presentations from that meeting. Since that time, The Communication Initiative has worked to support the collaboration of and exchange of information between the nine countries in support of implementation of the recommendations from that meeting.

This collaborative work was technically conducted through new information and communication technologies and was supported by the United Nations Children's Fund (UNICEF) West and Central Africa Regional Office (WCARO). Of the nine countries concerned, eight manifested both in the follow-up of the communication plans and the implementation of the recommendations. A report on progress through September 2006 is below.

GUINEA

In partnership with the Expanded Program of Vaccination of the Ministry of Public Health and the Country Office of the World Health Organization (WHO)/Guinea, UNICEF undertook an important action in the framework of reinforcing the role of communication in the implementation of routine vaccination and Polio eradication strategies. Among these the following can be sited:

• Recruitment of a POLIO/EPI Communication Consultant and the designation of a communication focal point at the Vaccination Programme.
  
  They are in charge of coordinating activities, revising communication activities in matters of EPI and the eradication of poliomyelitis in Guinea with the active implication of all the active national and international partners.
• Undertaking a behavioural study on communication as regards to vaccination.
  
  This will help in the collection and the analysis of knowledge, perceptions and preoccupations of parents in view of identifying their educational needs from which communication objectives will be derived, pertinent approach and communication strategies will be defined to better stimulate the demand and the continuous utilisation of services and products of vaccination. The results of this study shall be available at the end of October 2006.
• The organisation of a pre-campaign supervision week for the third round of the vaccination campaign against Maternal and Neo Natal Tetanus (MNT) in eight districts.
  
  Following the analysis of the strengths and weaknesses of the previous vaccination campaigns, especially concerning communication, partners decided to organise a preparatory week for the third round of MNT in March 2006 in the eight high risk districts; during that week, the following interventions were implemented:
  • reinforcement of the involvement of administrative and community leaders
  • reinforcement of the usage of rural community radios
  • reinforcement of the participative involvement of the civil society (NGOs and local associations)
  • reinforcement of interpersonal communication skills of vaccination teams on the management of Post Immunisation adverse effects

  This supervision week activities contributed to the improvement of the campaign performance as compared to the two previous rounds.

• Improvement of vaccination visibility through a national generic mark (promotion/marketing)
  
  In order to polarise the public attention on vaccination in Guinea, the main EPI partners admitted that it was useful and necessary to reinforce the generic mark of vaccination. Before then, the EPI logo was only the WHO common symbol of vaccination; the new generic mark proposed has three exciting elements:
  • the EPI logo improved and readapted to the socio-cultural context of Guineans;
  • a nationwide generic song; one of the sequences of this song will serve as a musical support to all electronic messages (radio and TV); and
  • a leading slogan.

  On the basis of an open tender, a special agency was chosen for the conception and realisation of the new generic mark; it is certain that the product shall be exploited in the next vaccination campaign against measles scheduled for next November.

• Contact Bulletin
  
  In the framework of regular exchange of information on the greater EPI activities with the different actors, a contact bulletin is edited monthly by the EPI with the support of the WHO Guinea country Office.
• Increase of the performance of the Expanded Programme on Immunisation
  
  Important progress was accomplished thanks to the implementation of the << Reach each district approach >> at the end of December 2005 the cumulated vaccination coverage rate for DPT3 was 86% while in 2004 it was 69%. No prefectoral division registered a DPT3 vaccination coverage rate of <50%, nine (9) were between 50 and 70% and twenty nine (29) had 80% and above.

Guinea Contacts:

Almany Barry: abarry@unicef.org

Diallo Mamadou Rafi: rafi@biasy.net

MALI

During the first semester of 2006, Mali took actions aimed at reinforcing the communication component of the EPI such as:

• The organisation of three vaccination workshop pools for the validation and the harmonisation of social mobilisation tools in April and May 2006.
  

  These workshops concerned all the actors charged with the planning and implementation of communication activities at the level of the eight health regions of the country plus Bamako district. These workshops enabled:

  1. the sharing of some successful experiences on matters of communication such as:
     
     • the communication on support of routine EPI experienced within the framework of the strategy for the acceleration and the development of child survival.
     • the organisation of synchronised discussions with the participation of religious leaders, traditional heads, political, administrative and health authorities;
  2. to share and validate communication and social mobilisation plans with regards to Polio NIDs and routine EPI.
  3. to conceive and to validate the following communication tools: elements of Interpersonal Communication (IPC) for vaccinators, guidelines for IPC for routine EPI, polio and other vaccination campaigns; a multimedia outline for messaging on vaccination as well as a follow-up plan; a logical framework for the elaboration of an operational EPI communication plan.
• The organisation of a workshop aimed at validating a guide for messages on vaccination from the 7th to 11th August 2006.
  
  This workshop contributed in reinforcing the skills of the actors in charge of implementing the communication activities on the field but especially to put at the disposal of the former, appropriate tools to better inform, sensitise and help the population to adhere to vaccination.

Mali Contacts:

Nchamoun Chouaibou: cnchamoun@unicef.org

Coulibaly Abdoulaye Nene: anene@afribone.net.ml

CAMEROON

Within the first semester of 2006, the EPI communication team of Cameroon undertook high-level advocacy, concretised partnership in view of effective social mobilisation and a communicational support during the two rounds of the local immunisation days (LIDs) against poliomyelitis.

• Organisation of advocacy missions in the ten provinces of the country.
  
  In view of arousing a more constant and sustained engagement of administrative, political and the other national authorities, the Ministry of Public Health with the support of WHO and UNICEF organised during the first trimester of 2006 missions led by central senior officials to the ten provinces of the country. These missions held meetings regrouping all the authorities of the provinces and presided over by the Governors gave the occasion to the officials from the Ministry of public health, to clarify some misunderstandings that cropped up on the different operational strategies of the EPI and especially to explain the relationship between the Supplementary immunisation Activities (SIAs) against poliomyelitis and routine vaccination.
• Consolidating partnership between the Vaccination Programme and the rural and community radio networks of Cameroon.
  
  In the framework aimed at promoting a better media coverage of vaccination activities and of continuous sensitisation of the populations on vaccination, the Central Technical Group of the EPI of Cameroon signed partnership conventions with 40 rural and community radios throughout the country.
• Experiencing a community-based communication approach in favour of polio eradication and Maternal and Neonatal Tetanus (MNT) elimination.
  
  During the Local Immunisation Days (LIDs) against polio (February and April 2006), and the two rounds of the vaccination campaign against the MNT in June and August 2006, the EPI of Cameroon with the support from UNICEF carried out a pilot experience on focusing communication intensive interventions in some health districts retained according to some priority criteria; the experience consisted in:
  • involving authorities and other local leaders as well as non-governmental organisations and associations in the sensitisation of the population in favour of vaccination;
  • involving community local front line workers (social mobilisers) in the sensitisation of the population on vaccination in a home-to-home basis after proceeding to an account of the target population.

  The following results were recorded from this experience:

  • 86% of the target population were counted by mobilisers through the door to door strategy;
  • 4% of the population were not informed about the vaccination campaign;
  • 77% of the population were informed about the disease against which vaccinations were being carried out; and
  • the main sources through which the population was informed on those campaigns were: Local mobilisers (82.8%), Radios (24.8%), Churches and Mosques (13%), Television (4.2%).

Cameroon Contacts:

Martin Engoulou: mengoulou@yahoo.com

Efangon Awomo: efawomo@yahoo.com

COTE D'IVOIRE

Two major activities were realised concerning communication in Côte d'Ivoire in 2006; a national integrated communication strategic plan was elaborated and an external EPI review was conducted with a communication component.



The Elaboration of a national Integrated Strategic EPI Communication Plan

Following the recommendations of the technical consultative meeting on communication for polio eradication held in Yaounde from the 22 to 24 June 2005, Côte d'Ivoire elaborated with the participation of development partners, representatives of other priority programs and civil society organisations, an EPI integrated communication strategic plan; this plan was shared with The Communication Initiative Team that gave some orientations for its improvement. Considering the fact that the external review of the Côte d'Ivoire EPI was organised after the elaboration of this integrated communication strategic plan (July-August 2006), the EPI communication team intends to revise it in order to take into account the recommendations of the said review.

External review of the EPI communication component.

The Ministry of Public Health supported by the WHO, UNICEF and the Preventive Medicine Agency (l'Agence de Médecine Préventive - AMP), organised the external review of the EPI. This review covered the following aspects: institutional and financial aspects of the EPI, vaccination coverage, operational and logistic management of the EPI, communication/advocacy and social mobilisation.

There was a need to assess the real communication, social mobilisation and advocacy situation of the vaccination programme in Côte d'Ivoire because of two main reasons:

• during the 2001 review, this aspect already presented many deficiencies
• the socio-political crises had a major impact on the country's health system

The external review of the communication component aimed at analysing the communication, social mobilisation and advocacy aspects in favour of the EPI and proposing sound recommendations.

The methodology used had as a reference frame:

• a Communication for Development conceptual model that was adopted for the EPI by UNICEF, WHO, BASICS and the Rotary Club (2003) which is found in the communication guide for the elimination of poliomyelitis and the routine EPI
• the communication methodology for health developed by BASICS and USAID
• the Global Immunisation Vision and Strategy for 2006-2015 (GIVS) approved during the 58th World Health Assembly in April 2005 (see doc 58/12 Add.1).

The review was conducted through a survey carried out at the central, regional and peripheral levels (literature review, interviews with central, regional and divisional level health authorities and development and local partners and focus groups targeting parents of both sexes at the level of the councils).

Important recommendations coming out from this review are in a nature to rationalise and reinforce the communication component of the EPI of Côte d'Ivoire; these recommendations come from domains such as: reinforcing institutional, managerial and financial aspects of EPI communication, improving advocacy, social mobilisation, better organising community based communication interventions and empowering and increasing community ownership of EPI communication.

The formulated recommendations shall be exploited in the framework of the elaboration of the communication component of the Combined Multi Year EPI Plan (CMYP).

Côte d'Ivoire Contacts:

Siguifota Ouattara: ouattarasiguifota@yahoo.fr

Ziao Cyrille: amcziao@yahoo.fr

Aristide Aplogan: aaplogan@aamp.org

Dominique Kondji Kondji: kondji2002@yahoo.fr

Epa Kouakou: ekouakou@unicef.org

Maya Vandenent: mvandenent@unicef.org

TCHAD

During the first trimester of 2006, Chad lead an experience on a preventive and curative management of polio campaign refusal cases in a health region and undertook a small survey on the knowledge and perceptions of parents on polio and Oral Polio Vaccine (OPV) .

The experience of the preventive and curative management of refusals in the Western Mayo Kebbi health region in Chad

Following the notification of a wild polio virus case in Pala in the western Mayo Kebbi health region in December 2005, the EPI management in agreement with its traditional partners (WHO and UNICEF) decided to reinforce the communication strategies and activities in this region during the polio NIDs round of April 2006.

As such, the preventive and curative management experience of refusals that was previously successfully conducted in N'djamena Centre health district, was applied in the above region by the regional health team which benefited from the support of administrative, political, traditional and municipal authorities as well as the technical support from two communication consultants of UNICEF and one epidemiologist from WHO.

The strategic approach of the experience was based on:

• increasing traditional leaders, local religious and women groups responsibility on the local management of known cases of refusals; the intervention of administrative authorities before and after the campaign was forbidden.
• the identification and numbering of cases of refusal in households and compounds by local leaders.
• the organisation of the campaigns with the full participation of local leaders, and the administrative authorities; the coordination of community based social mobilisation and the management of refusals cases were taken care of by the mayor of the rural council of Pala; the health authorities took care of technical support.
• the holding of meetings in socio-cultural communities by traditional chiefs on the campaign.
• a door to door sensitisation before and during campaign by community mobilisers appointed by traditional and religious leaders (people from the same community).
• carrying out of negotiation sessions before the campaign with families known to refuse vaccination by the local leaders.
• sensitisation through community radio (Radio Soleil of Pala) with announcements from influential dignitaries in local languages and witnesses of parents whose children had been affected by the wild polio virus detected in Pala in December 2005.

During this experience, 154 cases of refusals were censured in the Pala district and all were convinced and accepted to let their children be vaccinated after negotiations and sensitisation; the total number of children vaccinated after negotiation was 294 in Pala district. It has been noted that many cases of refusal are due to a lack of interpersonal communication with parents and misconduct of vaccination teams.

The realisation of a survey on parents' knowledge and perception in relation to polio and OPV

During the March 2006 polio NIDs, the Chad EPI communication team with support from UNICEF communication consultants, carried out a survey on knowledge and perceptions of parents in relation to poliomyelitis and oral polio vaccine in 9 of the 18 health regions that comprise this country; this survey revealed for instance that:

• 69% of parents knew the minimum age when a child must start receiving oral polio vaccine.
• 59% of parents consider that oral polio vaccine has no danger on children against 41% that find it dangerous.
• 57% of parents interviewed think that polio NID replaces the routine EPI.

TChad Contacts:

Garba Tchang Salomon: garbasal@yahoo.fr

Achta Abderamane Aboubakar: aabderamane@unicef.org

Kunjbe Kodio Freddy: kkfreddy@yahoo.com

NIGER

The Niger EPI Communication team have elaborated, during the first trimester of 2006, an EPI national communication plan that is a component of the EPI national strategic plan.

Niger Contact:

Elhousseynou Dia: diaelhousseynou@yahoo.fr

BURKINA FASO

Planning and advocating for the introduction of a new vaccine (pentavalent) in the EPI

Burkina Faso had during the year 2006, elaborated an EPI communication plan, a plan for the introduction of a new vaccine (the Pentavalent); an illustrated pamphlet of the introduction activities of this new vaccine was edited. In the framework of the introduction of the pentavalent vaccine into the EPI of Burkina Faso, the Ministry of Public Health undertook with the support of UNICEF and WHO, high level advocacy activities and social mobilisation actions in order to gain support from the high authorities of the country.
The following can among others be sited:

• the official launching of this initiative took place on January 12,2006 under the patronage of Chantal Compaoré, wife of the President of Burkina Faso who is the NIDs godmother of that country;
• the organisation of an advocacy meeting with religious and traditional leaders; and
• the holding of a press conference uniting close to 39 journalists representing 23 press organs.

All the documentation produced on this occasion was shared with The Communication Initiative team.

Burkina Faso Contacts:

Sorgho Miyeba: miyebas@yahoo.fr

Modeste Yaméogo: myameogo@unicef.org