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Purple Pinkies       Dr. Roma Solomon, Director Mr. Manojkumar Choudhury, M & E Officer      CORE Group Polio Project Indi...
Social Mobilisation for Hard to          Reach Populations• Brief introduction through narrative & slides• Role Play• How ...
Polio cases (thousands)       0                             100                                                 200       ...
Progress in Polio Eradication                         1988 – 20121988                                                     ...
THECORE GROUP POLIO     PROJECT      INDIA    1999 - 2012
IMAGINE   THE• 394 million people live in U.P., Bihar & W. Bengal• 500,000 children are born every month in U.P and Bihar•...
Field Operations                 Small mop-up in India           4,200,000 children under age 5               280,000 vial...
Two National Immunization Days          (Booth-based) Much fanfare in a campaign mode
172 million children under 5      immunized in every NID                          ButMore than 15% children continued to  ...
1999House to House    strategy  introduced
Stiff resistanceencountered
Community Resistance grew in W. Uttar Pradesh,2001 Hindu and Muslim mothers in Western U.P. felt strongly                 ...
Shift from extensive mass awareness approach to    addressing specific   conditions/needs of      specific groups
Communication response initiatedCORE volunteersfrom schools,nursing schools &NGOs in Highrisk areas of UttarPradesh tackle...
Community Mobilisation Coordinators           (CMCs) were Born                             • Selected from the            ...
Each CMC covers 400-500 houses
Analysed ‘Resistance to develop    ‘Negotiation strategiesShift from instructive to negotiation approach                  ...
Shift to localised mobilisation               activities• Government mobilization  – Formation of district core groups on ...
Hard to Reach??
How Do We Reach?Let me count the ways…………….
CMCs visit each pregnant woman andgive Congratulation Card after childbirth
CMCs track polio immunization status of children                    under 5 yearsBy focused IPC for Communities           ...
Health Camps  Childrens    Rallies
1. Greater involvement of religious leaders2. Formation of state ulemas committee3. Appeals from religious institutions an...
9 million people exposed to polio messages during religious                   congregations in 2010
Billboards, posters, etcfor brick kilns, construction sites, & transit teams                                          Wher...
Flip book             Flash Cards                                                      Message booklet            Flash Ca...
Leaflets on Diarrhea Management and Routine Immunization
• Booth day – Bulawwa toli – child mobilisers – Decorated polio booths inaugurated by local   influencers – Visit to X hou...
2009Who was sustaining transmission?Very young: DefinitelyMigrants:   YesOlder children: Maybe(?)
Status of Wild Poliovirus Cases – UP             Year 2009*                                         75% cases             ...
Emphasis on Birth Dose
Migrants • Brick Kilns Children of parents working in brick kilns • Construction sites Children of parents working on cons...
CMCs conduct special IPC sessions with migrant families on     the importance of polio & routine immunization       More t...
201080% polio cases contributed by only 2% (107) of India’s          blocks
Revised Communication Package for Polio             Developed
Revised Communication Package for the very            High Risk Blocks                     Get 2 drops of                 ...
% Resistant Houses (XR) in UP - CMC areas               2007- 2011                                Source:Tallysheet
Mapping for Monitoring      Relevance and Use•Lack of detailed maps in rural & urban areas•Need to map growth momentum•Des...
CORE Work Area Map of Ward 46, Howrah, W.Bengal               Booth Locations
Web based Booth-specific Information
2011    Rukhsar fromW. Bengal, the only case                           25th Feb. 2012                           India decl...
Each childreceiving polio drops gets the   left pinky marked with   purpleindelible ink
Purple Pinkies_Solomon_5.3.12
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Purple Pinkies_Solomon_5.3.12

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Purple Pinkies_Solomon_5.3.12

  1. 1. Purple Pinkies Dr. Roma Solomon, Director Mr. Manojkumar Choudhury, M & E Officer CORE Group Polio Project India CORE Group Spring Meeting 3 May , Wilmington, DE
  2. 2. Social Mobilisation for Hard to Reach Populations• Brief introduction through narrative & slides• Role Play• How we reach the unreached• Using LQAS for improving social mobilisation activities• Short film – ‘A drop of dialogue’
  3. 3. Polio cases (thousands) 0 100 200 300 4001985198619871988198919901991199219931994199519961997199819992000 the world in India Last type 2 polio in2001200220032004 1988 200820052006 1&3 Monovalent2007200820092010 Bivalent20112012 Polio Eradication: Historical Context 2012: 14
  4. 4. Progress in Polio Eradication 1988 – 20121988 2009 Type 1  125 endemic countries 4 endemic countries  1000 cases per day Type 3 (India, Nigeria, Pakistan, Afghanistan)  350,000 cases per year 1604 cases/year 2010 2012 1292 cases -20% reduction since 46 cases; 43 in endemic 2009; 99% reduction since 1988 & 3 in non-endemic countries Source: WHO 17 04 2012
  5. 5. THECORE GROUP POLIO PROJECT INDIA 1999 - 2012
  6. 6. IMAGINE THE• 394 million people live in U.P., Bihar & W. Bengal• 500,000 children are born every month in U.P and Bihar• 2.3 million vaccinators used in one National Immunization Day• 500,000+ vaccinators cover about 45 million children in each SNID• 900 million doses of OPV were used in 2011• 9,125 community mobilisers visit over 3 million families each month in the three states• In 2011, the SM Net tracked 30,000 migrant families and helped vaccinate 1,814,266 children on the move in transit and border areas.
  7. 7. Field Operations Small mop-up in India 4,200,000 children under age 5 280,000 vials of vaccine 50,000 square miles 37,000 vaccinators 4,000 supervisors 2,500 mobilizers 2,000 vehicles18,000 vaccine carriers/ice/markers/chalk/tally sheets 3 days
  8. 8. Two National Immunization Days (Booth-based) Much fanfare in a campaign mode
  9. 9. 172 million children under 5 immunized in every NID ButMore than 15% children continued to be missed in every Round…
  10. 10. 1999House to House strategy introduced
  11. 11. Stiff resistanceencountered
  12. 12. Community Resistance grew in W. Uttar Pradesh,2001 Hindu and Muslim mothers in Western U.P. felt strongly Muslim mothers that polio program targets a reported the specific community highest rates of hearing rumours/ concerns about OPVCommunities believed that… (Unicef KAP study)o Polio immunization led to impotencyo It was a family planning programo Different color of polio vaccines were used for different communities
  13. 13. Shift from extensive mass awareness approach to addressing specific conditions/needs of specific groups
  14. 14. Communication response initiatedCORE volunteersfrom schools,nursing schools &NGOs in Highrisk areas of UttarPradesh tackledresistance to OPV Increase in female vaccinators
  15. 15. Community Mobilisation Coordinators (CMCs) were Born • Selected from the same communities • To overcome resistance and • Sustain community participation for polio eradication and routine immunizationUnicef & CORE set up the Social Mobilisation Network inUttar Pradesh, deploying hundreds of CMCs in High risk areas to tackle resistance
  16. 16. Each CMC covers 400-500 houses
  17. 17. Analysed ‘Resistance to develop ‘Negotiation strategiesShift from instructive to negotiation approach Focus on skill building of communicators (CMCs & Vaccinators)
  18. 18. Shift to localised mobilisation activities• Government mobilization – Formation of district core groups on polio & RI – Involvement of other departments like education, women & child welfare, etc.• Religious and opinion leaders’ mobilization – Regular and continuous meetings – Izthema meetings (Meetings of Muslim ladies)• Targeted IPC & mother/influencer meetings with resistant families/pockets
  19. 19. Hard to Reach??
  20. 20. How Do We Reach?Let me count the ways…………….
  21. 21. CMCs visit each pregnant woman andgive Congratulation Card after childbirth
  22. 22. CMCs track polio immunization status of children under 5 yearsBy focused IPC for Communities Mapping & Registers Providing Immunization status of each child to vaccination teams
  23. 23. Health Camps Childrens Rallies
  24. 24. 1. Greater involvement of religious leaders2. Formation of state ulemas committee3. Appeals from religious institutions and leaders
  25. 25. 9 million people exposed to polio messages during religious congregations in 2010
  26. 26. Billboards, posters, etcfor brick kilns, construction sites, & transit teams Wherever you go, make sure your child receives OPV
  27. 27. Flip book Flash Cards Message booklet Flash Cards Snakes and Ladder Game Streamer
  28. 28. Leaflets on Diarrhea Management and Routine Immunization
  29. 29. • Booth day – Bulawwa toli – child mobilisers – Decorated polio booths inaugurated by local influencers – Visit to X houses
  30. 30. 2009Who was sustaining transmission?Very young: DefinitelyMigrants: YesOlder children: Maybe(?)
  31. 31. Status of Wild Poliovirus Cases – UP Year 2009* 75% cases below 2 yrs of age * data as on 19th Jun 2009
  32. 32. Emphasis on Birth Dose
  33. 33. Migrants • Brick Kilns Children of parents working in brick kilns • Construction sites Children of parents working on construction sites 6. Slums Migrants in urban/peri-urban slums 4. Nomads Communities who travel from place to place for livelihood, setting up temporary homes on empty tracts of land near railway stations, market places, etc. Often work as blacksmiths, basket weavers, puppeteers, acrobats, fortune-tellers, singers and dancers.
  34. 34. CMCs conduct special IPC sessions with migrant families on the importance of polio & routine immunization More than Soap strips distributed to 4000 promote hand washing behavior informers enrolled Barbers, shopkeepers, etc. engaged as informers on migrant groups
  35. 35. 201080% polio cases contributed by only 2% (107) of India’s blocks
  36. 36. Revised Communication Package for Polio Developed
  37. 37. Revised Communication Package for the very High Risk Blocks Get 2 drops of OPV + polio plus messages
  38. 38. % Resistant Houses (XR) in UP - CMC areas 2007- 2011 Source:Tallysheet
  39. 39. Mapping for Monitoring Relevance and Use•Lack of detailed maps in rural & urban areas•Need to map growth momentum•Desire of wider audience to view the locationand data concurrently
  40. 40. CORE Work Area Map of Ward 46, Howrah, W.Bengal Booth Locations
  41. 41. Web based Booth-specific Information
  42. 42. 2011 Rukhsar fromW. Bengal, the only case 25th Feb. 2012 India declared Non-endemic country
  43. 43. Each childreceiving polio drops gets the left pinky marked with purpleindelible ink

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