The Afghanistan Challenge and Strategy [Presentation from the Sharing Learning from Polio SBC Side Event at the 2022 SBCC Summit]

"...in Afghanistan country programming, you have to continuously adapt yourself and your strategies into the situation...."

Wild Polio Virus Type 1 (WPV1) may be at its historical lowest in polio-endemic and conflict-affected Afghanistan, but recent environmental surveillance (ES)-positive isolates and a human WPV1 case in Kunar province indicates persisting circulation. Access issues (reaching children in security-compromised areas with oral polio vaccine, or OPV) and a large outbreak in bordering areas of neighbouring Pakistan have historically posed significant threats to polio eradication in the country. This context provides a launching point for a presentation delivered by UNICEF Afghanistan's Pa Ousman Manneh at the Sharing Learning from Polio SBC: Misinformation, Social Data and Conflict side event at the 2022 International SBCC Summit.

Manneh discusses some of the changes that have affected the country since the Taliban (what he calls the "de facto government") took over in August 2021, following the withdrawal of international troops. Whereas in January 2020, 75-100% of children in some areas were inaccessible, after August 2021, all areas of the country were green on a map - meaning polio workers could theoretically go anywhere. However, new challenges arose. The Taliban said they had no problem with the polio campaigns but that they had to take place mosque to mosque. Women, who are the custodians of the children, are not allowed into any mosque setting, so, once again, children have become inaccessible, as the mosque-to-mosque campaign modality is not in sync with socio-cultural norms.

Manneh stresses the need to adapt to the situation on the ground, as it is continuously changing. For example, in one picture he showed, taken some months ago, female polio mobilisers were allowed to go household to household (H2H) to deliver OPV. However, since then, the Taliban has forbidden girls and young women to even attend school, and female mobilisers must go to the mullah, malik, or wakili-e-Guzar's home or the head of the community to do their community engagement sessions (rather than going door to door). The Taliban indicates that women cannot singly move from one area to another without a Maharam (a male family member), which complicates not only the mobilisers' work but also mothers' efforts to take their child to a health facility. In addition to these issues, 8 social mobilisers were killed in northern Afghanistan in February 2022.

Thus, social and behaviour change (SBC) communication planning is needed for both accessible and inaccessible areas prior to August 2021. UNICEF Afghanistan is also working to ensure an established mechanism to enhance reaching out to the Taliban that involves, for example, access negotiation and maximising use of internal interlocutors, including specially recruited extenders. Pa said, "As an outsider, I find it difficult to differentiate who is a Taliban and who is not in a Taliban, even in my own setting. So you have to be extremely sensitive, but again you have to know that like you need people who can really penetrate and get in touch with the other group."

Other SBC-related activities include: establishment of informal channels of communication and engagement with critical local, influential, and religious leaders through staff/partner contacts; preparation/pre-positioning of locally, religiously, and culturally relevant and acceptable materials for dissemination to inaccessible areas when opportunities arise; strong leadership and high-level engagement of conflicting parties; the maximising of multi-disaster emergency opportunities that avail themselves (COVID-19 - e.g., sharing soap/sanitizer with the Taliban in exchange for allowing polio workers certain latitude - and the earthquake) for reaching out; and service expansion closer to conflict communities (Helmand/Uruzgan).

In response to one audience member's question, Pa delves into the specifics of the mosque-to-mosque strategy, which requires special advocacy with the governor. For most mosques, if women's husbands are there or other siblings are there, women can bring their children for OPV. But, particularly in Kandahar, the polio programme has designed what they call female-to-female engagement, whereby female community engagement officers go to the community leader's house and have a discussion of 30 minutes to one hour to ask for certain exceptions to any restrictions. They also have female safe spaces, which are set up in collaboration with gender and child protection units. In Kandahar alone, there are 16 women and girls safe spaces that within three months can be visited by over 30,000 women and girls. So, the polio programme capitalises on those spaces to ensure that women can be engaged and possibly take their children there for OPV.

Recommendations to emerge from UNICEF Afghanistan's work include:

• Cultivate a sensitivity to local socio-cultural practices and norms, and adapt campaign modalities, SBC interventionsm and initiatives accordingly.
• Separate deep community engagement from campaign-operational SBC communication plans, and ensure adaptivity and flexibility to accommodate unexpected surprises.
• Maximise use of community-based radio discussions with a range of panelists (religious leaders, respectable community leaders, doctors), as radio waves have no barriers.
• Foster increased involvement of women and female-to-female communication, which is critical if polio is to be eradicated in Afghanistan.
• Build strategic partnerships that are based on mutual understanding and trust - no discrimination!

Click here, and then click on the Part 2 video recording, to locate and watch Manneh's presentation (beginning at approx. 1 hour and 17 minutes into that Part 2 recording).