TFI Follow Up meeting COMMUNICATION FOR EPI/Polio Dakar, Senegal, 5 – 7 April 2008

Flow of data and information National State LGA Ward Data Information for action / feedback

Process Collect/receive IPDs data for the LGAs/states from WHO (exported Excel files include all the data from the different forms used during the IPDs). The data are then converted into specific charts as required and compared with identical charts from previous IPDs IPDs data for states or LGAs is mapped to allow for visual interpretation of the geographical patterns over time. Feedback thru Consultants and review meetings Analysis by states sent to national data FP who gives feedback

Actors Involved Socmob data officer at UNICEF Nat Socmob working Group (NSMWG) M&E working Group (Chair is WHO) Health Education officers (LGA/State) State Consultants (WHO/UNICEF) WHO data FPs Other partners (COMPASS, RED Cross)

2008 Monitoring Indicators Major % reduction in NC Households (trends analysis) % reduction in missed children (trend analysis) % reduction in Zero dose children Trend analysis of sources of information Trend analysis of knowledge of campaign Other Trend analysis of data from Koranic schools Trend analysis of data for children immunised on the streets

Priority Zones: Trend in Non-compliance Tally Data Trend in NCHH in 6 VHR States NCHH by LGA, Sept 07NCHH by LGA, Jan 08 NCHH by LGA, Feb 08

JANUARY 2007 JANUARY 2008 Strategic Result: Sources of Information Independent Monitoring Data FEBRUARY 2008

Strategic result: Missed Children in the 6 VHR States Monitoring Data 10.6% reduction in children missed due to non-compliance in the 6 Very High Risk States from Nov 07 to Feb Nov 07Jan 08Feb 08 % M i s s e d C h i l d r e n Non-compliance Child Absent House Not Visited 7.0% 7.8% 5.6%

Reasons for Child Absent, Feb 08 Monitoring Data

Jigawa State– Trend in NCHH September 2007 February 2008 January 2008 November 2007 Tally Data Sule Tankankar

Missed Children (%) by Ward Sule Tankakar LGA, Jigawa State – January 08 IPDs

Sources of information, Danadi Ward, Sule Tankakar LGA, Jigawa IPDs JAN-08

Key Communication Issues for HR Danadi Ward in S/Tankankar 1.Very high level of missed children. 2.SECT (Digawa) does not believe in western medication 3.Non-compliance, overt and passive 4.Significant levels of zero-dose children 5.No correlation between influence of traditional institutions and compliance 6.Inadequate implementation by teams/health workers to counsel HH for acceptance. Responses: Line listing of Qur`anic schools and population of children Additional teams provided by Jigawa Use of TBAs in every team as vaccinators. Use of Qur`anic schools teachers as vaccinators in HR. Engagement of Emir of Gumel

Indicators for Special Initiatives Koranic schools No of Schools sensitized No of schools that allowed immunisation No of Children reached in Koranic schools Child to child and Youth participation outreach No of youths involved/participating No of eligible children identified No of identified children that are immunized

Indicators for Special Initiatives (2) Community Dialogues (CDs) No of CDs conducted No of participants in CDs Issues raised in CDs No of Non-compliant children immunised after CDs IPC improvement initiative No and categories trained (vaccinators, TBAs, CBOs WFPs, HEOs) Quality of training Basic skills (GATHER)

FOMWAN SENSITIZATION OF QURANIC SCHOOLS for JAN AND FEB 08 IPDs across 7 HR states (Bauchi, Jigawa, Kaduna, Kano, Katsina, Zamfara) No. of Islammiya schools mobilized 313 No. of Teachers sensitized685 No. of ceremonial events during which public sensitization was done 76 No. of women reached during sensitization events 4831 FOMWAN H2H MOBILIZATION for JAN AND FEB 08 IPDs across 7 HR states (Bauchi, Jigawa, Kaduna, Katsina) No. of Children in Non- compliance HH 12,493 No. of Children in resolved Non-compliance HH 9,004 % of Non-compliance cases resolved 72% Strategic Results: Community Mobilization Federation of Muslim Women Associations of Nigeria (FOMWAN) resolved over 70% of non-compliance cases identified

Strategic Result: Children Vaccinated in Koranic Schools

Impact of Community Dialogues Children ImmunisedNon-compliant Households Tally Sheet Data for Settlements where dialogues were monitored

Review of microplans Feedback and guidelines for next IPDs Deployment of national consultants to supervise states STOP teams focus on supportive supervision for data 2 annual retreats for SM personnel Monthly State reports (LGA and state) Follow Up & Supervision Mechanisms

Key Challenges Weak Capacity of personnel at ward, LGA and state to analyse social mobilization data to guide planning of interventions Weak feedback from states on linkages between epidemiological and SIA data and targeted communication interventions Inconsistent data collection tools across states on different initiatives by partner agencies

Key Challenges contd. Frequent gaps in the data received from the states and sometimes data are entirely unavailable Weak capacity of vaccination team personnel to collect social mobilization data at household/settlement level Weak capacity of NPHCDA monitoring and evaluation personnel to support SMWG in data analysis in the absence of UNICEF personnel Poor access to social data collected and analysed by partner agencies on various communication approaches

Key Lessons Learned Profiling and disaggregated analysis of communities and households has now led to better understanding of reasons and therefore better response Data analysis and use helps to pin point problem areas requiring priority attention HR analysis is key to deployment of Human and Financial Resources

Recommendations/Suggestions Retain position of EPI Social Mobilization Data Specialist in new UNICEF Country Programme NPHCDA to assign staff from the data department of the agency to NSMWG to help build capacity, share workload UNICEF or partners to field Consultants with basic data analysis skills at State level to facilitate the use of social data on immunization for communication NSMWG and MEWG to harmonise tools for state- specific and agency-specific initiatives and then ensure partners regularly share their data.

Next Steps Guidelines on data collection, analysis and use Harmonize and share basic tools Orientation on use of current tools

Routine Immunisation (RI) Reaching Every Ward (REW)

Process and Actors Not systematically planned for Data collected through annual KAP Partners collect periodic data (PRRIN) SMWG M and E Working group SM consultants Integration of indicators in supervisory checklists (3 critical messages)

Priority Zones Polio HR States/LGAs Priority wards based on numbers of un- immunised children (some wards in Lagos, Oyo and Benue)

Indicators % of caretakers who can state benefits of immunisation % of caretakers who can state Vaccine Preventable Diseases % of caretakers who can state number of doses required before childs 1st birthday % of caregivers who can state correct age for measles vaccination No of Community Dialogues that indicate discussion of routine immunisation No of Health talks on radio that discuss/integrate Routine immunisation

Number of doses of DPT required by child in first year Knowledge on Routine Immunisation – KAP 2007 Age a child should be vaccinated against measles

REW Indicators No of Community Coordinating Groups functional in wards No of Health Facilities with a community link plan No of community mobilizers or Community Health Workers involved in defaulter tracking –b. Reasons for defaulting No of community groups mobilized in support of immunization –b. Type of support they provided as a result of the mobilization Caregivers knowledge of diseases prevented, immunization schedule and dates of clinic sessions/outreaches) Health educators monthly plans (facility based and outreach) Sources of information on immunization

Follow up and Supervision Mechanism Ensuring that Village Development Committee (VDC) health FP reports on immunisation to community and Ward Development Committee (WDC) HEO follows up (LGA/State) Supervision from state and LGA

Key Challenges Weak supervisory system especially for health education No FP for SM at community and ward level No agreement on indicators and tools System not in place for regular data collection for RI communication SM very centralised at LGA level

Key Lessons Learnt Establishment of a system for planning and monitoring communication for RI is a necessary first step for regular data collection

Suggestions and Way Forward Strategic communication planning for communication for RI –indicators and tools –training –data collection, analysis and systematic use

Targeted advocacy makes a difference in the lives of children and brings a smile First lady of the Federal Republic of Nigeria at National flag off for IPD