Polio eradication: How far can ‘influencers’ go?

Anti-polio vaccine propaganda and misinformation from elites in some communities is a major challenge, and rejection from parents has been a recurring decimal, leaving many children unimmunised during repeated rounds of house-to-house polio programmes in Nigeria.Yet experts say every child under five years needs to be immunized during every polio vaccination exercise and that if […]

Anti-polio vaccine propaganda and misinformation from elites in some communities is a major challenge, and rejection from parents has been a recurring decimal, leaving many children unimmunised during repeated rounds of house-to-house polio programmes in Nigeria.
Yet experts say every child under five years needs to be immunized during every polio vaccination exercise and that if too many children are missed during such campaigns, the virus will continue to circulate in communities, putting all others at risk.
 In Sokoto, 24 wards of four local government areas were identified as high-risk wards where most children had not been immunized against the polio virus.
Perhaps this was why in the last round of immunisation plus-day, local government areas, including Sokoto South, Sokoto North, Kware and Ilela were under two phases of implementation, first in the very, very high risk (VVHR) wards and then to very high risk (VHR) wards.
However, new initiatives are now being employed towards meeting the challenges-chiefly, the engagement of so-called ‘influencers’ including doctors, Polio Survival Group, Qur’anic/ Islamiyya school malams, religious and traditional leaders and drummers in resolving non-compliance in the very high risks local government areas of the state.
Their intervention has helped resolved some cases of noncompliance.
UNICEF International Consultant Mekonnen Aderaw gave a report on Doctors Against Polio (DAP), Polio Survivor Group (PSG) and Malams’ engagement during the July IPDs in Sokoto in which the number of non-compliant cases resolved by each group was noted.
Doctors’ involvement comes with a plus-they are able to diagnose other health complications in communities where they are on immunisation duty.
DAP members visited 1,281 non-compliant households and immunized a total of 1,937 children; they worked with the council teams in planning social mobilization activities in local governments areas such as Wamakko and Kware; they also led community dialogues in Kware and were engaged in IPDs, mobilization and immunization, diagnosis and  referral for less complicated cases.
Polio Survivors Association of Nigeria was also noted to have shown its commitment to fight against polio with its motto ‘Seeing is Believing.’
To leverage this opportunity, Aderaw said PSG was identified and engaged in 6 VHR LGAs of Sokoto state since June 2013 IPDs.
A total 66 PSGs were engaged in IPDs this June-and 63 in July.
Aderaw noted: “In Wamakko, 610 cases of non-compliance households were resolved while 1,226 noncompliant children were immunized.
In Kware, 685 noncompliant households were resolved and 1,117 children immunized; at Sokoto South, 625 noncompliant households were resolved and 942 children immunized; in Sokoto North, 55 noncompliant households were resolved and 146 noncompliant children immunized.
On the part of the malams, Aderaw said six vulnerable high risk LGAs of Sokoto state including Sokoto South, Sokoto North, Wamakko, Illela, Kware and Gwadabawa were identified for Qur’anic School Malams engagement.
He added that 66 and 56 malams were engaged in the June and July IPDs respectively and that through their intervention about 56 percent of the Non Compliance cases at Quranic Schools were resolved.
After some churches rejected the vaccines on account of concerns about vaccine safety and immunisation process, the churches were line-listed and a special team from the followers themselves were trained to address the issue.
A total 34 churches were noted to have sent teams for training for the July round with a total of 2,457 children immunized in Sokoto South and Sokoto North.
Similarly, during the monitoring of the September sub-immunization exercise by journalists against polio, the members came across one Alhaji Usman Kebbe of Sarkin Adar/Gandu ward in Sokoto North local government area of Sokoto state who for the first time in 10 years allowed children from his household to receive polio immunization.
Alhaji Kebbe said his change of mind was based on the preaching conducted by a renowned Islamic scholar Sheikh Ahmed Gumi on issues concerning health last Ramadan, and vowed that henceforth no eligible child from his household would miss immunization.
Director of Disease Control and Immunization, in Sokoto State Primary Healthcare Development Agency,  Dr. Aminu Shehu during a review meeting after the September polio immunization days confirmed that the most important thing done during this round was the engagement of influencers for in-between round activities and during implementation.
“We have implemented our activities taking into consideration lessons learnt from earlier activities especially in issues like reaching populations at nomadic and border areas, cold chain assessment and so on. There is also emphasis on team work and linkage between experts on the field.
All the field officers were to closely monitor the teams they work with or even go to the field themselves with vaccines and tally sheets in case there are missed children they come across.
This is besides remote monitoring to ensure that we track and verify how vaccinators are doing on a daily basis,” Shehu stated.
Nigeria is said to be closer to stamping out the disease, the Global Polio Eradication Initiative weekly report showed that as of 17th September, 2013, the total number of WPV1 cases for this year stood at 47 as against the 88 cases in September 2012.
But pundits say more still needs to be done if the war against polio is to be won in the country.
Among proffered ways at a meeting organized by UNICEF with JAP members in Sokoto was designing a comprehensive high level advocacy plan to engage the Sultan of Sokoto and others at all levels to mobilize religious leaders for PEI and manage anti-polio vaccine propaganda, developing easy and culturally appropriate information-education-communication materials and training council consultants and surge teams.
“People need to understand that the future of their children is their responsibility. And this starts from allowing their children to be immunnized,” Dr. Shehu said.