Presented at: The Technical Advisory Group (TAG) Meeting on Communication for Polio Eradication

Presented by: Dr. Samira Mohamed, Federal Ministry of Health (FMOH)

This PowerPoint presentation was part of a June 2005 joint United Nations Children's Fund (UNICEF)/World Health Organisation (WHO) meeting dedicated to examining communication in the context of the final global push to eradicate polio. At this meeting, country-specific presentations were made by communication practitioners in 16 of the 21 countries which have experienced cases of wild poliovirus in 2004 and/or in 2005 (to June). The total number of global poliovirus cases increased from 784 cases in 2003 to 1,255 cases in 2004, with 1,004 cases reported to August 9 2005 (548 for the same period in 2005). Communication strategies presented at this meeting were primarily focused on:

1. Analysing the results of programmes implemented to June 2005, and
2. Detailing the planned communication programme for the next 6 to 12 month period, designed to support a reversal of the above trend and achievement of the goal of eradicating polio worldwide.

According to this presentation, Sudan (one of 6 countries with re-transmission) experienced 127 cases of poliovirus in 2004 after having previously stopped poliovirus circulation for three years (from April 2001 to April 2004). In 2005, (to June), 3 cases of poliovirus have been reported.

Factors contributing to the re-introduction of poliovirus are listed as including:

• Cessation of NIDs (National Immunisation Days) after 2002;
• Low routine immunisation coverage;
• Open international borders (Chad, Central African Republic);
• High population movement (Darfur Internally Displaced Persons (IDPs), pilgrims);
• Peaceful environment in Southern Sudan;
• Introduction of the Wild Polio Virus (WPV) during the high transmission season; and
• Insecurity.

From April 2004 to May 2005, 6 NID campaigns have been conducted. Sources of knowledge for the May 2005 NIDs were identified as being from radio (53%), television (21%), megaphone (17%) and other (8%). Within the 53% with access to radio, geographical disparities are identified, with central states identified as being "media rich" (91% access), and southern states identified as being "media poor", (15-22% access). Community radio listening groups were also engaged to provide a forum and opportunity for community dialogue on polio.

Various other media are also being developed. One example is folk media such as songs for children and adults produced in audio tapes, which are to be mounted on video vans and played. Dramas and skits are also under development.

Identified high-risk areas include: transit & border points; way stations for returnees; internally displaced person (IDP) camps; homeless urban populations (ie. construction site dwellers); temporary workers and nomadic groups. Access to these populations is also challenging due to difficult terrain and a poor transportation infrastructure.

A summary of the situation in Southern Sudan was also provided, indicating that Wild Polio Virus (WPV) transmission has been reestablished for P1 and P3; that gap areas for Acute Flaccid Paralysis (AFP) surveillance in the Upper Nile region have been identified, and that, unlike in the North, supplementary immunisation activities (SIAs) have been continuous in Southern Sudan since 2000.

In January 2005, a peace agreement was signed between the North and the South which allowed for increased access to populations (+27% since 2002), and a recognised official counterpart in both regions. However there remains some insecurity due to inter-tribal and rebel fighting. Risks specific to the South therefore include:

• Isolated and scattered populations;
• Limited access due to security and logistical reasons;
• Limited education/training of staff/population; and
• Different tribes and cultures.

Communication strategies to address these challenges are underway, including: advocacy with local leaders and the United Nations (to improve security & access); advocacy with non-governmental organisations (NGOs) and the UN (to improve logistics); training and awareness campaigns; and identification, mobilisation and training of local human resources to improve contact with various tribes and cultures.

Click here [1] to download the full PowerPoint presentation as a PDF file.