"Communication for Development (C4D) plays a central role in the successful introduction of oral cholera vaccine as an additional tool in cholera prevention and control, both in endemic and epidemic settings."
This oral cholera vaccine (OCV) communication framework aims to support cholera-prone and outbreak countries to develop their national and sub-national communication strategy for OCV uptake and cholera prevention, control, and management. It is a product of ongoing collaboration among the United Nations Children's Fund (UNICEF), Johns Hopkins University (JHU), the International Rescue Committee (IRC), and International Medical Corps (IMC) to develop communication guidance and tools on OCV for governments, implementing agencies, communities, and the media.
As detailed here, the goal of OCV communication is to achieve broad and sustained uptake among cholera-prone populations of OCV as integral to other cholera preventive, treatment, and management actions. The specific behaviour objective of OCV communication is to increase the number of children, women, and men from the most at-risk, vulnerable, and hard-to-reach populations to complete the required 2 doses of cholera vaccinations as an additional preventive measure against cholera. Namely, based on a risk assessment, an integrated approach that includes OCV vaccination is outlined that will target geographic areas and communities that are particularly vulnerable, especially marginalised populations, crowded and unhygienic settings, urban slums, refugee and displaced sites, and communities that lack access to safe water, sanitation and hygiene, and health services.
Part 1 provides a guideline for an integrated OCV communication strategy, which includes the following steps:
- Establish a communication team and a coordination mechanism.
- Conduct a rapid communication assessment - e.g., Table 2 shows the desired actions by different levels of participant groups that may result from the interplay of communication approaches, a supportive environment from the community and health delivery system, and an enabling environment from the government, civil society, and the media.
- Plan your communication strategy - C4D is a research-driven systematic process that operates through interrelated, interdependent, and interacting approaches with respective audiences or participant groups. These are described in detail in the resource but include, in brief:
- Behaviour change communication (BCC), which focuses on the individual as the unit of change.
- Communication for social change (CFSC), which focuses on groups or collectives as the unit of change.
- Social mobilisation, which is the process of engaging a wide network of partners, stakeholders, and allies around a common cause. Eleven steps in planning for this are outlined. Some social mobilisation strategies that can influence family demand for OCV and uptake of cholera prevention behaviours are described, such as: engage and educate community influencers on the risks and benefits of OCV immunisation along with other key messages, defining and rolling out a local a media strategy that gives community members voice and visibility, organising interactive training sessions for non-governmental organisations (NGOs)/community-based organisations (CBOs)/networks, and hold meetings with health workers/vaccinators/community mobilisers.
- Advocacy - See Table 1 for specific behaviour objectives for OCV advocacy addressed to policymakers and programme managers.
- Media engagement - A media plan is outlined, and Table 3 shows a suggested checklist of activities for media engagement.
- Design the creative strategy: messages, channels, and media materials - Table 4 shows key messages for different audience groups/participants in OCV and cholera prevention, control, and treatment measures. Ideas for manging rumours and misperceptions are also listed.
- Plan to monitor and evaluate, which includes: (i) behaviour monitoring (tracking the process, outputs, and outcomes related to the communication objectives), and (ii) implementation monitoring, which refers to tracking operations and management of the communication intervention. Table 5 includes illustrative behaviour monitoring and evaluation indicators for adoption of OCV and other cholera prevention. Examples of monitoring and evaluation (M&E) tools are provided.
- Document good practices and lessons learned, which allows for the identification and validation of innovations, lessons learned, and good practices that in turn allow partners, allies, donors, stakeholders, and direct beneficiaries to learn from experience.
Figure 3 shows the Strategic C4D Socio-Ecological Model (SEM).
Part 2 offers some tools and resources such as examples of communication materials, how-to guides, suggested templates, and sample formats for planning. Specifically, this portion of the resource offers, first, various examples of interpersonal communication (IPC) tools/communication materials (e.g., a OCV and Cholera Prevention Leaflet from Haiti in French) and, second, items such as a sample template for behaviour analysis of participant groups in OCV introduction and cholera prevention and a guide to organising refresher training on IPC for health care workers. The hyperlinks, footnotes, and the reference list are also designed to help the communication planner/manager to effectively advise and oversee specific communication tasks in the strategy that are usually subcontracted to individual consultants and institutional contractors.
UNICEF website, February 15 2017.