I am Shailesh Pandey, associated with UNICEF, Papua New Guinea as a C4D Consultant and providing my support to the three highland provinces of the country i.e. Jiwaka, Simbu and Western Highland Province (WHP) to ensure the planning and quality execution of all the communication for development activities under Polio Outbreak Response.

The key issue what I identified here is low coverage of routine immunization i.e. 35% in the province Jivaka of Papua New Guinea where I am based. Secondly, the OPV coverage is also low (80%) compare to the country data (90%). However, the routine immunization coverage of the entire country is also very low i.e. below 50%.

This is to be noted down that this country was declared as polio free country by WHO in the year 2000 but after 18 years in 2018 a polio outbreak occurred again. Low routine immunization coverage was one of the major reasons behind this outbreak. Even the children up to 15 years also got affected during the outbreak. Resulting, it was decided by the government to vaccinate the children up to 15 years by conducting the several SIA campaigns. The whole scenario shows the poor level of the immunity of the people of the country due to low coverage of routine immunization.

The guideline I selected is “Integration of immunization program: Working together”.

Effective counseling of the mothers during the pre-natal checkup and after the delivery about the complete immunization schedule- This is very important activity that can be very impactful to enhance the level of awareness of the mothers towards the importance of immunization of them and their child. From the time of pregnancy up to the delivery all the mothers visit the health centers several times and that is the right time to do an effective counseling even at the same time we can provide the immunization card for mother and child so that they could be able to understand the schedule of the immunization.

Proposed activities are given below- 

Strengthening the systems for civil registration and vital statistics- At the place where I am working this is a big problem that contributes much confusion regarding the actual coverage of the immunization. Therefore, this is very much essential to do the proper registration of all the pregnant women as well as all the eligible children for immunization. We can utilize the health workers for the same in their respective areas. It will also contribute to improve the denominators used to monitor immunization coverage rates.

Advocacy with the high level authority of health and other departments to ensure the integration of the different activities- We need to do the intensive advocacy with the high level health authority to make sure the integration of the immunization with the other health services i.e. MCH Program, Malaria, HIV/AIDS, WASH, Nutrition, Environment etc. At the same time we will have to the same with other government department such as Education, Women & Child Welfare etc. to make sure the integration of the immunization with these activities also because of having the same beneficiaries i.e. women and child.

This will also be helpful for very hard to reach areas also like whatever services are being reached in those areas from the government and other NGOs at the same time we can integrate this immunization too with all those supply.

Capacity building of the frontline workers to sustain the integration of the activities- This is also very important activity because the current capacity of the health workers is not appropriate to facilitate more than one activity together. Therefore, we need to build their capacity to deal with the several activities together to sustain the integration approach. We need to enhance their capacity especially in term of coordination within the systems as well as inter sectorial.

Awareness generation within the community- We need to develop a full-flag communication and social mobilization plan for the better awareness of the community to accept the immunization program like any other program. We need to engage the NGOs and other organizations working for women and child welfare in the project areas. We need to focus on the advocacy with the Church Organizations as well because they are the most trustable source of information for the community.

Media (Print/Electronic/Social) Engagement- We need to engage the media to promote the designed integration program. They are also one of the trusted sources of information especially to spread the message and information in the very hard to reach areas.

Advocacy Communication & Social Mobilization (ACSM)- We need to develop a full-flag communication and social mobilization plan for the better awareness of the community to accept the immunization program like any other program. We need to engage the NGOs and other organizations working for women and child welfare in the project areas. We need to focus on the advocacy with the Church Organizations as well because they are the most trustable source of information for the community.

I would recommend forming one committee with the participation of one member of all the government departments including NGOs at each level like from cluster to the national level to review the impact and recommend the ideas to sustain all the integrated activities at least once in a month. We can take the example of the polio task force that is formed at each level and is a very useful tool to activate all the stakeholders for ensuring their effective participation during the SIA campaign.