The Drum Beat 542 - Health Communication: Polio Lessons
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Health Communication: Polio Lessons
Journal of Health Communication: International Perspectives, Volume 15, Supplement 1
As part of its polio programme funded by the United States Agency for International Development (USAID), The CI has recently coordinated the publication of a supplement in the Journal of Health Communication (JOHC) which focuses on health communication lessons from the polio experience.
The editorial and papers in the supplement argue that the polio eradication experience provides a rich source of health communication knowledge. And yet, it is one that remains relatively unexamined. The supplement takes a small step towards drawing out some of the lessons and looking at what these experiences have to say to the wider field of health communication. They focus on a series of tensions and the manner in which the polio programme has dealt with them - tensions like:
- Short-term expectations / long-term change processes
- Pursuing a global agenda / local priorities and perceptions
- Using coherent and consistent messages / responding to contex
- Retaining global support / the reality of a complex and slow process
- Working in a data-rich environment / building a culture to use that data
The papers show that these and other tensions and the responses to them reveal lessons that may help inform future eradication efforts now under consideration, such as measles and malaria, and provide essential reading for health communication, generally. More immediately, these lessons may benefit the polio programme itself as it faces the enormous challenges of first interrupting polio transmission and then eradicating it - challenges generated by the need to maintain intensive and effective campaigns and immunisation activities in the face of ever-decreasing infections and levels of perceived risk. This supplement was prepared with the following goals in mind: to add to our understanding of the role communication has played within the polio programme, to provide some insight into the challenges ahead, and to contribute to the larger health communication discourse.
The articles within this JOHC supplement are available free of charge for the next 6 months (until November 7 2010). After that time, they will only be available for purchase.
FOREWORD
1. Immunizations: Building on Success in the 21st Century
by Scott C. Ratzan
"The Journal of Health Communication: International Perspectives has had a number of articles over the past 15 years dealing with immunization. It is clear to most of us - whether in public health, policy, medicine, communication, or the public - that many of the successes in averting disease and advancement of life expectancy can be attributed to the discovery and diffusion of effective immunizations..."
EDITORIAL
by Warren Feek
This editorial introduces a series of articles on lessons for health communication found in the experience of the campaign to eradicate polio. It focuses on the inevitable tensions and contradictions faced by the campaign against polio as well as other major health initiatives. It argues that communication has been an essential tool for navigating the complex negotiations, compromises, and changes in direction needed in the polio eradication campaign, and it suggests that the lessons learned from the polio experience are applicable to many other health interventions.
ARTICLES
by Silvio Waisbord, Lora Shimp, Ellyn W. Ogden, and Chris Morry
Communication is a critical component in assuring that children are fully immunised and that simultaneous immunity is attained and maintained across large geographic areas for disease eradication and control initiatives. If service delivery is of good quality, and if outreach to the population is active, effective communication - through advocacy, social mobilisation, and programme communication (including behaviour change activities and interpersonal communication) - will assist in the following: raising awareness, creating and sustaining demand, preventing or dispelling misinformation and doubts, encouraging acceptance of and participation in vaccination services, facilitating more rapid reporting of disease cases and outbreaks, and mobilising financial resources to support immunisation efforts. There is evidence of 12% to 20% or more increases in the absolute level of immunisation coverage and 33% to 100% increases in relative coverage compared to baselines when communication is included as a key component of immunisation strengthening. This article utilises evidence from Afghanistan, India, Pakistan, and Nigeria to examine how the Global Polio Eradication Initiative has utilised monitoring and evaluation data to focus and improve the quality and impact of communication activities.
by Rafael Obregón and Silvio Waisbord
The Polio Eradication Initiative (PEI) has been one of the most ambitious global health efforts in recent times. Social mobilisation (SM) has been a strategic component of the PEI. Yet, a close-up analysis of SM dynamics seems to be lacking in the health communication literature. This article examines critical aspects of the PEI experience in an attempt to move from dominant informational perspectives to a focus on emerging challenges in polio eradication efforts and new levels of complexity to SM. It examines available literature on communication and public health, available data on SM experiences that support polio eradication in Africa and Asia, and field work conducted by the authors where polio eradication efforts are ongoing. The analysis suggests that: SM should not be casually approached as a top-down informational strategy to advance pre-established health goals; centralised strategies hardly amount to SM; and hybrid options that combine both activist and pragmatic SM are concrete possibilities for global health initiatives. The study concludes that communication and SM strategies should rely on a clear understanding of the motives and agendas of involved actors, and that further studies using these perspectives should be a priority for global health programmes, including studies of the trust level, or lack thereof, among social actors.
by Sebastian Taylor and Lora Shimp
Health communication is increasingly considered a priority element of investments and interventions intended to improve personal and public health. But a prevailing focus in health communication on information, education, awareness, and knowledge - and their assumed relation to changing behaviour - can underestimate the complexity of wider ecological conditions that influence and limit individual, household, and even community choices and capacity to choose. In this article, the authors use experience from the PEI - drawing on evidence from the India and Nigeria country programmes - to provide some insights into how the health communication interventions can be strengthened through the adoption of a more holistic ecological model.
6. Polio Eradication Is Just Over the Horizon: The Challenges of Global Resource Mobilization
by Gregory Alonso Pirio and Judith Kaufmann
This study draws lessons from the resource mobilisation experiences of the Global Polio Eradication Initiative (GPEI). As the GPEI launched its eradication effort in 1988, it underestimated both the difficulty and the costs of the campaign. Advocacy for resource mobilisation came as an afterthought in the late 1990s, when achieving eradication by the target date of 2000 began to look doubtful. This article suggests that the reality of funding shortfalls undercutting eradication leads to the conclusion that advocacy for resource mobilisation is as central to operations as are scientific and technical factors.
ACCESS ALL OF THE ABOVE ARTICLES ONLINE: click here.
Other CI SPACES for a communication lens on immunisation and vaccines:
- Our Polio Theme Site
- All CI Sections - Immunisations and Vaccines
CI's Polio Communication Forum is hosting a discussion related to the Journal of Health Communication supplement Health Communication: Polio Lessons. We hope you can join us and some of the authors of the papers in a discussion which will start with the question "What, if anything, does the polio communication experience have to teach about health communication?" and then go where the conversation leads. If you haven't yet joined the forum, please take a minute to follow the link above and register. Once registered, you will be able to participate fully online and will be able to receive email updates (if you so choose) whenever someone makes a comment. If you have registered, we look forward to your contributions!
Please VOTE in our NEW Polio Poll!
Do you feel the polio experience has a lot to teach us about health communication?
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RESULTS of recently closed poll (May 10 2010)
In conflict-prone polio endemic areas, which do you view as the best ways to reach un- or under-immunised children?
19% Negotiating access with parties in conflict. 19% Woman-to-woman interventions in homes.
17% Media campaigning with information, education, and communication (IEC) materials in local languages, as well as door-to-door neighbourhood dissemination.
16% Health camps that provide immunisation with more comprehensive care opportunities in secure areas.
14% Negotiating ceasefires during immunisation campaigns.
14% Advocacy efforts with religious leaders.
2% Sports events with media campaigning.
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The Editor of The Drum Beat is Kier Olsen DeVries.
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