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’ & general public outreach // promo Internet campaign (CEO, etc) // constantly improving our language & methods of communications to overplay anti-vaccination activists // Good news: we will win, but it is a long row to hoe

Transcript

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