ASSESSING THE USEFULNESS OF COMMUNICATION STRATEGIES TO ENHANCE COMMUNITY MOBILIZATION FOR IMMUNIZATION AGAINST VACCINE PREVENTABLE DIEASES IN THE BUEA HEALTH DISTRICT

Summary

Background: Communication is a critical component in ensuring that people are fully vaccinated. Although numerous communication interventions have been proposed and implemented in various parts of Cameroon, the impact of communication strategies used has not yet been felled in the Buea Health District.

This study forms part of the ‘Communicate to vaccinate’ project, an initiative aimed at building research evidence for improving communication with parents and communities about vaccinations in low- and middle income countries.
This study will be on the usefulness of how communication strategies may enhance mobilization of the People of the community for immunization on vaccine preventable diseases.

The total population for study will be 400 patricians from the Buea Health District. Questionnaire will be used as instrument for data collection. Descriptive research design will be adopted for this study. The total number of participants which will include nursing mothers, married men, students and youths that have been vaccinated at least once will be used for the study.

A statistical software SPSS V26 and Microsoft excel 2016 will be used for analyzing the Data. The analyzed data will be presented in table, pie chart, bar chart. The independent sample t-test will be used to see the differences means between interpersonal and mass media communication.

Descriptive statistics will be used to described the factors influencing immunization in Buea to understand the various situations to show how useful communication strategies will enhance immunization coverage.
Keyword: Communication, Mobilization, Community, Immunization.

CHAPTER ONE
INTRODUCTION

1.1 Background to The Study
Immunization remain the most cost-effective public health strategies to reduce morbidity and mortality associated with vaccine preventable diseases as compared to other strategies such as health promotion through education, hygiene and sanitation and many others [1]. More than 3 million children deaths worldwide are said to be prevented each year through vaccination [1,2].

Routine immunization (RI) has contributed immensely to significant reduction in the mortality from vaccine preventable diseases among children [1]. Globally, it is estimated that about two to three million deaths occur yearly as a result of vaccine preventable disease (VPD) with approximately 1.5 million deaths among children who are under-five years old [3, 4].

However, vaccine preventable diseases (poliomyelitis, measles, tetanus and yellow fever) remain the most common cause of childhood mortality with an estimated three million deaths each year. In 2018, Global efforts had immunized about 86% of infants worldwide with three doses of diphtheria-tetanus-pertussis (DPT) about 86% of infants worldwide (116.3 million infants) received 3 doses of diphtheria-tetanus pertussis (DTP3) vaccine, 89% had received BCG and 86% had received the first dose of the measles vaccine [5]
Despite these huge benefits, childhood vaccination programme face numerous challenges including low and stagnant coverage level, underutilization of vaccine services, inadequate sustainable financing, misleading information, and poor communication strategies use to educate and create awareness of community about vaccination and it effect [4]
The World Health Organization (WHO) established the Expanded Programmed on Immunization (EPI) in 1974, with the goal of ensuring full accessibility of routine vaccines by children.

According to the EPI calendar, a child should receive one dose of Bacillus Chalmette Guerin (BCG) immediately after the baby is born, four doses of oral polio vaccine (OPV), Diphtheria Pertussis Tetanus (DPT), measles, yellow fever neonatal tetanus, rubella, human papillomavirus (HPV) and many other vaccines to ensure maximum protection against vaccine preventable diseases.

Provision of these vaccines to the recommended ages and interval will ensure the individual with adequate protection from vaccine preventable diseases [3].
Polio is the common name for poliomyelitis, which come from the Greek words grey and narrow, referring to the spinal cord, and the suffix-itis meaning inflammation [6]. Poliomyelitis shortened, become polio.

It is an infectious diseases caused by the poliovirus and it is a perfect example of a vaccine preventable disease. Poliomyelitis is usually spread from person to person through infected fecal matter entering the mouth, it is also spread by food infected with saliva [6]. The infected persons or people may spread the disease for up to six weeks with no symptoms present.

The diseases may be diagnosed by finding the virus fasces or detecting antibodies against it in the blood of an infected person. The disease is prevented using the polio vaccine.

Polio vaccine are vaccine use to prevent poliomyelitis. They are basically two types which are commonly used, an inactivated polio vaccine given by injection (IPV) and a weaken polio vaccine given through the mouth (OPV) [7].
Measles cause by virus that live in the nose and throat mucus of an infected person, can be spread through coughing and sneezing, as one breathed the contaminated air or touch a contaminated surface then touches their eyes, noses or mouth they become infected [6].

Human papilloma virus (HPV), that causes cervical cancer, yellow fever, mumps, and many other diseases that can be prevented by vaccine which is the key part to immunization. The world has come very close to the eradication of some of these vaccine preventable disease through the global eradication initiative, a programmed which communication channel have to play a central role.

The public health initiative is organized by the WHO, Rotary international, the US center for disease control (CDC) and the United Nation International Children Emergency Fund (UNICEF) [6].
Mass media and information communication strategies that are used in immunization effort worldwide will enhance the success of the programme.

However, polio and many vaccine preventable diseases still exist, in Africa and Cameron remain one of the country in the world that have not stopped transmission of polio, measles, hepatitis, and many other infectious diseases. Eradication efforts today face some of the greatest communication challenges they have encountered [4]. Many of these have receive attention in the national and global media, but they grow from discussion in homes and villages, community, religious leaders. Marginalized communities where VPD circulate are in dyeing need of basic services of health and immunization.

looking at past events in Cameroon, the importance of communication for the mobilization of population against these diseases has not been realized within the sociocultural, religion, and political contexts. These and other challenges require good communication action is able to inform or educate, remind, teach skills provide support and facilitate decision making communication strategies to enhance a successful well applied planned in a systematic way [8].
The eradication of VPD requires that nearly every child under age of 5years receive multiple doses of vaccine, with some dose provided during routine immunization and the rest through supplemental immunization activities (SIA) campaign [9]. Failure to immunize children result in an immunity gap that enable reoccurrence of the diseased to circulate, resulting in large human and financial cost.

Communication strategies for VPD are design to enhance immunization coverage by identifying missing children, disaggregating reason for refusal, identifying the most effective channels of information, and engaging effective influencers to overcome resistance [8]. The study also aims to look at factors that will influence vaccine acceptance.
We define a communication intervention as a purposeful, structured, repeatable, and adaptable strategy to inform and influence community decisions to personal and public health participation, disease prevention and promotion, policy making, service improvement, and research [10,11].

Some if these communication strategies may include; behavior change communication, communication aimed at informing or educating, communication aimed at reminding and recalling and communication aimed at equipping with teaching skills. These communication strategies can be carried out using different channels such as the mass media (internet, tv, radio, posters, schools, build-board, leaflet, and books), interpersonal communication (door-to-door communication, communication at social gathering such as meetings, churches, market and schools) so as to pass the information across the population.

Beyond the traditional campaign, stakeholders should introduce a series of innovative and impactful special interventions targeted at vaccinating more people potentially missing through the house-to-house campaign. These strategies included: School Vaccination, Hospital vaccinations, Market vaccination, Reaching Every Child (REC) and Reaching Every Settlements (RES), vaccinations in the IDP camps etc [9].

These vaccination strategies cannot be successful without good communication intervention such as behavior communication, communication aimed at informing or educating, reminding or recalling, enhancing community ownership, teaching skills and providing support communication intervention will help in more settlements being accessed and thus more children vaccinated in security compromised areas than the previous years.

These are milestones both for Cameroon and for the global campaign to eradicate all vaccine preventable diseases [9]
Communication channels to enhance immunization in this work will be classified under two main headings; interpersonal communication methods (house-to-house, hospital, market, school and churches) and mass media communication methods (internet, radio, television, and poster etc.) through education, tv shows and sensitization on vaccine preventable diseases [9].
1.2. PROBLEM STATEMENT