Download Working with the Media

The Importance of
Communication in PEI / EPI
By Shabnam Afzal
Communication officer UNICEF
What is Communication
The word communication is derived from a latin word
“Communicare” means common, to give a share, to reveal
to have some thing in common.
The process of exchange of ideas, feelings, facts or
information between two persons or more than two
persons
“It is the process in which you understand someone
message and make him/her understand of yours”
SMCR Model
Sender
Message
Channel
FEED BACK
Receiver
Verbal & non-verbal communication
Verbal communication involves.
Greetings
Dialogue / information
Counselling
Non-verbal communication involves
Posture and expressions
Paying attention
Showing patience
Dressing with respect to local traditions
Channels of communication
Print Media
News papers / Magazines
Letters Memos
Billboards / Posters / flyer
Electronic Media
Radio
TV
Internet
Telephone
Perception
• No person sees things exactly the same way as
another. Each has a unique set of experiences ,
a unique perceptual filter, through which he or
she compares and interprets messages., While
communicating , receiver uses that filter to give
meaning to or make sense out of the
experience
What do you see?
PERCEPTION
Do not assume that what you say or the
Visual aids you use is fully understood
by others, ask for feedback to ensure that
your message is received as intended.
Group Exercise
VISUAL CUES
Draw a quadrangle. Within the right side inside the
quadrangle draw an arrow half way extended upwards.
Now draw a triangle beneath the quadrangle on the
right side, just touching it. On left side draw a circle
beneath the quadrangle not touching any .
We only see tip of an ice berg
Behavior
Experiences
Values, believes,
emotions
Submissions
We Communicate better when we
understand how people see
How people see shape what they know
What they know shape what they believe
What they believe shape how they act
Attitude & Behavior
Attitude
• The way you think
• The way you believe
Behavior
• Collection of actions exhibited by human beings and
influenced by:
•Culture – Attitude – Emotion – Authority - Genetics.
•
Response ( Action or reaction ) of an individual / group
to a stimuli
Target audiences
• Primary
• Directly involved with the woman/her child:
• Father
• Mother
• Grand father
• Grand mother
• Mother-in-law
• Husband
• Secondary
• Not directly involved but play important role in community/society
• Health care providers, LHWs
• TBAs
• Religious leaders
• Community leaders
Research on effectiveness related
to behavior change shows that:
Isolated communication actions focusing on
behavior change at individual level usually are not
sustained …
Instead, a more effective approach includes:
Many different types of communication activities
at different levels, for a sufficient time and
according
to
the
needs
of
states/districts/communities
Policy/Regulations
Institutions
Community
Family/household
Individual
Orbits of Influence and Multiple Levels
of Engagement or Support
Behavior Change Communication
 An Interactive process with specific audiences /
beneficiaries to develop tailored messages and
approaches using a variety of communication
channels for developing positive behaviors
 Providing information that people need in a wrapping
that is acceptable to them
Social Mobilization
Involves planned actions and processes to reach ,
influence and involve all relevant segments of society
across all sectors from the national to the community
level , in order to create an enabling environment
and effect positive behavior and social change
Advocacy
Mobilizing support of key individuals for your cause
Advocacy is the act or process of supporting a cause or
issue. We advocate a cause ore issue because we want to
;
 Build support for that cause or issue
 Influence others to support it
 Try to influence or change legislation that affects it
Research shows:
•
Unvaccinated children tend to have uneducated
mothers – which requires special attention and focus
on health education with mothers
•
2/3 of mothers (rural/urban) confirmed LHWs have
talked about vaccination and encouraged them to take
children to health facility
•
Parents of unvaccinated children have less exposure to
media and rely more on face to face interaction and
information sharing
Interpersonal Communication
IPC
Interpersonal communication is the process of
understanding b/w two or more persons.
Advantages:
• Message can be
tailored according to
area.
• Feed back is possible.
• Questions can be
ensured.
Disadvantages:
• Human resources
intensive.
• Takes time.
• Untrained
communicators can
give wrong messages.
Examples of Good Interpersonal
Communication Skills ???
Good Communication Skills
• Verbal and non verbal communication (explain the
difference and how both work!);
•
“Active" listening in which the health worker or contact
demonstrates to the parent/caregiver that they are heard
and understood;
• Re-phrasing what the caregiver has said to make sure it is
correctly understood;
• Use of open-ended questions. The questions require more
than one word answers (examples of these?!);
• Non-threatening eye contact;
• Providing complete attention; and –
• Being polite, respectful and not showing a bad or uncaring
attitude toward the child or the caregiver.
Other Basics Related to Enhanced
Interpersonal Communication Skills
•
•
•
•
•
•
Use simple clear language or local language as
much as possible;
Greet people upon meeting and be courteous;
Dress appropriately and respect local culture;
Look at the person when talking and showing both
interest and concern.
Answer those questions you know the answer to
truthfully; refer to others those questions which
you do not know – and don’t shy or insecure
about this.
Summarize to show that you have understood
PROBING QUESTIONS
•
•
•
•
•
•
Questions can’t be answered with a “yes” or “no”
response.
Are you Dr. Javed Iqbal?
What is your name?
Do you know how to prepare ORS?
Can you tell me how ORS is prepared?
Has your child been fully immunized?
How many and at what site your child has been
vaccinated?
NON-VERBAL COMMUNICATION
GESTURE:





Yawning.
Frowning.
Slouching in a chair.
Looking at watch.
Arms crossed.
MESSAGE:





I’m tired, bored.
I don’t like you.
I’m not interested.
I want to leave.
I’ve had enough.
The IPC Do’s
Polio team members should:
• DO treat families, care-givers and community
members with respect
• DO remain patient with parents and not get into
arguments
• DO listen to reluctant parents’ concerns or questions
• DO answer any questions and address concerns with
reason
• DO promise to bring to the attention of higher
authorities any non-immunization health issues that
they are concerned about
The IPC Don’ts
Polio team members should never…..
• NEVER force parents into accepting OPV or any form
of immunization
• NEVER be rude to parents because they are not
informed or have misconceptions about immunization
• NEVER Attack a parent’s values
• NEVER Immunize without consent
• NEVER Joke that vaccine will make children sick or
sterile
Addressing
Concerns and Questions
IPC
• Vaccinators, Mobilizers all members of the
polio team are health educators
•Must be equipped to answer the tough
questions parents may have (consider approach
and manner)
•Must be able to provide accurate information
(and use support materials if needed)
Health Care providers interact with
the community …..
• Static EPI / fixed sites
• Out Reach services
• public places and Health ceners
Barriers to Immunization
Two Types of Barriers
• Behavioral
• Non behavioral
Behavioral Barriers
•
•
•
•
•
•
•
•
Lack of understanding of importance of
immunization.
Mothers don’t know about immunization
schedule.
Do not know about subsequent doses.
Fears of side effects..
Husband doesn’t want mother to take child for
immunization.
Mother’s perception of unpleasant treatment at
facility
Refusal to have child immunized for religious
beliefs.
Do Not follow immunization schedule properly –
Non – Behavioral Barriers
• Families have limited access to immunization
services
• Health facilities are far away
• Long waits at health facilities
• Staff absent
• Lack of vaccine/D. Syringes
• Inappropriate vaccination timings
Possible Actions
•
•
•
•
•
•
Orient community leaders, encourage them to
promote immunization
Improve IPC skills of health workers
Promote immunization in media
Ensure health workers can explain to parents
when to come for next immunization?
Health workers can explain possible side
effects and what to do?
Develop child-to-child programmes – students
can adopt families in community to ensure
they know when to seek services
Possible Actions
a. Provide training for health workers
b. Ensure parents are aware of:
•
Outreach services.
•
•
•
Dates.
Times.
Location
Individual Exercise
What are some common questions that parents
ask (or you think they may ask) about OPV, the
polio program, or routine and other health
services?
Write down these questions – and let’s see if
others can answer (and how they would
answer?!) …
Possible/Sample Questions
• Does OPV cause children to become
sterile?
• Is the vaccine given only to Muslims or
certain groups?
• Is an infant less than two months old too
young to get the vaccine?
• Is it safe for a sick child to get the vaccine?
• Why do vaccinators come to deliver OPV
when other health concerns are much
greater?
• Why do vaccinators come so often, isn’t so
much medicine harmful for the child?
Role Play
• Apply good communication skills
• Parent questions the harmful side effects of the
vaccine and is concerned that the child might die if
they take the vaccine. / Religious concerns
• What information shall be given to the mother when
she comes to vaccinate her child
Group Role Plays
Role Play Scenarios:
Group A: Parent says the child has already been
immunized through routine immunization and
therefore doesn’t need to be immunized again.
Group B: Parent says that her child has a fever, doesn’t want her
child immunized.
Group C: Parent questions the harmful side effects of the vaccine
and is concerned that the child might die if they take the vaccine.
Group D: Parent uses some “hidden resistance” – the vaccinator
has seen a young child, but the parent either says the child has
already been immunized in this round, that the child is older than
five years old, that there is no child in the house, or that the child in
the house is a neighbor’s child.
• Advocacy: To create visibility for the National Emergency
Action Plan and national ownership about the threat of
Polio in Pakistan and what is required to eradicate it
• Social Mobilization and IPC: Intensify efforts in highest
risk UC’s, with 300+ new communication staff in UC’s and
Districts by year end
• Reaching High Risk Groups: Strengthen data collection
to be able to better identify high risk groups and reach
them with appropriate communication strategies
• Data Collection Tools: Revise existing tools and add new
tools rapidly guide communication strategy and action in
the field
trateg
Strategic Principles
Advocacy and Training
IEC and Social
Mobilization
Improved Service
Improved Delivery
Service Delivery
Care Taker Participation
Pull
PULL
Push
PUSH
Immunized
Child Child
Immunized
Positive Behavior
• It is important that the community feels
and understands that their children
health is their responsibility
Conclusion
• Only once barriers are analyzed, can
effective action be planned to overcome
these.
• Once barriers to immunization are
overcome, more of the population should
be demanding immunization.
• .
Thank You