The Drum Beat 819 - Social Data, Misinformation, Conflict: Polio Learning

• 1.Challenge Mapping in Pakistan
  by Jahan Uddin Challenge mapping involves collecting social data and qualitative information at the granular level, which helps address local issues in high-risk areas and ultimately supports efforts to minimise resistance to polio vaccination in Pakistan. An area is considered to be high risk when oral polio vaccine (OPV) refusals are high, such as among Pashtun populations. In these areas, there are serious trust issues between the government and communities. Previously, the approach was to address refusals by the Pashtun community as one entity. When UNICEF engaged those tribal, political, and religious leaders that belong to their sect, as well as those doctors and faith healers they believe, then UNICEF started getting some results in those areas: minimising more than 70% of refusals. 
   
• 2.The Mozambique Response to the WPV and cVDPV Outbreaks
  by Ketan Chitnis On May 15 2022, a case of wild poliovirus type 1 (WPV1) was reported in Mozambique - the first in that country since 1993. Mozambique was also affected in 2022 by a concurrent outbreak of circulating vaccine-derived poliovirus type 2 (cVDPV2). Ketan Chitnis characterises the response in 2022 as data informed, with an eye to addressing misinformation and ensuring acceptance of OPV and trust in the polio programme. Among the lessons learned: While communities have multiple priorities, when they are consulted, engaged in respectful conversations, have their questions clarified, and are provided with communication that is socially acceptable, levels of demand for OPV and vaccination behaviour are high. 
   
• 3.Qualitative Research on Perceptions of Polio Vaccination in the Context of COVID-19 Vaccination (COVAX) Rollout in Cameroon and Ethiopia
  by Ross McIntosh In this presentation, Ross McIntosh presents the findings of qualitative research UNICEF conducted in early 2020 to look at perceptions of polio vaccines in the wake of the COVID-19 emergency in Cameroon and Ethiopia. Essentially, the research showed that COVID-19 has created very considerable hesitancy around polio vaccination in Cameroon but very little in Ethiopia. Community members expressed all kinds of misperceptions of polio vaccination. McIntosh stresses that vaccination modalities should be considered from the perspective of intended communities, urging: "we really need to speak to target communities to hear what they have to say about vaccination modalities before we make the decision to do them." 
   

• 4.Innovating, Learning, and Progressing - Misinformation Management and Digital Community Engagement Unit
  by Adnan Shahzad and Hameed Kashan This presentation explores the work of UNICEF Polio Team's Digital Community Engagement Unit (DCEU) around digital engagement and misinformation management in the wake of the COVID-19 pandemic. DCEU is an initiative that UNICEF piloted in five countries in partnership with Public Good Projects (PGP); it is reaching more than 38 countries as of this presentation. DCEU uses online social listening tools to analyse the social media landscape and to track circulating narratives around polio vaccines. DCEU then alerts the relevant UNICEF regional and country offices to these communication challenges. Once analysed for potential impact, DCEU partners with UNICEF country offices to create misinformation response campaigns. 
   
• 5.Leveraging Innovative Approaches to Track and Prevent Misinformation and Support Routine Immunization
  by Deepa Risal Pokharel and Surani Abeyesekera For UNICEF, social listening to detect vaccine hesitancy goes beyond digital communication or tracking rumours or misinformation that spread on social media. During the COVID-19 pandemic, there has been a lot of offline conversation, whether through the media or WhatsApp groups among religious leaders, friends, and communities. This presentation examines UNICEF's infodemic management strategies, which are designed to support demand for all vaccines. In pursuing this work, UNICEF has set up different partnerships, such as with the Yale Institute of Public Health and the Public Goods Project (PGP), and Meta. For example, through a collaboration with Sabin Vaccine Institute and Monash University, UNICEF held co-design workshops in Uganda, Rwanda, and Kenya to create Cranky Uncle, a smartphone game teaching players how to spot misleading techniques in vaccine misinformation. 
   

• The Drum Beat 817 - Social Listening: Polio, Immunisation, and Vaccines
   
• The Drum Beat 814 - Misinformation and Polio
   
• The Drum Beat 811 - Eradicating Polio in Humanitarian and Crisis Contexts
   
• The Drum Beat 799 - Polio, Vaccines, and Social Media
   

• 6.Community Feedback and Response Mechanisms: Pakistan Experience
  by Julianne Birungi and Arifa S. Sharmin In Pakistan, one of the remaining polio-endemic countries, vaccine hesitancy is high, and the amount of false information is concerning. In this presentation, one member of the team at UNICEF Pakistan describes the work the organisation is doing to combat misinformation through community feedback and response mechanisms. In response to a baseline environment and crisis situation, an 11-member social media team now engage in social listening 24/7 as part of their human-centred design framework, whereby they put the community at the centre to be able to address concerns about vaccination. In pursuing digital engagement, the polio programme seeks to build a bridge that connects parents/caregivers/people, providing real-time information. 
   
• 7.Misinformation Management in Afghanistan - Polio
  by Eman Eltigani Eltigani begins this presentation by sharing recent rhetoric, circulating via video, that compares people who support the polio programme in Afghanistan to infidels. This video, which was first circulated online but has since spread to offline circles, is an example of the ways in which misinformation is affecting not only the effort to eradicate polio in this endemic country but also the extent to which it is actually endangering the lives of workers on the ground. In such a context, social listening and digital engagement are crucial, Eltigani argues. In response to one audience member's question, Eltigani indicates how UNICEF Afghanistan is trying to increase access to information - e.g., by working with the communication team on a listening project that involves distributing solar radio to the community and ensuring that their hotline is also working. 
   

• 8.The Afghanistan Challenge and Strategy
  by Pa Ousman Manneh Manneh discusses some of the changes that have affected Afghanistan since the Taliban took over in August 2021, following the withdrawal of international troops. The Taliban said they had no problem with the polio campaigns but that they had to take place mosque to mosque. Women, who are the custodians of the children, are not allowed into any mosque setting, so, once again, children have become inaccessible, as the mosque-to-mosque campaign modality is not in sync with socio-cultural norms. Manneh stresses the need to adapt to the situation on the ground, as it is continuously changing. UNICEF Afghanistan is carrying out a variety of SBC activities and also working to ensure an established mechanism for reaching out to the Taliban that involves, for example, access negotiation and maximising use of internal interlocutors. 
   
• 9.Sustaining the Gains of Polio Eradication: Addressing Vaccine Refusals in Northeast Nigeria
  by Elizabeth Onitolo Onitolo discusses UNICEF Nigeria's work to address vaccine refusals in conflict-affected northeast Nigeria, which has been affected by insurgency in the last 12 years. The rising cases of missed children due to vaccine refusals pose a huge risk for sustaining Nigeria's gains in securing its status as a wild-polio-free country in August 2020. In most cases where UNICEF Nigeria encounters caregivers who are refusing vaccine, the issue is that there have been too many rounds of polio vaccination or because of their religious beliefs. Onitolo describes UNICEF Nigeria's efforts to respond, shares key learnings from this work, and makes recommendations - e.g., leverage multiple community platforms and local networks to implement suitable community engagement interventions, such as community dialogues and house-to-house visits. 
   
• 10.Conflict & Its Impact on Polio Eradication South Khyber Pakhtunkhwa: Innovative Social & Behavior Change Strategies & Models
  by Ejaz Ur Rehman and Sheeba Afghani Following the United States invasion of Afghanistan in 2001, Pakistan and the merged Tribal Districts experienced increasing violent conflict that has further challenged the attempt to eradicate polio in this region. Ur Rehman begins by presenting some context for the conflict and discussing the nature of challenges for polio eradication, especially fear and mistrust among communities. In this setting, SBC has an evolving role, including within known chronic refusal clusters/large-scale demand-based refusals, as well as in response to fake finger marking and other hidden refusals. During the discussion session with audience members, Ur Rehman details the work of the religious support persons (RSP) network, which was formed in 2014. In response to some challenges these RSP have faced, UNICEF Pakistan has expanded its approach so as to emphasise the value of immunisation beyond just polio. 
   

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