22 April 2008

Reaching the last child

Twenty one year old Naheed Parveen has discovered a new passion. Whenever she visits her friends and neighbours, she asks about the health and progress of the small children around. ‘I keep a look out for news of new born babies, so I can motivate their parents to immunise them against polio,” she says.
While the eastern Indian state of Bihar grapples with an alarming rise in the number of poliovirus infections in the past year, unreached children continue to remain vulnerable in certain pockets.
Naheed is one of the 300 community mobilisers under an expanded SMNet programme who help build a bridge between their communities and the programme, helping to break down resistance and ensure better quality operations and reach to vulnerable children.Two years ago, Naheed’s grandfather, a Muslim cleric, had a marked apathy towards the Pulse polio programme. Today, announcements about the usefulness of the vaccine are issued from his mosque in one of Bihar’s ‘vaccination unfriendly’ blocks.
“Two years ago, vaccinators would be chased away from this neighbourhood,” says Najma Parveen, the block mobilisation coordinator who inducted Naheed into the Polio social mobilisation network. “Naheed is a bright girl and a college student. Her grandfather is a respected religious figure. Our vaccination team, who often had to face verbal abuse and sometime physical threats in the past, now reaches infants in the same problem areas, because the Maulana’s granddaughter accompanies the vaccinator.
“It wasn’t easy for a girl with my family background to step out of the house. My father gave his permission grudgingly when I pointed out that the honorarium for the job would help me pay for my college books. My grandfather finally came round to understanding that the polio vaccine did not have any side effects like making babies barren in later life. So he allowed announcements about the polio programme to be made after religious gatherings at the mosque,” Naheed says.
A local woman says firmly, “We only allowed our children to receive vaccination because the Maulana’s granddaughter personally accompanied the vaccinator, and we have her word that the vaccine is safe.”
Naheed says that motivation is an ongoing task. “I also ensure that the new born babies receive the complete immunisation package by accompanying the mothers to the PHC.” In traditional Muslim households, the women refrain from moving out of the locality on their own.
If refusals to the polio vaccine in Bihar have come down to 0.1 percent over the past three months, it is largely because of the consistent efforts of community mobilisation coordinators, Block Mobilisation Coordinators and the SMnet teams.
Community mobilisation coordinators work with the womenfolk in the family on a regular basis, assessing their needs and devising localised strategies for outreach.
Shagufta Naaz, a CMC in the Tripolia locality of Gulzarbagh block overcame the resistance of traditional Muslim families by donning the burkha (hijab). Says Shagufta, “Women in my family don’t usually wear traditional Muslim clothing, as is the case in most middle class educated families. However, I realised that to successfully ensure complete coverage in my area, I would have to penetrate families with a very traditional mindset. When I began using the burkha, I found it far easier to achieve rapport. I was not treated with suspicion. There were 19 refusals in this area four months ago. As of today, there is only one family left uncovered, but I am sure that with a little help from the local community influencers, we will be able to vaccinate the last child within the next two days.”
Shazia, a CMC from the Sher Shah Gali area, holds non-formal classes for small children in front of her house. “Some women asked me if I could teach their small kids, and I agreed. After all, as an educated young person, spending an hour helping children is time well spent. It also helps me influence the women to look after the children better,” she says. Shazia states that several women have begun to have their children vaccinated when their husbands are out of the house. “Even if the husbands resist, the women have begun to understand the importance of protecting their children from the polio virus.”
“Local influencers are an asset to the polio communication campaign,” says Naheed, “the success of a mobilisation coordinator can be measured by the number of local leaders she can network with to come out and support the vaccination campaign. We also support Anganwadi workers to update the list of newborns so that ICDS services can also reach the children.”

Author: Frank Krishner

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