Вересень 2010 ЄДНАЙМОСЯ ЗАРАДИ ДІТЕЙ UKRAINE: Restoring public trust in immunization
<ul><li>2008:   </li></ul><ul><li>MoH prematurely launched MR campaign without proper roll out. </li></ul><ul><li>Newly va...
Examples of covers in the Ukrainian press
<ul><li>Vaccination crisis - a time bomb that could happen elsewhere:  </li></ul><ul><li>Soviet  legacy : obligatory vacci...
<ul><li>UNICEF has since 2008 been working closely with the MoH to rebuild public confidence in immunisation.  </li></ul><...
<ul><li>It’s critical to  strengthen immunization services in Ukraine in order to reduce and better handle adverse events ...
UNICEF actions: medical community Outcomes : -  260   medical professionals from all regions of Ukraine improved their com...
MoH capacity and partner collaboration: <ul><li>observing MoH low capacity both at the central and regional levels:  </li>...
<ul><li>Awareness raising  campaigns  on immunization and influenza </li></ul><ul><li>Coverage:  national; all medical fac...
Campaign outcomes: - Outdoor campaign outreach:  over 40 cities  (all regions); -  over 70 %  of people have seen the ads;...
<ul><li>Coalition building  – i.e. Donors’ letter to President  resulted in his public response in media requesting Prime ...
UNICEF actions: Internet outreach <ul><li>Web-based resource on immunization for parents, doctors, media </li></ul><ul><li...
UNICEF actions: impact Negative attitude to immunization in Ukraine: 2008  year   2010  year 32%  22% In Kiev : 2008  year...
<ul><li>Unstable political environment (3 ministers of health and 4 chief sanitary doctors changed) </li></ul><ul><li>Nume...
<ul><li>Innovative approaches (i.e. Pool of advertising  agencies developed creative concepts pro bono) </li></ul><ul><li>...
Lessons learned:  <ul><li>Using international media to influence decision-makers  </li></ul><ul><li>New media : virus vide...
Campaign outcomes: - over 70% enjoyed the adds - Over 60 % were motivated to change their behaviour (follow the messages) ...
Health for All,  [email_address] ДЯКУЮ !
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Ukraine immunization comms meeting

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  • Spring 2008: MR campaign ran into trouble after MoH failed to adequately roll out the campaign, prematurely launching it. Newly vaccinated adolescent boy died and MR vaccine was incorrectly blamed. I nability of MoH effectively articulate convincing arguments for vaccination led to m edia and political firestorm, fed by internet based anti-vaccine forces. Government postponed the campaign and in February 2009 abandoned an attempt to immunise nine million people against measles and rubella A concerted internet led anti-vaccine campaign continues portraying immunisation as more dangerous than the diseases it meant to combat creating a public crisis of trust in the health system. It has also demonized international partners, such as WHO and UNICEF. Summer 2010, GoU disposed MR vaccines costed USD 5 million to international donors. During 2010 immunization coverage dropped up to 40% in some regions due to parents’ refusal and lack of vaccines provision.
  • Spring 2008: MR campaign ran into trouble after MoH failed to adequately roll out the campaign, prematurely launching it. Newly vaccinated adolescent boy died and MR vaccine was incorrectly blamed. I nability of MoH effectively articulate convincing arguments for vaccination led to m edia and political firestorm, fed by internet based anti-vaccine forces. Government postponed the campaign and in February 2009 abandoned an attempt to immunise nine million people against measles and rubella A concerted internet led anti-vaccine campaign continues portraying immunisation as more dangerous than the diseases it meant to combat creating a public crisis of trust in the health system. It has also demonized international partners, such as WHO and UNICEF. Summer 2010, GoU disposed MR vaccines costed USD 5 million to international donors. During 2010 immunization coverage dropped up to 40% in some regions due to parents’ refusal and lack of vaccines provision.
  • Vaccination crisis - a time bomb that could happen elsewhere, the following factors constitute it: soviet legacy: UNICEF+ - pervoprohodtsy Distrust of immunisation is widespread among medical workers. media: contradictory information, aggressive coverage parents: choice with no knowledge/ abcense sufficient friendly easy-accessible information - now days there are many parents who are afraid of vaccine safety and who are questioning and are not immunising their children The anti-vaccine movement is strong. capacity of anti-vaccine forces to disrupt public health interventions on a scale not seen before. MoH: lack of capacity; A failing health care system - people’s distrust to public health system doctors: they would not encourage vaccination profit making: re-shaping of market shares among hidden wars of vaccines producers (Russian vs French vs Indian) A highly politicized governmental system.
  • UNICEF has since 2008 been working closely with the MoH to rebuild public confidence in immunisation. The project has developed key strategies for responding to the anti-immunisation movement: situation assessment (KAPB, stakeholders); equipping medical workers (workshops, forums, materials); building a pro-immunisation coalition; developing an information platform to be followed by a campaign (Internet, IEC materials, video/radio): educating media, religious leaders, civil society activists, other opinion makers
  • // Evaluation (omnibus, KAP) // scaling up parents’ &amp; general public outreach // promo Internet campaign (CEO, etc) // constantly improving our language &amp; methods of communications to overplay anti-vaccination activists // Good news: we will win, but it is a long row to hoe
  • Ukraine immunization comms meeting

    1. 1. Вересень 2010 ЄДНАЙМОСЯ ЗАРАДИ ДІТЕЙ UKRAINE: Restoring public trust in immunization
    2. 2. <ul><li>2008: </li></ul><ul><li>MoH prematurely launched MR campaign without proper roll out. </li></ul><ul><li>Newly vaccinated boy died: MR vaccine was incorrectly blamed. </li></ul><ul><li>MoH failed to articulate convincing arguments for vaccination led to m edia / political firestorm, fed by internet based anti-vaccine forces. </li></ul><ul><li>2009: </li></ul><ul><li>Gmvt postponed the campaign and eventually abandoned an attempt to immunise nine million people against MR </li></ul><ul><li>Anti-vaccine campaign continued: portraying immunisation as dangerous; feeding public distrust in system; demonizing WHO, UNICEF. </li></ul><ul><li>2010 : </li></ul><ul><li>Gmvt disposed MR vaccines at a cost of $ 5 million to donors. </li></ul><ul><li>Immunization coverage dropped average up to 50% due to parents’ refusal and vaccine scarce/shortage. </li></ul>Ukraine: vaccination crisis 2008 - 2010
    3. 3. Examples of covers in the Ukrainian press
    4. 4. <ul><li>Vaccination crisis - a time bomb that could happen elsewhere: </li></ul><ul><li>Soviet legacy : obligatory vaccination - coverage up to 95 % even in the 1990s; no major outbreaks public at large would remember. </li></ul><ul><li>No new knowledge on immunisation is widespread among medical workers . </li></ul><ul><li>Media: contradictory information. </li></ul><ul><li>Now days parents have choice with no knowledge/ lack of convincing, easy-to-digest information; many of them are afraid of vaccine safety . </li></ul><ul><li>The anti-vaccine forces have capacity to disrupt public health interventions on a scale not seen before. </li></ul><ul><li>MoH: lack of capacity . A failing health care leads to people’s distrust to public health system. </li></ul><ul><li>Politicized governmental system combined with vaccine producers wars for the market </li></ul>Declining public trust: context
    5. 5. <ul><li>UNICEF has since 2008 been working closely with the MoH to rebuild public confidence in immunisation. </li></ul><ul><li>The project has developed key strategies : </li></ul><ul><li>situation analysis (KAPB, stakeholders, omnibus); </li></ul><ul><li>equipping medical workers (workshops, forums, materials); </li></ul><ul><li>building a pro-immunisation coalition; </li></ul><ul><li>developing an information platform </li></ul><ul><li>to be followed by a campaign (Internet, </li></ul><ul><li>IEC materials, video/radio); </li></ul><ul><li>educating media, religious leaders, </li></ul><ul><li>civil society activists, </li></ul><ul><li>other opinion makers. </li></ul>UNICEF involvement:
    6. 6. <ul><li>It’s critical to strengthen immunization services in Ukraine in order to reduce and better handle adverse events following immunization through c apacity building for health care workers: </li></ul><ul><li>Components: crisis communication and training for key medical speakers; workshops on handling the media following adverse events; development of tools for improved surveillance of AEFI and training health professionals on using them ; distribution of materials. </li></ul><ul><li>Coverage: all oblasts of Ukraine, frontline workers, as well as health officials, press services staff. </li></ul>UNICEF actions: medical community
    7. 7. UNICEF actions: medical community Outcomes : - 260 medical professionals from all regions of Ukraine improved their communication capacities on immunization & influenza issues - 276 medical professionals from all regions of Ukraine improved their technical knowledge & communication on AEFI - 2,160 doctors improved their knowledge on vaccines safety and efficacy  <ul><li>Outcomes (accord. to the assessment of the trainings effectiveness) : </li></ul><ul><li>98% of participants think that all information received is useful and was needed </li></ul><ul><li>100% of participants do share and disseminate new information and knowledge received during the trainings (via conferences, seminars, briefing with staff) </li></ul><ul><li>92% of participants improved their work with media following the trainings </li></ul>
    8. 8. MoH capacity and partner collaboration: <ul><li>observing MoH low capacity both at the central and regional levels: </li></ul><ul><li>enjoying strong cooperation with WHO at the CO level: </li></ul><ul><li>exploring USAID, SDC, WB support, including funding; </li></ul><ul><li>involving business, civil society, opinion-leaders. </li></ul><ul><li>RESULTED in: UNICEF in Ukraine is a catalyst of all </li></ul><ul><li>pro-immunization efforts, well-recognized </li></ul><ul><li>by MoH, donors and local partners. </li></ul>
    9. 9. <ul><li>Awareness raising campaigns on immunization and influenza </li></ul><ul><li>Coverage: national; all medical facilities, kindergartens, pharmacies, (all together about 35,000 facilities) railway, subway </li></ul><ul><li>Components: outdoor, media appearances, internet, video, IEC materials (brochure for parents, posters), PSA, documentaries, viral videos </li></ul>UNICEF actions: general public
    10. 10. Campaign outcomes: - Outdoor campaign outreach: over 40 cities (all regions); - over 70 % of people have seen the ads; - 101 420 376 – Number of times citizens have contacted with the outdoor (only immunization) advertising - UNICEF actions: general public <ul><li>68% of population liked the adds </li></ul><ul><li>43% absolutely influenced opinion on immunization </li></ul><ul><li>85% of them are positively influenced </li></ul>Unexpected result: 34% said they have seen the ads on TV (we invested only in outdoor campaign
    11. 11. <ul><li>Coalition building – i.e. Donors’ letter to President resulted in his public response in media requesting Prime Minister to address the problem </li></ul><ul><li>Educating: Trainings and briefings for media, religious leaders, NGOs, other opinion-multipliers </li></ul><ul><li>EIC materials : press kit on immunization, advocacy video, international pro-vaccination films in Ukr, brochures, photo/video database </li></ul>AND: Monitoring (daily press monitoring shared with MoH); strong coordination (MoH, WHO); proactive in crisis (quicklines, Q&A, crisis communication plan) UNICEF actions: opinion-makers
    12. 12. UNICEF actions: Internet outreach <ul><li>Web-based resource on immunization for parents, doctors, media </li></ul><ul><li>New media – i.e. infographics </li></ul><ul><li>Partisan video; virus web-site </li></ul><ul><li>Bloggers </li></ul>
    13. 13. UNICEF actions: impact Negative attitude to immunization in Ukraine: 2008 year 2010 year 32% 22% In Kiev : 2008 year 2010 year 64% 24,5% Market price of the campaign (both immunization and influenza) about 1 mln USD
    14. 14. <ul><li>Unstable political environment (3 ministers of health and 4 chief sanitary doctors changed) </li></ul><ul><li>Numerous scattered anti-vaccination activists, no one major opponent to appeal </li></ul><ul><li>Evaluating intervention’s effectiveness (i.e. new media, bloggers) </li></ul><ul><li>Ukraine 46 mln country (9 mln children; 500,000 born annually)- challenging to outreach all parents, public at large, especially resources wise. </li></ul>What are the challenges:
    15. 15. <ul><li>Innovative approaches (i.e. Pool of advertising agencies developed creative concepts pro bono) </li></ul><ul><li>Free of charge placement of outdoor (MoU with Ukrainian outdoor association) </li></ul><ul><li>Playing with the topics that are priority political agenda (i.e. Ukraine&EURO 2012 argument in the donors’ letter to President) </li></ul><ul><li>Humanizing UNICEF language (real lives stories) & new approaches (virus video) to deliver the message </li></ul><ul><li>Crisis creates opportunities (fruitful partnership with MoH) </li></ul>What works well:
    16. 16. Lessons learned: <ul><li>Using international media to influence decision-makers </li></ul><ul><li>New media : virus video, promo Internet campaigns, infographs </li></ul><ul><li>Keep an eye on media environment/reporting to be proactive not reactive </li></ul><ul><li>Practical outputs and measurable results. </li></ul><ul><li>Crisis Communication Plan including major sensitive aspects to be in place </li></ul><ul><li>Anti-immunisation groups use politicians and lay activists to communicate predominantly emotional messages </li></ul><ul><li>Our arguments to be well-adopted to your country context </li></ul><ul><li>Be prepared for being alone at the beginning: allies to join once your efforts bring results </li></ul>
    17. 17. Campaign outcomes: - over 70% enjoyed the adds - Over 60 % were motivated to change their behaviour (follow the messages) Unexpected outcomes: - outdoor operators printed and placed additional amount on their own $. - got in social media: “Got sick? Tweet from home!” UNICEF actions: general public Influenza
    18. 18. Health for All, [email_address] ДЯКУЮ !

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