1. 1 Communication in Practice 12 th Annual Measles & Rubella Initiative Meeting 10 th -11 th September, 2013 RJ Davis, WB Mbabazi, M Charles, A Patel

2. “ “I wrote a report to the Minister and also sent it to the English-language dailies. He read my report in the newspaper.” — S. Ramasundaram, Former Head Health and Family Welfare Department Tamil Nadu, India

3. Communication Approach we use Audience Response Channels Message Objective Sender Response

4. Measles/Rubella Control/Elimination 1. High morbidity and mortality disease entities; 2. Spread easily and fast causing epidemics 3. Dictates that We Move Faster  Reaching at least 95% of all infants with the first MCV/RCV in all Districts  Reaching at least 95% of all <5yrs old children with a second dose of MCV in all districts a) Through Routine (MSD) b) SIAs/Mass Vaccination Campaigns 4. When we fail to access the less accessible we fail to reach 95%

5. 3. Communication Objectives Advocacy  Mobilize leaders to participate and support Measles/Rubella control/elimination efforts  Mobilize all stakeholders for epidemic prevention and control efforts. Social Mobilization  Promote desired measles control behaviors  Create awareness about measles/Rubella disease, especially outbreaks (predicted or real).  Demystify misinformation, rumors & misconceptions

6. Communication Objectives cont’d Social Mobilization Cont’d  Mobilize the population to participate in epidemic prevention/containment interventions including: 1. Community mobilization 2. Early detection/notification of measles/Rubella epidemics 3. Active case research/reporting 4. High-risk populations surveillance 5. Mapping and knowledge building of community resource persons etc.  Research and evaluation to detect and counter emerging adverse behaviors

7. 4. Rationale for Communication  Definition and mapping of Stakeholders  Builds partnerships  Creates agents of change  Assures community reach bearing in mind that the communities are more affected planners

8. 5. Choice of communication channels Promoting Media Mix  Assure that Communication plans are part of POA/cMYP and cover  Print (leaflets, posters, Banners, Q&A, News Inserts and advertorials) is good but has limited reach  Electronic (Radio, TV and Mobile Phones) has more reach but costs more and is limited by coverage/network range  Folk media (Megaphones, Roadside shows, locally generated drama, community events, using places of worship, etc) is more appropriate but is least thought about  Inter-personal communication (IPC), most effective 1. Face to face health Education sessions by HWs 2. House-to-House Canvassing

9.  Audience number 1  Planners in the Ministry of Health  Donors  Politicians  Audience number 2.  Health communication experts  Health workers  Researchers  Audience number 3  Parents/Caretakers (who are also voters)  Any unintended audiences Who, exactly, is our audience? Media that can reach

10. Key considerations of the messages 1. Does message make news:  Affects lots of people,  Affects them today,  stirs controversy? 2. Does message have a human face? 3. Is message important for policy? 4. Is message short and simple? 5. Any hidden message? … rationale for Pretests Formulation of Key messages (<3)?

11. 6. Review of Past Performance in measles/Rubella communication -- Simple, consistent messagin

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13. PRE-CAMPAIGN VOLUNTEER VISITS DOCUMENTATION, Dakar Region, Senegal 2010 Number of H/holds visited Total persons sensitized before volunteer visit # of persons sensitized in H2H Visit M'bao1,8801358,213 Keur Massar7696265,037 Rufisque1,67042562,067 Diamniadio1,47032561,756 Nabil choucair2,544176111,796 Philip Maguillen1,35915765,854 Gaspard Kamara2,556168918,858 Polyclinique1,57025396,265 Subtotal13,81815,83859,846 Only ¼ of respondents were sensitized prior to the H2H visit of RC volunteers

14. PRE-CAMPAIGN VOLUNTEER VISITS DOCUMENTATION, Tanzania; Nov 2011 425,087 (34%) H/holds were aware of the measles campaigns before theH2H visit was conducted by TRCS Volunteer REGION *Target H/holds No. of H/holds visited % of H/holds visited # of Children registered HH with measles SIA information before TRCS volunteers visit Parents that agreed to send children for vaccination (n) (%) (n) YesNoYesNo Arusha331,540289,76787.4 300,306 28,325 261,442 288,234 1,533 Dar Es Salaam 359,086 335,59693.5 426,010 66,620 268,976 331,335 4,261 Mara301,335 292,15791.1 396,239 165,154 84,066 284,249 7,908 Tabora364,258 329,22286.3 565,244164,988 149,441 320,109 9,113 Total1,356,2191,246,742921,687,799425,087763,9251,223,92722,815

15. Mobile Phone supported H2H Visits Documentation, Kenya, November 2012 15 District H/Holds Visited #Children Counted H/Holds informed prior to the visit # H/Holds Consenting to a measles SIA dose % H/Hold Consenting to SIA Embakasi/Njiru 13,401 18,761 7,604 8,648 65% Kasarani 9,434 12,264 4,824 5,428 58% Dagoreti 7,844 9,413 4,044 5,142 66% Starehe 5,480 6,576 3,480 4,861 89% Kamukunji 3,650 4,380 2,506 2,810 77% Westlands 2,464 2,218 1,426 2,160 88% Langata 2,526 2,779 1,503 2,283 90% Makadara 1,978 2,571 1,082 1,624 82% Kisumu East 15,200 19,760 9,230 12,958 85% Busia 6,459 7,751 3,149 5,082 79% Nambale 4,606 8,291 2,056 3,056 66% Total73,04294,76440,90454,052 74% 40,904 (56%) households were aware of the measles campaigns before the house visit was conducted by KRCS Volunteers

16. RESULTS OF SITE INTERVIEWS WITH CAREGIVERS, TWO RURAL PROVINCES COVERED BY BURUNDI RC, 2012 SIA HOUSE VISITS RADIOCHURCHES ALL OTHER POPULATION RED CROSS VOLUNTEERS Ruyigi231971550,5710562 Gitega323123692,01361,022 Total555030211,425,8461,584

17. 7. Standardizing H2H measles/Rubella communication practices  H2H Canvassing Field Guide  Developed in 2012  Been tested and used in 5 countries  Prospects  Document use of the H2H field manual  Test use of manual in Routine EPI communication  Publish guide for global use

18. Anne Ray Charitable Trust  18