[Re: https://www.hifa.org/dgroups-rss/polio-vaccine-communication-12-national... ]
Dear Neil,
I guess that anyone in charge of polio communication should ask themselves the questions your raised. When I am asked about the communication strategy I would propose for any health program, I like to answer “I don’t know, let’s see what the target population thinks.” There is no one-size-fits-all communication strategy. Here are some clues to address your four questions.
1. For sure different settings require different approaches. Vaccination depends not only on vaccines, the cold chain, logistics, human and financial resources; it also relies on the population’s adherence to each specific vaccination program. Assessing adherence and analyzing any sign of mistrust should be considered as important as planning an efficient cold chain. This assessment will lead to the design of an adapted communication strategy or might lead to recommendations to change the vaccination program’s approach.
2. NIDs are appropriate in some settings provided that the population adheres to them (for example to control an outbreak of polio caused by vaccine-derived viruses or imported wild viruses). They are inappropriate in areas where a significant part of the population is hostile to them.
3. After more than 20 years of distrust and hostility in some areas –hostility used and fueled by Boko Haram or the Taliban—I do not think that any change in the NIDs would improve the situation. Unfortunately, it is much more easier to lose trust than to win it back. The Global Polio Eradication Initiative has engaged traditional and religious leaders in the campaign, without securing sufficient buy-in from the population.
4. Various studies (including some I conducted in West Africa) show very high adherence of the population to the expanded program on immunization (EPI) worldwide, including in places where there is a substantial distrust of NIDs. This is a major strength from a communication perspective. Virologists, pediatricians and public health specialists are competent to evaluate the logistical strengths and weaknesses of EPI and make relevant proposals.
The communication strategy for any public health program, including vaccination, should be based on what I call the “health culture” of the target population regarding the health issue at stake. The “health culture” includes knowledge and perceptions of the issue and of the public health campaign’s promoters.
Best wishes,
Bernard
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HIFA profile: Bernard Seytre is a Consultant at BNSCommunication in France. Professional interests: Health communication and education. seytre AT bnscom.fr