The polio eradication programme in India is evidence based. It has evolved over a decade from careful analysis of data, collected at the local, block, district, state and national levels. The data is used to drive communication planning; it shows what is being done well, what is working and what needs to change.

There are also annual large scale household surveys of knowledge, attitudes and practices (KAP studies), used to evaluate whether the programme is managing to change knowledge and behaviour about polio and other targeted health issues.

Community Level

At the local level the community mobilizer recordsa large amount of detailed information in her field book including how many children have been immunized, how many have been missed and how many parents have refused. She also records which children are due for routine immunization and how many have actually received it. This information is summarized each month in ‘form A’ and given to the supervising block mobilizer.

Block Level

The block mobilizer in turn summarizes this information in ‘form B’. The BMC also visits houses where parents are refusing the oral polio vaccine during an immunization round, and collects information about this in the BMC field book. This field book also records supervision activities such as how many CMCs and influencers were visited during a round, how many routine immunization sessions were monitored, the number of CMCs appointed and given training, partnership meetings attended and information on tracking of high risk groups.

District Level

The district mobilizer uses information from ‘form B’ to produce ‘form A’, which summarizes information for the district. This data is entered into a data base by an external agency, and then is used to produce a monthly report, analysed at the state level. Findings are reported back to the district, block and community levels for planning improvements for the next immunization round.

Tools

A power point presentation is produced for each block and districtshowing trends. The data is fed into the UN produced ‘devinfo’ software programme to produce one page profiles for each district and block. They show key performance indicators for the communication effort and are evaluated regularly, so the programme can improve next time around, and make strategic changes when and where they’re needed.

Extra Monitoring

During immunization rounds, staff from partner agencies who are visiting the field are given monitoring forms to check a range of indicators, such as the visibility of information, education and communication materials (IEC). Around 4000 such forms are filled out for each round, and analysed to show where improvements need to be made.

Indicators Measured

Monitoring of polio awareness by the Social Mobilization Network includes the following weekly, monthly and quarterly indicators. Results are collated and shared with partners for evidence-based strategic planning of the polio programme.

Process (in high-risk areas, defined by an agreed epidemiological and operations criteria)

• numbers of community mother meetings - monthly
• numbers of newborns identified and immunized - monthly
• number of planned/held/facilitated RI sessions - monthly
• numbers of interface meetings involving influencers, volunteers and service providers – by SIA
• % of mosques making fixed site announcements – by SIA
• % effective use of IEC materials at fixed site booth - by SIA
• numbers of orientations of stakeholders at block level – by SIA
• number of media workshops held in high-risk districts – quarterly
• number of communication plans prepared by district – by SIA

Communication Effects

• % of families who know the local community mobilizer, and day and site of polio SIA – by SIA
• % of households converted, by type of house (XS, XR, XV, XL, XH) – by SIA
• % of vaccinator teams with assigned influencers accompanying teams to all x houses – by SIA
• reasons families give for refusing to immunize their child – annually
• % of families who believe OPV causes sterility - annually

Outcome/Impact

• % eligible children immunized at a polio booth - by SIA
• % households missed for immunization by category, generated and remaining (Xr, Xv, Xo, Xs, Xl) - by SIA
• % of identified newborns (< 1 month old) receiving OPV through SIA or RI – monthly
• average number of doses in children by 12 months of age – biannually 
• % of negative vs. positive/neutral media stories by district, state, national - monthly

Communication Review

An annual independent external communication review is held, with international consultants from organisations including CORE, CDC and UNICEF.  This review has invites consultants, who are experts in the field, to come up with recommendations for the communication programme. A final report is produced that helps UNICEF make strategic decisions and which also goes to the Government of India to help its planning.