Analysis: Polio eradication in Nigeria

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Nigeria: Kick Polio Out of Africa campaigners/Photo:GPEI

Communication interventions in Nigeria have proven to be a vital part of the polio eradication effort. The success of the polio communication efforts can be verified by the 12% reduction in the number of missed children, as the well as the increase in overall coverage.

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New communication strategies have played an important role in reducing the number of wild polio virus cases (WPV) to 80% under the 2006 level. For example, thousands of children in high risk states were reached in Koranic schools, through child-to-child and youth outreach participation programmes. A series of community dialogues, in partnership with the Federation of Muslim Women Association of Nigerian (FOMWAN) mobilized 313 schools, sensitizing 685 teachers. FOMWAN also played a role in 76 ceremonial events that reached 4,831 women. In the ensuing house-to-house mobilization, over 72% of non-compliance cases were resolved, evidence that the increased mobilization efforts were effective.

The communication efforts were developed based on the results of the 2006 desert survey, which identified numerous factors affecting immunization rates, such as the reasons families refused treatment, the source of the families information and the factors influencing the family decisions. The data provided insight into how to develop and deploy effective communication initiatives that reached specific communities.

In November 2007, recording and monitoring forms used during polio immunization activities were revised to provide additional communication data. One of the modifications provided information on the reasons for why children were absent from the home. This directly addressed the main reason why children were missed in recent immunization rounds. The resulting human resistance analysis proved central to the effective deployment of resources.

The additional information guided operational and communication interventions to increase their overall coverage in the highest risk areas. In early 2008, both national and state-specific social mobilization plans were developed and implemented to increase media coverage and community leader involvement.

National efforts began with a forum of traditional religious leaders and the media to establish support for upcoming immunization rounds. The forum created a list of action points that included:

  • asking the Sultan for an additional commitment to the polio eradication;
  • engaging the Governor of Borno State to address the challenges of local anti-polio preaching;
  • sending a letter in Arabic to all Koranic Schools informing them of the coming round of immunizations;
  • enlisting the assistance of Islamic Voluntary Aid workers who are attached to Koranic schools’ vaccination teams; and
  • increasing the radio and television exposure for Ministry of Religious Affairs officials.

A national mass media operational plan was developed in April 2008 that re-established a media sub-committee and created a new organization, Journalists Against Polio. To compliment town announcements, Mobile Van Announcements were introduced in high risk areas.

Efforts to improve documentation and data evaluation processes were also bolstered. Human interest stories will be regularly generated to keep the public aware of and connected to both the importance and success of the Polio Eradication Initiative. The World Health Organization (WHO) will continue performing communication analyses following the supplementary immunization activities (SIAs). Community Dialogue Audits and the Annual KAP Study will continue and UNICEF will publish quarterly EPI updates to keep partners and the public aware of progress.

Refusal Trends

Vaccine refusals in Nigeria have been declining steadily in high risk states, but continue to be a concern as a small number of noncompliant households can quickly become a major issue if not addressed. The Nigerian polio eradication team has recently started tracking noncompliance in the northern states that are most at risk for wild poliovirus transmission.

These maps, created by the UNICEF Nigeria country office, offer insight on where communication interventions need to target noncompliance issues.

These maps, created by the UNICEF Nigeria country office, offer insight on where communication interventions need to target noncompliance issues.

UNICEF Image
© UNICEF/Nigeria
UNICEF Image
© UNICEF/Nigeria
UNICEF Image
© UNICEF/Nigeria