CHAPTER ONE

INTRODUCTION

1.1       BACKGROUND TO THE STUDY

Eradication of polio has been described as one of the greatestprimary health care achievements of the twentieth century and iswidely seen as aworthwhile and cost-effective public healthmeasure (CDC, 1999). More than 3 million child deaths of polio origin worldwideare said to be prevented each year through polio vaccination (WHO, 2014; Bosch-Capblanch, Banerjee and Burton, 2012). Despite these huge benefits, polio eradicationprogrammes face numerous challenges including low andstagnant communication/coverage levels, under-utilization of polio vaccine services,inadequate sustainable financing, and misleadinginformation on polio vaccination and its effects(Obrego´n, Ketan, Morry, Warren, Jeffrey and Galway, 2009; Mohammed, Datta, Jamjoon, Magoba-Nyanzi, Hall and Mohammed, 2009).

Nigeria has one of the highest rates of under-5 mortalityin the world and vaccine-preventable diseases account forapproximately 22% of child deaths in the country.Though polio vaccination rates have increased in Nigeria in thelast decade, only 52% of eligible children in SouthernNigeriawere fully vaccinated in 2013, and in the North,even fewer children (10 - 27%) were fully vaccinated. Theselow rates have been attributed partly to vaccine hesitancy,a behaviour influenced by a number of factors, includinga lack of trust in the vaccine or the provider, peoplenot perceiving a need for or not valuing the vaccine,poor access, lack of knowledge, rumours, religious beliefs,illiteracy, and other social and political factors (NDHS, 2013).

For polio to be specific, primary health care officials in Nigeria has been very successful in the fight against the scourge of polio through immunization has seen and confirmed by World Health Organization that declared Nigeria Polio free nation in 2016. The researcher is however of the opinion that this success might be tied to the communication strategies used by these primary health care officials.

Effective communication strategies can address some ofthese issues by making more people aware of the benefits ofpolio immunization; correcting false beliefs, rumours, or concernsthat prevent people from getting immunized against polio; andinforming people where and when to get immunized,thereby potentially increasing polio vaccination rates (Waisbord andShimp, 2010).

In the context of this study, communication strategy is defined as a purposeful,structured, repeatable, and adaptable plantoinform and influence community decisions to personal and public health participation, disease prevention andpromotion, policy making, service improvement, andresearch (Hill, 2011). Communication strategies are believedto have contributed to the successes recorded in thepolio eradication initiative in Nigeria (UNICEF, 2012). The country’sNational Social Mobilisation Working Group, headed byUNICEF, is responsible for developing and coordinatingcommunication strategies for all childhood vaccinations.

At state and local levels, social mobilisation committeescoordinate these activities which tend to focus on thefollowing three objectives: advocacy, social mobilization and behavioural change communication (NPHCDA, 2008).Currently, a wide range of communication strategiesare being used in Nigeria. Most of the strategies usedare developed at the national level and then implementedlocally (Gavi, 2014)) which may result in inadequate communityinvolvement in their planning and implementation (FMOH, NPHCDA, 2014).

To improve communication, it is important to identify what strategies are being used, where, and for whichpurposes (Kaufman, Synnot, Hill, Willis, Horey and Lin, 2013); which communication strategies areeffective; and how people want to be communicatedwith (Ames, Glenton, Lewin and Parents, 2015). To better understand some of theseissues, a global taxonomy of communicationstrategieshave been developed. This taxonomy aims to map thecommunication strategies that are used in a way thatidentifies the key purposes of each strategy, thereby helpingto ensure that these strategies address the most relevantdeterminants of polio vaccine hesitancy (Willis, Hill, Kaufman, Lewin,Kis-Rigo and De Castro, 2013).

1.2       STATEMENT OF THE PROBLEM

Effective communication strategy is a critical component in ensuring the eradication of a number of childhood diseases including polio. Although numerous communication strategies have been proposed and implemented in various parts ofNigeria, the range of communication strategies used has not yet been mapped systematically. Moreover, evidence-based studies revealed that planned communication strategies such as intensive interpersonal communication and social mobilization, media campaigns, and political and national advocacy combined have contributed to reducing polio incidences in Nigeria. However from the foregoing, this study will examine the communication strategies used by primary health care officials in the efforts to eradicate polio in Nigeria. The study will also explorehow to integrate evidence-based communication strategiesthat are adapted for local conditions into polio vaccinationprogrammes in Nigeria.

1.3       OBJECTIVES OF THE STUDY

The following are the objectives of this study:

1. To identify the communication strategies used by primary health care officials in the efforts to eradicate polio in Lusaka community of Bauchi State.
2. To examine the effectiveness of the communication strategies used by primary health care officials in the efforts to eradicate polio in Lusaka community of Bauchi State.
3. To assess the challenges associated with the communication strategies used by primary health care officials in the efforts to eradicate polio in Lusaka community of Bauchi State.

1.4       RESEARCH QUESTIONS

1. What are the communication strategies used by primary health care officials in the efforts to eradicate polio in Lusaka community of Bauchi State?
2. What are the effectiveness of the communication strategies used by primary health care officials in the efforts to eradicate polio in Lusaka community of Bauchi State?
3. What are the challenges associated with the communication strategies used by primary health care officials in the efforts to eradicate polio in Lusaka community of Bauchi State?

1.5       HYPOTHESIS

HO: Communication strategies used by primary health care officials in the efforts to eradicate polio in Lusaka community of Bauchi State are not effective

1.6       SIGNIFICANCE OF THE STUDY

The following are the significance of this study:

1. The outcomes of this study will form a useful guide for stakeholders and policy makers in health sector in evaluating the communication strategies used by primary health care officials in the effort to eradicate any childhood diseases.
2. This research will be a contribution to the body of literature in the area of communication strategies used by primary health care officials in the efforts to eradicate polio, thereby constituting the empirical literature for future research in the subject area.

1.7       SCOPE/LIMITATIONS OF THE STUDY

This study is limited to Lusaka community of Bauchi State Nigeria. This study will also cover the communication strategies used by primary health care officials in the efforts to eradicate polio in the community.

LIMITATION OF STUDY

Financial constraint- Insufficient fund tends to impede the efficiency of the researcher in sourcing for the relevant materials, literature or information and in the process of data collection (internet, questionnaire and interview).

 Time constraint- The researcher will simultaneously engage in this study with other academic work. This consequently will cut down on the time devoted for the research work.

REFERENCES

Ames H, Glenton C, Lewin S. Parents’ and informal caregivers’ views and experiences of routine early childhood vaccination communication: qualitative evidence synthesis (Protocol). Cochrane Database Syst Rev 2015; 7: CD011787

Bosch-Capblanch X, Banerjee K, Burton A. Unvaccinated children in years of increasing coverage: how many and who are they? Evidence from 96 low-and middle-income countries.Trop Med Int Health 2012; 17: 697710.

CDC (1999).Ten great public health achievements United States, 19001999. USA: Centers for Disease Control and Prevention.

FMOH, NPHCDA (2014). National routine immunization strategic plan 20132015 intensifying reaching every ward through accountability. Abuja, Nigeria: NPHCDA

GAVI (2014). GAVI alliance country tailored approach for Nigeria 20142018. Geneva, Switzerland: GAVI.

Hill S. The knowledgeable patient: communication and participation in health. Chichester, UK: Wiley; 2011.

Kaufman J, Synnot A, Hill S, Willis N, Horey D, Lin V, Face to face interventions for informing or educating parents about early childhood vaccination. Cochrane Database Syst Rev 2013; 5: CD010038.

Mohammed AJ, Datta KK, Jamjoon G, Magoba-Nyanzi J, Hall R, Mohammed I. Report on barriers to polio eradication in Nigeria. Abuja: WHO; 2009.

NDHS (2013).Nigeria demographic and health survey. Abuja: National Populaton Commission and ICF Macro

NPHCDA (2008).National integrated communication and social mobilization strategy for immunization in Nigeria. Abuja, Nigeria: NPHCDA.

Obrego´n R, Ketan C, Morry C, Warren F, Jeffrey B, Galway M, etal.Achieving polio eradication: a reviewof health communication evidence and lessons learned in India and Pakistan. Bull World Health Organ 2009; 87: 62430.

UNICEF (2012).UNICEF quarterly newsletter on polio eradication initiative in Nigeria.The Game Changer.

Waisbord S, Shimp L. Communication for polio eradication: improving the quality of communication programming through real-time monitoring and evaluation. J Health Commun 2010; 15: 924.

WHO (2014). Progress towards global immunization goals: summary presentation of key indicators. Geneva: World Health Organization.

Willis N, Hill S, Kaufman J, Lewin S, Kis-Rigo J, De Castro Freire SB, ‘Communicate to vaccinate’: the development of a taxonomy of communication interventions to improve routine childhood vaccination. BMC Int Health Hum Rights 2013; 13: 23