Vaccination Hesitancy: An Overview

 

Using Mobile Phones for Polio Prevention in Somalia

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Vaccination Reminder Band for Pakistani Infants

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Why using polio infrastructure to support broader health services could help secure eradication

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Lessons Learned for Routine Immunisation from the Polio Eradication Campaign

Author: Sue Goldstein, May 21 2015 - "Of the 19.3 million children under-immunized with DTP-3 in 2010, 6.6 million were in Africa and 60% of those children lived in only five countries. The...

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"There is a real sense of collaboration - between the different parties that govern the country and its provinces; between the civil administration and the military; and, between the [polio...

Polio-Free India: The Role of the Social Mobilization Network (SMNet)

By Chris Morry and Kier Olsen DeVries - submitted May 5 2015 Backdrop to the SMNet Story:
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USAID and the Maternal and Child Survival Program (MCSP) support for this theme site does not reflect the views of USAID or the United States Government.

The Communication Initiative Network and Partnership convenes the communication and media for development, social and behavioural change community to share knowledge, connect, debate relevant issues, and critically review each other's work in order to advance effective development action across and between all development priorities. Contact Warren

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This TED-Ed lesson includes a focus on disease eradication efforts, such as smallpox ("the first and only human disease to be permanently eliminated [in 1980, after decades of global efforts, including household visits]") and polio, which,...

This document outlines the strategies developed by the Afghanistan Polio Eradication Initiative (PEI) programme as part of its revision of the National Emergency Action Plan (NEAP).

"[I]t has been shown that a supportive approach, where supervisors and health workers work together to solve problems and improve performance, delivers improved results for the immunization programme."

"The ease with which information can be disseminated now means that negative comments about vaccines can go 'viral' on the internet without balanced professional input. As a result, the media have found rich pickings in vaccine safety issues...

"Effective communication helps to mobilize resources for the immunisation programme and encourages other actors and organisations from various sectors and the community to participate in immunisation activities."

From the World...

"The development of an effective behavior change communication strategy requires an indepth understanding of the many stakeholder viewpoints, perceptions, and norms. There is considerable evidence that focused messages to inform parents about...

This practical guide on training facilitators to communicate about immunisation emerged from a collaborative in-service training session, held in January 2005 in Addis Ababa, Ethiopia. That training was part of an initiative developed by the...

Author: Nikhil Patil, March 9 2015 - Non-compliance to polio immunization is a major challenge to effectively reaching 100% coverage of the vaccine across Nigeria and eliminate polio transmission. One solution to address non-compliance has been...

The aim of this guide is to help health workers use their own data to identify problems and causes of low immunisation coverage and to plan solutions to increase immunisation coverage. Jointly produced by the Expanded Programme on Immunization (...

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Target Tuberculosis

Target Tuberculosis (Target TB) is a United Kingdom (UK)-based non-profit organisation established in 2003 that provides funding, support, and advice to local partner organisations in Southern Africa and South Asia which work directly with economically poor and marginalised communities affected by TB. As of December 2009, Target TB is working with partners in East Timor, India, Malawi, Pakistan, Tanzania, Uganda, and Zambia.
Communication Strategies: 

Through its projects, Target TB draws centrally on interpersonal communication to equip local people with the skills and knowledge to encourage their fellow community members to seek TB and HIV/AIDS care/services. In many efforts, the involvement of volunteers is a central strategy, and organisers note that involvement of the community in the selection of these volunteers has ensured local participation and ownership of various projects.

The following illustrations of Target TB's work illuminate the core communication strategies (for additional details, visit the Target TB website):

  • India:
    1. Target TB is working in partnership with Alternative for India's Development (AID) to bring TB healthcare and awareness to remote and marginalised tribal communities in Jharkhand and Orissa. AID has strong established relationships with communities in these regions having previously carried out sexual health and HIV control programmes for many years. Building on their community-based and -led experience, AID is integrating TB into their existing programmes. For instance: healthcare workers and community representatives are given training in TB control to improve their knowledge and awareness of TB, reduce stigma and encourage people with, or at risk of, TB to go for testing; mobile clinics provide testing and treatment services to isolated tribal communities where no other facilities are available; activities such as street drama, rallies, advocacy workshops, and regular health newsletters are used to help strengthen community participation in the campaign against TB; and advocacy workshops and regular coordination meetings are held in order to strengthen government TB control efforts and improve the quality of TB services to meet the needs of tribal communities.
    2. Target TB is working with a network of 6 local Indian NGOs in Theni district, including 1 association of HIV-positive people. With Network Theni, Target TB is: mobilising and coordinating field workers and community volunteers to carry out TB control activities; carrying out TB awareness campaigns to improve the general public's understanding of TB; working in partnership with government health services to ensure best practices for TB treatment and improving access to basic healthcare facilities; strengthening the local support network for people affected by both TB and HIV; and working in collaboration with the Maharashtra Association for Anthropological Science to carry out studies into the impact of community-based TB control programmes and civil society groups' impact. (Study findings will be used to advocate for improvements at local, national, and international levels.)
    3. Target TB has been working in partnership with Blossom Trust, a local NGO based in Virudhunugar District, Tamil Nadu, since 2007. Together, they are: mobilising and training volunteers and members of community groups in TB control and helping them coordinate TB control activities in their local communities; helping TB patients access healthcare services and provide them with home-based care and support treatment in line with Direct Observed Therapy Short course (DOTS); and conducting education campaigns to raise awareness about TB using a range of methods, such as street theatre with "edu-clowns", cable TV programmes, mobile TB exhibitions, and World TB Day activities.
    4. Target TB is working in partnership with Raphael Ryder-Cheshire International Centre for the Relief of Suffering to provide what they describe as high-quality TB testing services, comprehensive TB treatment support, and a specialised in-patient facility to TB patients.
    5. Target TB is partnering with AKS Hope, a small community-based organisation working to reduce the burden of TB in the Madrasi slums. As part of this collaboration, awareness raising camps are held in urban slum areas of Dehradun to inform people about the causes, symptoms, treatment, and prevention of TB. Also, volunteers are trained to: identify people with, or at risk of, TB, to refer people with symptoms for testing, and to provide DOTS. Finally, advice, information, and support are provided to TB patients with HIV or drug-resistant TB.
  • Malawi: Target TB is collaborating with the Sue Ryder Foundation (SRFIM) on a 3-year effort to provide information and education about TB to people in remote rural areas. During the pilot phase, Government District TB Officers provided 2 information, education, and communication (IEC) officers with training designed to foster their capacity to spread health information messages to the rural communities of Bwanje valley. The IEC officers linked up with SRFIM mobile clinics in remote rural areas where health services are limited, giving health talks at the clinics. These talks sought to educate people on the signs and symptoms of TB, to indicate where to go for testing, and to explain how TB can be treated. The IEC officers also carried out community visits which involved speaking with community leaders, as well as patients and their families. (According to Target TB, because traditional practices often provide the basis for health making decisions in Malawi, it is crucial to involve community leaders and traditional healers). The project also trained 455 volunteers to spread information about TB within their own communities by giving health talks at community meetings. The volunteers also identified people displaying TB symptoms (e.g., coughing for more than 3 weeks) and referred them to the nearest government health centre for testing.
  • Pakistan: Target TB is working in low-income areas of Faisalabad with Tamir Welfare Organisation, a local non-governmental organisation (NGO), to promote awareness about TB and to help address the human resource shortages and knowledge gaps within the existing National TB Programme. Organisers are training 500 health workers and volunteers from 50 private and public health institutions in TB management to increase TB identification and provision of DOTS treatment support. As part of this effort, lady health workers are introduced to the use of drama as a means of spreading information about TB. Health education workshops are being held in schools and amongst village leaders, supplemented by informational materials in local languages. Audio-visual equipment is also used to show films about TB and HIV.
  • Tanzania: In the Central and Southern Highland Zones, Target TB is working with the Tanzanian Network of Organizations of People Living with HIV/AIDS (TANOPHA) to strengthen HIV positive people's participation in the national response to TB and HIV/AIDS and improve the management of TB and HIV co-infection. Representatives from HIV-positive people's groups are trained on TB prevention and treatment and the relationship between TB and HIV. These representatives then disseminate this knowledge to members of their groups. They also conduct community outreach activities such as public meetings, discussions, drama, and role play to increase awareness, reduce stigma, and encourage people to access health services relating to TB and HIV. Posters and leaflets with TB messages are being produced and distributed by the HIV-positive people's groups to increase awareness of HIV and TB and encourage people to go for TB testing in their local communities.
  • Timor-Leste: Target TB is working with a local NGO, Klibur Domin, to implement a TB Outreach Programme in 3 remote rural districts (Bazartete, Liquica, and Maubara). In order to strengthen existing community and health frameworks to support national TB control efforts, organisers are: training local community volunteers on the symptoms, diagnosis, treatment, and prevention of TB; building the capacity of volunteers to help refer people in their own communities for tests and to support TB patients throughout their treatment; and training and mentoring government nurses. The project is overseen by 2 health professionals: a TB resource nurse and a TB health promoter who are responsible for developing and distributing health promotion materials to community members, local leaders, and schools.
  • Uganda: Working with the International Medical Foundation (IMF), Target TB is focusing on people living with HIV in the slum areas of Namuwongo district in Kampala. The project aims to investigate the effectiveness of a new technique, microscopic observation technique (MOT), for TB diagnosis in low-resource, HIV-prevalent settings. After a 3-month trial phase, MOT will then be used to test HIV-positive people for TB in the Namuwongo district. Community volunteer workers will be trained to provide TB outreach and support services, including health education. The volunteers will work with local community leaders to educate people living in Namuwongo district about TB.
  • Zambia
    1. Target TB has been working in partnership with Zambian NGO Bwafwano Home Based Care Organisation (Bwafwano) in the Mkushi district since 2003; a grant from Comic Relief awarded in 2007 is supporting a 5-year integrated TB-HIV programme to raise awareness of TB and HIV/AIDS and improve access to health care services for over 55,000 people. Activities include: provision of direct support to people affected by TB and HIV, including home-based care and support services, basic medicines, nutritional supplements, transport to medical facilities and opportunities for income-generating activities; training local volunteers and peer educators, ensuring they are able to respond effectively to the needs of people affected by TB and HIV in their communities; conducting health talks, street dramas, mass awareness raising events, and establishing patient support groups; and establishing sustainable community networks to highlight and respond to the needs of people affected by TB and/or HIV, through collaboration with government health staff, other NGOs, and community-based organisations.
    2. Since 2001, Target TB has been working with the Zambian NGO Zatulet; in 2007, Target TB was awarded a grant from The Big Lottery Fund to implement a 5-year project with Zatulet. The project involves highly motivated and committed volunteers who work from 8 branches, across 4 provinces of Zambia. Key goals include empowering communities with the knowledge and skills to prevent and treat the disease, increasing people's access to TB testing and treatment services, improving the welfare of people affected by TB, and raising awareness in the wider population. Outreach activities in the local communities identify people with TB symptoms and refer them to the nearest testing and treatment centre. Also, organisers are providing home-based care and support for people affected by TB, including monitoring treatment adherence, providing psychosocial counselling, helping with household chores, and establishing TB/HIV support clubs. Trained volunteers inform the public about TB and HIV through activities such as health talks, street drama, one-to-one counselling, and large-scale awareness raising events.

The Target TB website provides information and resources such as a resource pack for teachers to use primarily with pupils aged 13 years or older. Target TB believes that it is particularly useful for the Citizenship programme of study. It features a lesson plan complete with a choice of suggested activities and resources, as well as comprehensive teachers' notes, follow-up ideas, and online resources about TB in the Global South.

Development Issues: 

Tuberculosis.

Partner Text: 

AID, AKS Hope, Blossom Trust, IMF, Klibur Domin, Network Theni, Raphael Ryder-Cheshire International Centre, SRFIM, Tamir Welfare Organisation, TANOPHA, and Zatulet.

Contact Information: 
Source: 

Target Tuberculosis website on May 4 2006, March 16 2007, and December 7 2009.

Report of a WHO Consultation on Strengthening the Active Engagement of Civil Society Organizations in the Global TB Prevention, Care and Control Efforts

Author: 
Haileyesus Getahun
Publication Date
October 1, 2010
Affiliation: 

Stop TB Partnership

This report summarises results of a World Health Organization (WHO) consultation, September 30 - October 1 2010, Geneva, Switzerland, on civil society engagement in global tuberculosis (TB) prevention, care, and control efforts. The meeting participants represented international, national, and local non-governmental organisation (NGO), faith-based organisation (FBO), community-based organisation (CBO), and patient-based organisations working on health and development, patient support, and advocacy.

Source: 

Stop TB Partnership website, January 20 2011.

AIDS, Population, and Health Integrated Assistance Programme North East Province (APHIA II NEP)

APHIA II NEP is a five-year (2007-2012) project between the Government of Kenya and the United States Agency for International Development (USAID), funded through an associate award to the Extending Service Delivery (ESD) Project and managed by Pathfinder International. The project was set up to provide improved and expanded sustainable HIV/AIDS and tuberculosis prevention, treatment, care, and support together with integrated reproductive health and family planning services.

Communication Strategies: 

The programme focuses primarily on three main areas: improved and expanded facility-based HIV/AIDS, tuberculosis and reproductive health/ family planning; expanded civil society activities to increase health behaviour; and expanded care and support for people and families affected by HIV/AIDS.

To achieve these objectives, the project uses a three-pronged approach tailored to meet the specific needs of the region's mainly pastoralist population. Firstly, it focuses on improving and expanding facility-based services by addressing gaps in resources, training and equipment; expanding nomadic clinics; and strengthening the management capacity of local organisations. Secondly, the project is working to expand and strengthens civil society activities by conducting outreach with community and workplace programmes, and reinforcing networking between clinics and communities. Thirdly, APHIA II NEP works to expand care and support services for people living with HIV/AIDS, orphans and vulnerable children, and works with religious and community leaders to reduce stigma and discrimination.

According to the project, people with HIV/AIDS have been highly stigmatised in the region, so the project's community outreach component focuses on behaviour change communication, which includes tailored messages to increase sensitivity and acceptance, and help prevent further infection.

HIV counselling and testing approaches that maximise confidentiality and convenience have been key to improving accessibility and acceptance of HIV testing. This includes the moonlight voluntary counselling and testing (VCT), where staff travel at night to bars and other locations where sales of alcohol and miraa, a type of amphetamine, take place. Counsellors bring a tent and create a temporary worksite, providing counselling, education, and testing in a convenient and discreet environment.

In addition, to reach the province's youth, the programme has trained peer health educators who lead "Chill Clubs" at 60 schools in the province, and promote abstinence, HIV/AIDS awareness, and sexual and reproductive health.

Programme staff have also assisted in the development of a pilot project - Care for the Mother - around safe motherhood and infant health. APHIA II NEP staff participated in a knowledge, attitudes and practices survey, and helped identify four women's groups to champion dissemination of information on safe motherhood and newborn care, increase the uptake of child spacing services and improve health in the region. Project staff also assisted in developing a low literacy curriculum for the project that is used to upgrade knowledge while teaching mothers to educate their community members about antenatal care, safe delivery, postnatal care, healthy timing and spacing of pregnancy, prevention of mother-to-child transmission of HIV, and voluntary counselling and testing.

The APHIA II website houses information, video clips, and a discussion forum related to the project.

Development Issues: 

HIV/AIDS, Reproductive Health,

Key Points: 

According to the organisers, some of the major accomplishments of the project include, but are not limited to: 14,295 new family planning acceptors; 79 service delivery points providing family planning counselling or services; 182 people trained in family planning/reproductive health; over 100,000 individuals counselled and tested; 60 Chill Clubs established; and partnerships with the National Organisation for Peer Education (NOPE), as well as religious leaders, parents, youth, business people, and civil servants to initiate a communications strategy to reduce HIV/AIDS stigma in the province.

In the future, the project plans to roll out the Standard Days Method using Cycle-Beads; emphasise post-training follow-up; continue support for and expansion of the integrated outreach services; identify and support orphans and vulnerable children - particularly girls - through people living with HIV groups; continue to strengthen couple counselling, as well as mobile, house-to-house, and moonlight VCT outreach activities; continue support for tuberculosis/HIV screening and multi-drug resistant TB surveillance; and complete Care for the Mother training for three remaining women's groups.

Partner Text: 

Government of Kenya, USAID, Extending Service Delivery (ESD) Project, Pathfinder International, Intrahealth, Management Services for Health, and Meridian Group International, Inc.

Source: 

ESD Country Brief: Kenya (PDF) on January 6 2011.

Interpersonal Communication and Counseling for Clients on Tuberculosis and HIV and AIDS

Publication Date
Publication Date: 

September 2009

This training curriculum for tuberculosis (TB) health care workers in Ukraine introduces principles of interpersonal communication and counselling of clients on TB and HIV. It provides a framework for the development of experience in TB and HIV counselling skills in a three-day workshop.

Publisher: 
Source: 

Stop TB Partnership website, December 28 2010.

Networking for Policy Change: TB/HIV Participant’s Guide

Publication Date
Publication Date: 
December 1, 2007

This document is a participant's guide for training on tuberculosis (TB)/HIV advocacy for policy change and includes background information on TB and HIV and further reading on networking, collaborati

Number of Pages: 

29

Contact Information: 
Source: 

Stop TB Partnership website, December 13 2010.

TB Activist Toolkit - TB Basics Module

The “TB Basics Module” provides activists with fundamental information about tuberculosis in order to strengthen advocacy and scientific literacy around TB and TB/HIV.

Publisher: 
Number of Pages: 

18

Contact Information: 
Source: 

Email from Soul Beat Africa to The Communication Initiative on July 20 2010.

Audio Slideshow: Coughs and Sneezes...

Author: 
Laragh Gollogly
Publication Date
August 9, 2010
Affiliation: 

World Health Organization (WHO)

In this audio slideshow posted on the British Broadcasting Corporation (BBC) website, Dr.

Contact Information: 
Source: 

Emails from Ellyn Ogden and Laragh Gollogly to The Communication Initiative on September 17 2010 and September 24, respectively.

Community Involvement in Tuberculosis Care and Prevention: Towards Partnerships for Health

Subtitle: 
Guiding Principles and Recommendations Based on a WHO Review
Publication Date
December 1, 2008

This World Health Organization (WHO) publication provides a series of recommendations, based on the principles of social justice, for promoting the involvement of people with tuberculosis (TB) and the

Contact Information: 
Source: 

WHO website, September 9 2010.

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