Association of Volunteer Communication Mobilizers’ Polio-Related Knowledge and Job-Related Characteristics With Health Message Delivery Performance in Kano District of Nigeria

The VCMs were deployed to increase community awareness for polio vaccination. A cross-sectional survey was conducted among 170 VCMs in both LGAs, with 118 from Ungogo and 52 from Nassarawa. The study found that 63% of VCMs in Nassarawa had appropriate levels of knowledge about health education messages, compared to 26.3% in Ungogo. Additionally, 32.7% of VCMs in Nassarawa mentioned that polio vaccination protects children from paralysis, compared to 15.3% in Ungogo. Among VCMs, 75% in Nassarawa knew the total number of under 5 children in their catchment area of work, compared to 31% in Ungogo. The study identified that for every 10 additional months of experience, VCMs delivered 1.3 more messages during household visits. VCMs who knew that polio causes paralysis delivered 0.5 more health messages than VCMs who did not have that knowledge. The results demonstrated that VCMs' polio-related knowledge was associated with health message delivery performance. The study sites were Nassarawa and Ungogo LGAs of the Kano state of Nigeria. Kano is one of the 11 states in northern Nigeria where religious propaganda to boycott oral polio vaccination occurred. The United Nation's Children's Emergency Fund (UNICEF) has a field office in Kano State and deployed the highest number of VCMs in these two LGAs. The VCMs in both LGAs received a similar type of training and supplies. The study design and sampling methods involved a cross-sectional survey during June through October 2014, using a structured questionnaire among 170 VCMs in both LGAs. The questionnaire was pre-tested and discussed among the lead investigator and one research assistant for better understanding of each question, codes, and expected responses from the VCMs. Both the lead investigator and one research assistant interviewed the VCMs in the primary care health facilities of the wards in both LGAs. The knowledge assessment involved asking VCMs three separate questions focusing on the consequences of polio infection, prevention strategies, and what messages they had delivered in their last household visits. The VCMs' knowledge was considered sufficient if they responded that polio causes paralysis, that it can be prevented by vaccination, and that all under 5 children need to be vaccinated regardless of age and sex, and whether they were ill or asleep when vaccinations were offered, or that polio vaccination can protect your child from paralysis. The performance measurement involved collecting secondary data on LGA-level vaccination coverage and measuring individual-level performance of the VCMs. The secondary data were collected from the WHO Kano Office on the clustered lot quality assurance sampling (LQAS) for Nassarawa and Ungogo LGA between January and April, 2014. The four months' preceding LQAS data were used to measure the VCMs' performance. The study's findings have implications for the performance of VCMs in polio eradication efforts. The results suggest that VCMs' knowledge and job-related characteristics are associated with their performance. The study's findings can inform the development of training programs and interventions to improve VCMs' knowledge and performance.