Demand-side determinants of timely vaccination of oral polio vaccine in social mobilization network areas of CORE Group polio project in Uttar Pradesh, India

The CORE Group is a USAID supported umbrella organization of nongovernmental organizations (NGOs) that collaborate on international health and development programs. In India, the CORE Group Polio Project (CGPP) works across twelve districts in the state of Uttar Pradesh (UP) and is a member of the Social Mobilization Network (SM Net) in India along with UNICEF, Rotary, the Indian Government’s and WHO/National Polio Surveillance Project (NPSP) as partners. The SM Net supports polio eradication through the following efforts: identifying high-risk areas and working with underserved communities in planning, implementing and monitoring social mobilization and other immunization activities. The primary effort of the SM Net is carried out by a three-level network of mobilizers (community, block and district level).

RI Monitoring is a concurrent evaluation of RI program. In Uttar Pradesh, India it is jointly performed by the Government of U.P, WHO, UNICEF, CORE (CGPP India) and other stakeholders.

Doers and Non-doers survey – is a quantitative tool of barrier analysis, widely recommended for designing behavior change strategies. This tool helps in identifying behavioral determinants (barriers and facilitating factors) of a particular behavior [44].

The Community Mobilization Coordinators (CMCs) are deployed in high-risk areas (HRAs) for polio. As the backbone of the SM Net, they are assigned responsibility for mobilizing about 500 households in either a rural or an urban area, and keep records of the immunization status of all children less than five years of age in those households. CMC areas are groups of communities in a block where the SM Net is deployed. See Weiss et al. (2013) for more details about the CMCs and CMC areas [14].

Full immunization coverage (FIC) measured as ‘Proportion of children aged 12-23 months vaccinated with BCG, 3 doses of OPV, 3 doses of DPT and first dose of MCV’.

RI cards – Immunization card also known as RI card or MCP card (Mother and Child Protection Card). In India, children receive RI cards from the public (government) and private health delivery system. In government health system, the pubic health care provider (e.g. Auxiliary Nurse Midwife) provides MCP cards to pregnant women at the time of antenatal registration. The MCP card has a provision for recording the vaccination status and maternal health care services (including tetanus toxoid injection); whereas most of the RI cards provided by private institutions contain only immunization status. Whenever a child is vaccinated, the vaccinator records the date of immunization in the card.

Index children – were the 6-11 months old children who received OPV3 before the age of 4 months or were yet to receive the third dose (received only first or second dose of OPV). Children who received OPV3 after the age of 4 months were excluded from the study.

Information Education and Communication (IEC) materials are the tools used by communicators to support the target audience in decision making about behaviors. CGPP India provides various types of print and electronic (audio-visual) materials to CMCs.