Baseline Survey - Final Report: CCGP-India

This 76-page report details a baseline survey carried out for the CORE Group Polio Project (CGPP) by SERC (Social and Environmental Research Centre) of Synovate from July 1-15 2008. The baseline survey's broad objectives were: to establish baseline values for project indicators and to provide inputs for advocacy, communication, and social mobilisation (ACSM).

A United States Agency for International Development (USAID)-funded polio eradication project, CGPP has been active in India since 2001. CGPP members in India - Adventist Development and Relief Agency (ADRA), Catholic Relief Services, and Concern Worldwide - conduct community-based social mobilisation activities designed to improve supplemental polio immunisation and routine immunisation (RI) coverage (e.g., of DPT3 and measles) in the 56 blocks of 10 districts (Baghpat, Bareilly, Mau, Meerut, Moradabad, Muzaffarnagar, Rampur, Saharanpur, Shahjahanpur, and Sitapur) in the state of Uttar Pradesh, as well as in high-risk areas of the state. The baseline survey centred around a structured interview schedule administered to 605 mothers who had children in the age group of 12-23 months within intervention areas of 10 districts of 46 of the 56 blocks. Of the 30 clusters covered, 14 clusters were urban; the remaining were rural clusters.

In brief, the 2008 survey found high acceptance among mothers for repeated polio doses; however, routine immunisation coverage and retention of immunisation records is low. The polio campaigns have a significant reach of the population, but knowledge of the age at which the first dose of polio should be given is limited.

Key findings:

• The Community Mobilisation Coordinator (CMC) emerged as the most common source of information in community for polio vaccination.
• There was a high rate of acceptance (82%) among mothers for repeated polio doses.
• About 70% of mothers believe that the first polio dose should be given within first 4 weeks.
• Last polio campaign reach was 96%.
• Only one-fourth of mothers visited the polio immunisation booth.
• Awareness of acute flaccid paralysis (AFP) is low.
• Perception was that sick children should not receive polio vaccination.
• Few mothers (40/605) reported that they have attended any meeting conducted by CMC.
• RI coverage and retention of immunisation card is low.

Recommendations:

• Literacy levels of mothers and the fact that they are largely at home needs to be taken into account while planning any communication activity.
• CMC can play a vital role in expanding coverage and increasing acceptance of immunisation services. Thus there is a need for their ongoing capacity-building and review of performances.
• Special focus is essential to assess specific barriers and devise strategies for reaching the 4% of households that are not covered during the campaign.
• The following findings illuminate some of the communication messages that can be focused on during the programme period:
  • 22% of mothers are not aware of when the first dose of polio should be given; creating greater awareness about the immunisation schedule among mothers is suggested.
  • There is an identified need to expand the channels through which mothers can become aware of the campaign.
  • 4% of mothers said that their households were not visited by vaccinators. To ensure that efforts are in line with national goal of not missing a single child during the campaign period, capacity-building of CMCs to identify and work with these families with effective communication approaches and strategies will be an important input for closing this gap.
  • Retention of the immunisation card can also be considered a proxy indicator to gauge mothers' engagement in routine immunisation. Communication messages encouraging mothers to seek and retain this card can thus be integrated into the messages directed toward mothers.
  • Communication messages used during interpersonal communication (IPC) with mothers should be designed to address the issue that sickness is not a contraindication of immunisation.
  • As a child grows, the subsequent doses of immunisation corresponding to later age declines. It is thus essential for messages to address the gaps in knowledge related to complete immunisation schedule and adherence for each child.