Contributions of Volunteer Community Mobilizers to Polio Eradication in Nigeria: The Experiences of Non-governmental and Civil Society Organizations

Abstract

The Northern states were the epicenter of the wild poliovirus outbreak in Nigeria in 2016. To raise immunization coverage, particularly of polio, the Polio Eradication Initiative (PEI) in Nigeria introduced the use of nongovernmental organizations and volunteer community mobilizers (VCMs) through the CORE Group Polio Project (CGPP). The CGPP has been contributing to Nigeria's polio eradication efforts since 2013. This article explores the contributions of the 2,130 VCMs deployed in 31 participating local government areas in the five implementing CGPP states from 2014 to 2017 to increase awareness, understanding, and acceptance of polio immunization. Data for the study were collected from primary and secondary sources using five collection methods: a survey of VCM supervisors, focus group discussions with VCMs and their supervisors, key in-depth interviews with community stakeholders, case studies of specific best practices of VCMs, and a review of documents and records. A review of the data shows that the VCMs received comprehensive training on the importance of the PEI, routine immunization, Acute Flaccid Paralysis (AFP) surveillance, social mobilization and community engagement, use of behavior change communication tools, and interpersonal communication skills. According to the data collected, the VCMs used the following innovative strategies to ensure high vaccination coverage: house-to-house mobilization, community dialogues, compound meetings, community health camps, and tracking of non-compliant families, missed children, and dropouts. The involvement of VCMs in Nigeria's PEI efforts has been a pivotal contribution to reductions in the number of households rejecting polio immunization, the proportion of families with missed children, the proportion of families that were non-compliant, and the number of polio cases.

The CORE Group Partners Project in North East Nigeria: Community Engagement Strategies to Combat Skepticism and Build Trust for Vaccine Acceptance

“…In most areas of Nigeria’s North East, the level of insecurity is such that only CGPP and UNICEF VCMs are presently mobilizing the communities. A companion article in this series 9 describes further the contributions of VCMs along with the non-governmental and civil society organizations with which they worked that contributed to these achievements.…”

“…Engaging the community led to the acceptance of polio immunization among communities previously opposed to all immunizations. A separate article in this series 9 analyzes the role of the volunteer community mobilizers (VCMs) in Nigeria, who made these transformations possible.…”

The Critical Role and Evaluation of Community Mobilizers in Polio Eradication in Remote Settings in Africa and Asia

“…The survey included 18 broad questions about program operation, management, and development over time, focusing on community mobilizer (CM) roles. The timeframe for data Not applicable 2.5 (2017) 4 4 (2017) 4 13.6 (2014) to 19.6 (2017) 8 Abbreviation: OPV, oral polio vaccine; OPV0, oral polio vaccine newborn dose; OPV3, oral polio vaccine third dose.…”

Certifying the interruption of wild poliovirus transmission in the WHO African region on the turbulent journey to a polio-free world

“…Additionally, 82% of local government areas met both core surveillance indicators annually. Throughout northern Nigeria, government officials and partners engaged traditional leaders and associations such as the Federation of Muslim Women's Associations in Nigeria, 18 youth groups against polio, 19 The Journalists Initiatives on Immunisation Against Polio, 20 and groups of polio survivors, community health workers, and traditional birth attendants, who used their networks to advocate, engage, and sensitise communities to advance polio immunisation efforts. In Borno State, Nigeria, special surveillance and immunisation initiatives were introduced, including recruiting community informants residing in inaccessible areas who regularly report cases of acute flaccid paralysis and have ongoing contact with adjacent secured areas in which surveillance activities have been intensified; taking stool samples from contacts and healthy children residing in or escaping from inaccessible areas; and the creation of the Reaching Inaccessible Communities initiative, a partnership between the polio programme and the Nigerian military to improve the reach of immunisation and surveillance activities in areas truly inaccessible to the polio programme.…”