Legacy of Polio—Use of India’s Social Mobilization Network for Strengthening of the Universal Immunization Program in India

Abstract

The Social Mobilization Network (SMNet) has been lauded as one of the most successsful community engagement strategies in public health for its role in polio elimination in India. The UNICEF-managed SMNet was created as a strategy to eradicate polio by engaging >7000 frontline social mobilizers to advocate for vaccination in some of the most underserved, marginalized, and at-risk communities in India. This network focused initially on generating demand for polio vaccination but later expanded its messaging to promote routine immunization and other health and sanitation interventions related to maternal and children’s health. As an impact of the network’s interventions, in collaboration with other eradication efforts, these high-risk pockets witnessed an increase in full routine immunization coverage. The experience of the SMNet offers lessons for health-system strengthening for social mobilization and promoting positive health behaviors for other priority health programs like the Universal Immunization Program.

Mobilize to vaccinate: lessons learned from social mobilization for immunization in low and middle-income countries

“…In India, the Social Mobilization Network (SMNet) was establishedin 2002 in Uttar Pradesh and 2005 in Biharto support polio elimination with emphasis on areas that were considered high risk for polio transmission and had demonstrated frequent refusal of vaccination. 23 SMNet trained and engaged more than 6,000 social mobilizers of whom 90% were women. Mobilization strategies were grounded in evidencebased communication and microplanning and comprised the use of mass media, print materials, house-to-house dialogs, peer-support groups and the training and mobilization of community influencers, including traditional and religious leaders.…”

Lessons from the West Africa Ebola Epidemic: A Systematic Review of Epidemiological and Social and Behavioral Science Research Priorities

“…Sierra Leone anthropologist Paul Richards [41] wrote: "It is striking how rapidly communities learned to think like epidemiologists, and epidemiologists to think like communities". Reductions in poliovirus transmission have been partly accredited to explicit community engagement and ownership, linked to sanitation and hygiene and vaccination uptake [42]. Social and behavioral science and EPI researchers can collaborate to situate communities at the center of real-time, rolling data collection to reflect disease transmission and response effectiveness.…”

Trust, Communication, and Community Networks: How the CORE Group Polio Project Community Volunteers Led the Fight against Polio in Ethiopia’s Most At-Risk Areas

“…They have worked tirelessly to promote vaccination, allay misconceptions, and change norms surrounding vaccination. 11,12,18,24 In host countries, the CGPP has made a notable impact on the fight against polio, using local nongovernmental organizations, volunteers, and CVs to make inroads into communities that were previously forgotten or left unvaccinated. Polio and routine immunization rates have steadily increased in the CGPP implementation areas over the life of the CGPP in Ethiopia.…”

“…In India, for example, a successful social mobilization program called SMNet used community mobilization coordinators to increase rates of full immunization for children. 12,13 In Somalia and Ethiopia, house-to-house visits by community health workers (CHWs) and mobilizers have helped improve vaccination coverage rates, especially for nomadic and pastoralist † populations. [14][15][16][17] Community participation has also increased immunization coverage in urban slum areas.…”