How India Mobilized to Eliminate Polio

Nighat Sultan, left, has helped establish advocacy camps in Meerut.
As a block mobilization coordinator, Nighat Sultan, left, has helped establish advocacy camps at the madrasa in her home city of Meerut.
CORE-India
Promoting immunization one house at a time
“Gradually, they came around to our point of view.”

February 2016—Up until the 1990s, between 500 and 1,000 children on average were paralyzed by polio in India every day.

With support from USAID, the CORE Group Polio Project began helping India to eradicate polio in 1999. The project trained community mobilization coordinators to encourage mothers and families to immunize their children against polio.

In March 2014, India was declared polio-free by the World Health Organization after years of hard work and dedication from legions of volunteers, health workers, community and religious leaders, lab staff, donors and others.

Through the CORE project, USAID helps train mobilizers to build networks and partnerships to effectively change behaviors within their communities. The mobilizers educate members of their communities about the importance of the polio vaccine, correct lingering misperceptions, and engage with local community leaders to reach every household with lifesaving vaccines and messages.

Nighat Sultan of Meerut, India, was among those who helped to achieve what many had once thought impossible. She began working with the project in 2004 after years of experience in social work. As a block mobilization coordinator, Sultan’s primary duties included engaging local coordinators as well as promoting immunization.

Early on, however, she encountered obstacles. Along with four other women coordinators, Sultan was assigned to Ajrada, a village district of 17,000 people. Many women and girls rarely left their homes, making it hard for the coordinators to reach families and children with lifesaving messages on polio immunization. When Sultan tried to visit families at their homes, she was often turned away.

“Nobody was prepared to listen,” says Sultan. “No one would turn up for the CMC [community mobilization coordinator] mothers’ meetings.”

Gradually, however, Sultan’s determination began to pay off. Household by household, she built personal relationships with mothers and families. She initially avoided mentioning the topic of vaccinations at all, only raising the issue after she felt welcomed by all members of a household.

“With the other CMCs, I was first able to convince [mothers] at the [household visits], and then went on to convince their mothers-in-law,” Sultan recalls. “Slowly, they were able to understand us.”

Sultan’s breakthrough came when she began to engage local religious leaders, or maulanas, in her area.

“In the beginning, they were reluctant to meet,” she says, but “gradually, they came around to our point of view.”

Sultan began visiting Maulana Aas Mohammad Gulzar Kasmi Sahib, a revered figure in the community, and his wife at their home. When Sahib mentioned an annual celebration that would soon take place at a nearby madrasa, drawing maulanas from far and wide, Sultan immediately saw an opportunity to gain support for her immunization work among influential religious leaders.

“With [Maulana Sahib’s] blessings, I went there and, through my advocacy, appealed to each one of them,” Sultan says. “Now we regularly hold advocacy camps at the madrasa. Mothers and children come in great numbers for the child to be immunized.”

“I still go to each house in Ajrada,” says Sultan. “That faith, that hope and love I had for social work is fulfilled with innumerable life-affirming positive events and messages.”

Today, with USAID support, the CORE Group Polio Project operates in 12 high-risk districts in India’s Uttar Pradesh state, reaching an estimated 600,000 children under 5 each year through 1,300 social mobilizers. By improving both supplemental and routine polio immunization coverage, the project has achieved remarkable success in the country, and continues to contribute to a healthier future.

The CORE Group Polio Project, which began in the late 1990s, is a multipartner, multicountry initiative to eradicate polio. In addition to USAID, the program is supported by dozens of civil society and community-based organizations. In India, the project focuses on social mobilization and community-level efforts to overcome resistance to polio vaccination, which is often concentrated in small subpopulations in specific communities.

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