This programme follows up on, and has been developed in response to, previous years' NIDs - which found television to be a key medium for disseminating polio messages. However, while continuing to draw on this medium, the MOHP worked in 2004 to develop innovative approaches to prevent public fatigue and boredom that might have been caused by repeating the same discussion on the issue. Geographically, MOHP opted to continue focusing on the urban areas of Greater Cairo, Menya, and Assuit, which pose a great challenge in reaching 100% coverage due to density and overcrowding.

Building on some of these existing opportunities to give polio wider public visibility was the programme's key strategy. To this end, Goodwill Ambassador Mahmoud Kabil (leading Egyptian film and television actor) volunteered his time in an integrated media awareness campaign that included:

• an education TV spot capitalising on the credibility of Mr. Kabil in speaking to the public, particularly those in the upper SES (who constitute a greater opposing group to immunisations in urban areas)
• a 5-second-long "count-down" public service announcement (PSA) that is aired prior to each NID campaign
• use of existing TV and radio spots and a celebrity song produced in 2002
• a wide-reaching short messaging service (SMS) campaign in cooperation with Mobinil
• initiation of media coverage of polio through in-depth reports by senior writers of key newspapers and magazines
• cooperation with existing TV and radio programmes to include polio
• using the Radio "Nile FM" channel to reach younger caretakers.

Some of the specific messages that Kabil conveyed in interviews and other media included:

1. All children of Egypt must be immunised at the same time during the NID in order to be able to eradicate polio completely from Egypt
2. Immunise all children from day one to 5 years
3. All children must be immunised even if they have been previously immunised, have completed their vaccination schedule, or are being followed by a private paediatrician
4. Vaccine quality is guaranteed; vaccination has no side effects
5. There is no maximum number of polio doses
6. Vaccination teams are well trained.

Evaluation of past efforts also found that megaphones and mobile trucks play an important role in reinforcing the vaccination messages on the community level, as do awareness activities in crowded areas (markets and bus stations) led by volunteers who are recruited by non-governmental organisations (NGOs). To maximise reach in urban slums, the youth volunteers of the Youth Association for Population and Development conducted door-to-door awareness campaigns in these areas. These strategies are designed to ensure full coverage of high-risk areas while engaging other stakeholders like youth centres, schools, religious leaders, and community organisations. In cooperation with the local health authorities in each of the areas being addressed, MOHP and the Youth Association for Population and Development also re-printed a simple Q & A brochure for caretakers to be distributed by NGO volunteers and others. A special advocacy meeting was also set up for religious leaders (both Muslim and Christian) representing high-risk areas.

Interpersonal training was another key programme component. Intensive capacity building of the MOHP District Managers on social mobilisation planning led to the inclusion of standard social mobilisation components within most of the microplans being carried out in Egypt's high-risk areas. Immediate supervisors and health educators within the Ministry also received communications skills training to improve their capacities to address the day-to-day issues that arise due to resistance or refusals.

Partnership - particularly with the private sector - supported several of this programme's social mobilisation activities. Egypt's leading mobile phone company donated over a 5 million SMS messages to all its subscribers. Coca Cola Company's billboards and trucks were branded with polio messages.

Immunisation & Vaccines, Children, Health.

In 2002, UNICEF was called upon by the Technical Advisory Group (TAG) to support MOHP in conducting social mobilisation and communication activities to complement the door-to-door "challenge" strategy that was the MOHP's focus. A diverse group of stakeholders including government, NGOs, media, and the private sector were approached to create awareness and to mobilise individuals to achieve maximum coverage. This mass media campaign, coupled with community interventions, reached up to 99% of a random sample of people who had heard of the 2002 and 2003 NIDs. The campaign was found to have motivated 58% through TV spots, 83% through TV programmes, and 86% through a celebrity song; approximately 86% said the megaphones motivated them to immunise their children. Most of the Egyptian children were covered during the 2002 and 2003 NIDs, but one confirmed polio case was reported in 2004. A survey of missed children was conducted to identify the profile of the missed children; it showed that a large percentage are missed between the ages of 4 to 5 years and under one year of age. These children tend to have non-working mothers who have some education and who on the third quintile of the wealth index.

The 2004 plan also included a documentation and evaluation component that will seek to provide a comprehensive photo and video record of campaign activates and to assess the impact of communications in high-risk areas.