1. Communication environment – current risks • Technical: • SIA quality not good, many areas with <95 reported coverage • AFP reporting rate has gone down and no cases reported from certain areas, • Direct programme monitoring not possible in many HRAs – quality indifferent • Low routine immunization • Difficulty in accessing remote locations in provinces like Nooristan, Badakshan etc. • Active hostilities and conflict situation in the south, south east • Presence of AGE in relatively ‘safe’ districts and provinces – low presence of government authority/control there • HR gaps and lack of technical capacity • Poor media environment in the country (low access, high illiteracy)

2. Potential risks that threaten goal • Excessive fatigue among health workers and communities • Heavy cross border movement of population • Missed children due to insecurity / access issues • children ‘not available’ and child sleeping/sick/newborn • Misconceptions and refusals – influence from across the border • Communication funding and human & resource gaps • At provincial level human resource for communication not in place. • Increasing difficulty in field-level / direct monitoring • A weakened civil society – limited partnerships

3. Potential Communication Response • Intensified Social Mobilisation (SM) intervention in high risk districts. • Reinforced training to strengthen interpersonal communication skills of community mobilisers (influencers) and vaccinators. • Monitoring checklists developed • Build environment for ‘behaviour change’ through mass media campaign. • Study on immunisation behaviours of communities and families – facilitating factors, barriers • Sustained advocacy with senior political heads, District ‘Shura’, Health ‘Shura’, religious leaders. • Working across sectors an line Ministries

4. Social Mobilisation Framework MONITORING TRAINING SM Team Leader Province Level Master Training at Provincial Level Soc Mob Team Leader REMT PPOs SM Coordinator CHS or Designated by NGO District Level DC TOTs at District Level CHSs at DH, CHC, BHC Health Facility Level DSTs District/Health shura Community Activists ( selected CHWs) Cluster Level Monitors Training at Cluster Level CHWs Elders Mullah Imams Teachers Village/ Health Shura Refresher Training before every round P r e - (S)NID P e r I o d IPC at Household Village Level Family Volunteers Volunteers

5. Social Mobilisation in Infected districts

6. Areas of social mobilization Social Mobilisation in Infected districts

7. Potential Communication Response continued • Special events to mobilise and motivate - like Polio football match • Special focus on mobile populations (nomads, semi-nomads, internally displaced persons, returnees) • Enhanced campaign visibility • Develop a cross border communication strategy

8. Overall priority issues • Gaining access to families and communities in security compromised areas • Improving planning, monitoring and evaluation • Use of intra NID, post-campaign monitoring and other social data to enhance communication response at the district and cluster level • Continued development and use of targeted IEC materials • Human and financial resources for communication activities • Institutional mechanisms and political support for inter ministerial collaboration

9. The specific communication issues and challenges on which you would welcome strategic and technical support • 1. Reaching missed children, especially ‘not available’ and those missed due to access issues • 2. Stronger use of data for social mobilization planning and evaluation • 3. Developing stronger quantitative and qualitative indicators • 4. Maximizing media use, including IEC materials • 5. Reaching nomads and IDPs • cross border issues • Reaching the women at home • Local level advocacy

10. Until Every Child is ProtectedEvery Child is at Risk