A recent and important research paper, written by Ellen A. Coates, Silvio Waisbord, Jitendra Awale, Roma Solomon, and Rina Dey, in the inaugural edition of the journal Global Health Science and Practice, looks at how, in response to low routine immunisation coverage and ongoing polio virus circulation, US-based CORE Group members and local non-governmental organisations partnered with Unicef in India to create the Social Mobilisation Network (SMNet), a network which has played a pivotal role in stopping transmission of polio in India.
It also looks at how important this network remains as India struggles to remain polio-free in a world where the virus continues to circulate and 27 million Indian children are born each year.
The SMNet’s goal was to improve access and reduce family and community resistance to vaccination. The partners trained thousands of mobilisers from high-risk communities to visit households, promote government-run child immunisation services, track children’s immunisation history, encourage vaccination of children missing scheduled vaccinations, and mobilise local opinion leaders.
Creative behaviour change activities and materials promoted vaccination awareness and safety, household hygiene, sanitation, home diarrhoeal-disease control, and breastfeeding. Programme decision-makers at all levels used household-level data that were aggregated at community and district levels, and senior staff provided rapid feedback and regular capacity-building supervision to field staff.
Use of routine project data and targeted research findings offered insights into and informed innovative approaches to overcoming community concerns impacting immunisation coverage.
This research paper is an eye-opener for our health practitioners and policymakers at district and provincial levels. I have hardly seen any meeting with community regarding the polio vaccination campaign. Our policymakers have never studied failures of eradication of polio from Pakistan. There is a famous saying: “The community is the barometer of success or failure of any intervention”.
Is their any proper community involvement. No. When the polio campaign starts, local health officials, doctors, nurses and other related staff of the health department called by the district administration discuss/finalise the polio vaccination plan. There is no community involvement from the planning to the implementation stage.
India has achieved the target of polio eradication through proper mobilisation and involvement of locally-based civil society organisation, opinion-makers and leaders/elders of society. In Pakistan only officials of the relevant health department are involved in the entire process – from decision-making to polio vaccination.
So, its impossible for Pakistan to eradicate polio. We are the world’s only nation which is struggling to eradicate polio. An important aspect of the Millenium Development Goals is polio eradication, which India achieved last year.
Every year 27 million children are born in India but still they have achieved most of their MDGs. I would like to suggest that the health department and the district administration must involve community-based organisations at the union council level before the start of each polio campaign. The district administration can make a ‘Polio Eradication Network’ at each union council level, which would ensure proper participation of all communities in the polio vaccination campaign.
There are many lessons for our planners to learn from the above-mentioned research paper in order to carry out polio eradication campaigns.
AIJAZ ALI KHUWAJA Karachi