This PowerPoint presentation, outlining Bihar's strategic plans to eliminate Type 1 polio and contain Type 3 in 2008, was presented during the December 2007 meeting of the India Expert Advisory Group (IEAG). The strategies outlined range from addressing challenges in recurrently infected and surrounding blocks, maintaining quality operations in "polio-free" blocks, making judicious use of monovalent oral polio vaccine 1 (mOPV1) and monovalent oral polio vaccine 3 (mOPV3), and accelerating the improvement of routine immunisation. Many of the strategies focus on expanding community mobilisation into hard-to-reach areas and responding to issues related to underserved populations.

Regarding access-compromised areas

Many villages are cut off for part of the year as the Kosi and associated rivers flood, leaving a number of extremely hard-to-reach areas with low immunisation coverage levels. The strategy to reach these communities is to increase human resources from the government and the United Nations Children's Fund (UNICEF), place these resources closer to the communities during flood periods, focus more on community mobilisation and awareness-raising during and between campaigns, and intensify monitoring in access-compromised areas.

Regarding an intensified underserved strategy

The presentation also explains plans to work more closely with other partner groups in Bihar, to coordinate better with the government, and to build partnerships with influential people and groups from underserved communities. The key initiatives are:

• Strengthening the polio team by inducting community mobilisation coordinators (CMCs) in critical areas.
• Focusing more on community-level activities, including:
  • Women Iztema (meetings)
  • Interface meetings
  • Mid-round counselling
• Implementing Mosque announcements.
• Establishing health camps in underserved areas.
• Meeting with all the key religious sect leaders.

The presentation covers other aspects of the strategy, including those focused on: improving identification of newborns, maintaining the quality of operations, placing mobilisers at transit points, improving media relations, strengthening accute flacid paralysis (AFP) surveillance, accelerating routine immunisation coverage, and building on an existing base of political support.

Click here to download the full presentation in PowerPoint format.

United Nations Children's Fund (UNICEF), India, October 2008.