Digital Engagement: Potential Applications for Polio C4D

"Digital solutions have direct value in health emergencies, specifically where they have been deployed and scaled for real-time surveillance and contact tracing, data collection, remote health worker training/motivation, social science data collection, risk communication and community engagement (RCCE), and demand generation." - from "Digital Health and Digital Engagement for COVID-19 Preparedness and Response: Rapid Guidance for UNICEF Offices", a document shared with webinar participants

Hosted by the polio communication for development (C4D) team at the United Nations Children's Fund (UNICEF), this webinar explored digital community engagement and its potential for polio C4D work worldwide, in the context of COVID-19. A related area of focus in the webinar was on addressing misinformation and building demand for vaccination. The virtual event drew 97 members of the UNICEF community from over 48 countries around the world, with attendees engaging in both English and French. Accordingly, the webinar video is available (below) in both languages, as is a bilingual PowerPoint presentation.

Speakers included:

• Ivan Amezquita, C4D Specialist Polio, UNICEF Headquarters (HQ), who spoke on "Digital Community Engagement: Strengthening Polio C4D Strategies". He noted that the C4D and strategic communications workstream is rapidly evolving in terms of the use of digital technology, platforms, and social media spaces. However, the limited access of vulnerable groups to digital media must be addressed to manage digital engagement, as a complement to other communication and social mobilisation workstreams. Amezquita pointed to experiences occurring in the field, especially in response to emergencies, disease outbreaks, and crisis - e.g., the COVID-19 pandemic. In tune with these developments, the Global Polio Eradication Initiative (GPEI) is looking at ways of adjusting C4D strategies to support countries interested in strengthening their capacities in digital community engagement. Amezquita discussed the functions and potential advantages of digital community engagement in the polio C4D context, including: research, data, and training; public information and promotion; tracking and addressing misinformation; and 2-way communication and engagement. An example of the latter function is UNICEF's interactive U-Report tool, which can be used to engage a variety of audiences, including youth and young parents, to generate demand for polio vaccine, answer emerging questions, and track and address misconceptions.
• Alex Muhereza, Statistics & Monitoring Specialist, Digital Health, UNICEF HQ, who defined "digital health engagement" as "A digitally-enabled health system where countries effectively adopt technology solutions that prioritize reaching the most marginalized and vulnerable families with health information and services, while strengthening the ability of health systems to collect, analyze, and use health data to continually improve the reach and quality of services." Muhereza presented a digital health roadmap, which involves the following: UNICEF staff knowledge and awareness of digital health; enhanced coordination and multisectoral collaboration, operational resources, and strategic partnerships in digital health; knowledge management, case studies, and a community of practice (CoP) for digital health, including an inventory of UNICEF-supported initiatives; and implementation research and monitoring and evaluation (M&E) of digital health investments for children and adolescents. For example, during the COVID-19 emergency, UNICEF is using technology to build a 2-way communication channel between government and frontline workers by, in part: training health workers on infection prevention and control and risk communication (via SMS (text), WhatsApp, etc. or links to eLearning courses); reporting potential COVID-19 cases; transmitting COVID-19 test results from laboratories immediately to health workers; and monitoring the situation - e.g., reporting stockouts of essential commodities such as sterile gloves, masks, and respirators. After outlining a number of key considerations in this work, Muhereza linked webinar viewers to the October 2018 document "UNICEF's Approach to Digital Health" [PDF, 52 pages] for further information.
• Angus Thomson, Senior Social Scientist: Demand for Immunization, Health Section, UNICEF HQ, who spoke on "Vaccination Demand Observatory, Social Listening & Engagement Program, COVID-19/Immunization". Thomson began by citing evidence from Project Vaccine Communication Tracking & Response (VCTR), a media monitoring system that tracks vaccine-related communications, with a focus on opposition and hesitancy, in public media data. These data indicate that vaccine-critical messages have more than doubled during the COVID-19 pandemic; from March to June 2020, these messages were viewed more than 4.5 billion times. Thomson then detailed the strategies being implemented by the Vaccination Demand Observatory, which is a partnership between UNICEF and global organisations focusing on social listening, misinformation, and vaccine demand (the Public Good Projects (PGP), First Draft, and the Yale Institute for Global Health). In brief, unlike previous efforts, this approach is built around a field infodemiologist, rather than dashboards. The infodemiologist provides analytics and insights to inform and measure all engagement, with the idea that the social listening and engagement strategy should integrate into a broader risk communication and community engagement (RCCE) framework, demand promotion framework, and vaccine readiness and delivery plans. In the context of COVID-19, the initial focus will be on: tracking, assessing, and addressing COVID-19/immunisation rumours in real time; understanding and addressing hesitancy and demand for new vaccines, including a SARS-CoV-2 vaccine and novel oral polio vaccine (nOPV2); and understanding and mitigating the impact of COVID-19 on demand for vaccination and on provision of and access to immunisation services.
• Kathleen Solis, C4D Specialist Polio, UNICEF Philippines, who spoke on the Philippines digital engagement experience. Solis began by describing the context, including, for example: declining immunisation coverage for all vaccines, low vaccine confidence after the 2018 dengue vaccine controversy; a polio outbreak declared in September 2019; ongoing outbreak response; an increasing number of COVID-19 cases; and an overstretched health system and personnel. Purposes of digital engagement in this context include: complementing government efforts through UNICEF social media channels and assets; lending UNICEF's voice to strengthen people's trust in vaccines; and contributing to increasing: knowledge of vaccine-preventable diseases, acceptance of vaccines, risk perception, confidence in vaccines and vaccinators, and shared responsibility. Solis outlined what has worked well (e.g., celebrity engagement, shareable content) and what some of the challenges have been (e.g., the need to stand out among competing information, fake news, and anti-vaccine sentiments).
• Annick Sidibe, Head of Communication Unit, EPI National Directorate, Ministry of Health Burkina Faso, and Sansan Hien, C4D Officer, UNICEF Burkina Faso, who spoke on the Burkina Faso digital engagement experience. They described the ways in which the country used digital tools, especially Facebook and WhatsApp, as well as the U-Report platform, during the 2020 polio outbreak response, to engage adolescents and young people in information sharing and family engagement and to ensure rapid rumour management. They also discussed challenges, such as poor availability of internet connection for the public and insufficient staff with capacity in digital engagement.
• Shah Jamal Akhlaque, C4D Chief, UNICEF Somalia, who spoke on the Somalia experience in paperless open data kit (ODK)-based RCCE for the COVID-19 Response. Akhlaque detailed the following: the context (e.g., frequent reporting requirements), experience (e.g., real-time data with dynamic analytical dashboard), and the scope of digital engagement (national-level RCCE planning and coordination, intervention tracking and reporting, rapid assessment, rumour tracking, community feedback, supportive supervision, capacity-building, and innovation in RCCE intervention). He talked about what worked well (e.g., facilitated informed decision-making) and what the challenges were (e.g., limited scope for capacity-building for COVID). Finally, he looked at potential future directions for the digital engagement strategy - e.g., to bolster existing collaboration with National Islamic Advisory Group (NIAG).
• Arifa Sharmin, Communication Specialist (Media), UNICEF Pakistan, who spoke on the Pakistan digital engagement experience. She described: approaches that have worked well (e.g., mapping social media influencers and engaging them as a neutral voice), the challenges (e.g., the fact that women's access to the social media is still limited compared to men's), and the support UNICEF Pakistan needs going forward (e.g., help with establishing a collaboration with YouTube and Twitter for blocking/deleting anti-vaccine propaganda).