Module 7 Communicating with caregivers about IPV and multiple injections

1. Training for the introduction of InactivatedPoliovirus Vaccine, Fractional Dose (fIPV) Module 7 Communicating with caregivers about IPV and multiple injections

2. Learning objectives • At the end of the module, the participant will: • Be familiar with ways and techniques of communicating with caregivers • Know the benefits of IPV and its importance to polio eradication, multiple injections, and routine immunization • Understand the safety of IPV when administered with other vaccines • Duration • 40minutes Note: This module should be covered with a related UNICEF Curriculum on Interpersonal Communication (IPC; 2h minimum), available here from Oct. 2014:http://www.who.int/immunization/diseases/poliomyelitis/inactivated_polio_vaccine/en/ Reference: UNICEF IPC curriculum

3. 3 A strong health worker recommendation for IPV and multiple injections is essential to increase caregiver acceptance. Key issues 1 Health workersneed to provide information to caregivers, listento theirconcernsand beprepared to politelyanswertheirquestions. 2 Health workers should use simple words and avoid technical terms with caregivers.

4. The importance of communicating effectively with caregivers about IPV and other vaccines Health workers play important roles in parent and caregiver accepting vaccinations for their children. Caregivers may not understand why their child needs an additional vaccine for polio and may be concerned about receiving multiple injections on the same visit. By listening patiently, understanding, encouraging and communicating effectively with caregivers, health workers can ensure that children receive vaccines and return for future vaccinations. For more information related to the importance of interpersonal communication, refer to page 25 of the IPC Curriculum Reference: UNICEF IPC curriculum

5. How to communicate with caregivers? • Be respectful and compassionate • Provide reassurance • Use simple words and avoid technical terms • Listen to caregiver's concerns • Make sure the caregiver has understood your key messages For information on the GATHER approach (Greet, Ask, Tell, Help, Explain, Return), and using it to improve quality of outreach visits, refer to pages 26-27 of the IPC Curriculum Reference: UNICEF IPC curriculum

6. How to communicate with caregivers? • Be respectful and compassionate • Be warm and welcoming • Show respect • Smile • Praise them for bringing their child forimmunizations and encourage them to continue bringing their child until fully vaccinated.

7. How to communicate with caregivers? • Provide reassurance • Explain to parents and caregivers that IPV is important and safe. • Reassure them that multiple injections are safe. • Remind them that it is better for the child to experience one, brief moment of discomfort than pain on two separate days. • Reinforce the importance of immunization overall

8. How to communicate with caregivers? • Use simple words and avoid technical terms • Keep your messages simple and clear. Avoid using medical words • Use words in a local language that caregivers can understand

9. How to communicate with caregivers? • Listen to the caregiver's concerns • Allow the caregivers to talk, encourage them to ask questions • Give them your full attention • Listen to their concerns and respond to them politely. Correct any misconceptions they may have • Keep your body language positive • If you do not know the response to any question, tell the caregiver(s) that you will return with the correct information the next time you see them at the facility or outreach

10. How to communicate with caregivers? • Make sure the caregiver has understood your key messages • Explain and check for understanding – ask questions to find out if the caregiver understood you • Remind the caregiver to bring the child for the second dose of IPV and for all other future vaccinations as per the schedule

11. Health Workers need to be prepared to inform parents/caregivers about: • Benefits and safety of IPV • Benefits of continued use of OPV for polio eradication • Missed/upcoming vaccines in the schedule • The importance of returning for the second dose of IPV • The importance of bringing their vaccine card to every session If applicable: • Benefits and safety of multiple injections • Questions about pain from multiple injections

12. Benefits of IPV It is important to emphasize to caregivers the importance of combining IPV and OPV. IPV and OPV each play different roles in making the child stronger – they each cause a different kind of immune reaction. Combining these vaccines protects children even more and gives them the benefit of both vaccines. For more information on the benefits of IPV and OPV, refer to page 35-36 of the IPV Curriculum. Reference: UNICEF IPC curriculum

13. How to explain the benefits of IPV Health workers can tell parents and caregivers: “Combining IPV and OPV provides stronger protection against polio. These 2 doses of IPV will help protect your children against polio disease even more – and will give your child the benefits of both vaccines.” “IPV strengthens immunity in the blood, while OPV strengthens immunity in the gut” “Using both vaccines together provides the best form of protection from polio – it protects your child and helps protect our community.”

14. How shouldyourespond to typical questions fromcaregivers? ? Why does my child need two different vaccines for polio? For more examples of questions, refer to Session 3.2 of page 22 of the IPV Curriculum. Reference: UNICEF IPC curriculum

15. Safety of IPV • IPV has been used in over 60 countries worldwide, over decades • IPV is a very safe vaccine, whether used alone or in combination vaccines • No serious side effects have been reported, only minor side effects • Minor local reactions may occur following IPV, as can sometimes happen with other vaccines. But a child will recover

16. How shouldyourespond to typical questions fromcaregivers? ? Does IPV have any side effects?

17. Talking to caregivers about the safety of IPV Health workers can tell parents and caregivers: “IPV is a very safe vaccine.” “With this type of injection, a small bump will appear on the skin, but this is normal and will disappear with time.” “After the vaccine, there might be a little bit of redness and the skin may feel tender.”

18. If applicable: Talking about the benefits of multiple injections Parents/caregivers may have concerns about their child receiving three vaccines at one visit. Health workers can address this by saying: “Giving a child several vaccinations during the same visit allows your child to be immunized as soon as possible. They are protected against multiple diseases during the most vulnerable early months of life.” “In addition, giving multiple vaccinations at one time means fewer vaccination visits for parents and caregivers.”

19. Talking to caregivers about the safety of multiple injections Inform parents and caregivers that:  “It is safe for your child to receive multiple injections at once. In many countries, children receive more than one vaccine injection in one visit.” “Early vaccinations mean early protection for the child”

20. How shouldyourespond to typical questions fromcaregivers? ? Is it safe to give multiple vaccine injections at one visit?

21. Talking to caregivers about the pain associated with multiple injections • Health workers should acknowledge that children will likely experience slightly more pain or discomfort when there are multiple injections. • However, they should remind caregivers that having to return for additional vaccines forces the child to experience pain on two visits. • Address concerns about pain by saying: “It is better for the child to experience one, brief moment of discomfort than pain on two separate days.”

22. How shouldyourespond to typical questions fromcaregivers? ? Will my child experience more pain or discomfort?

23. Things to remember:key messages • Vaccinations are important for the overall health of the child • IPV and OPV together provides stronger protection against polio • Even after the child receives IPV, caregivers should continue to accept OPV whenever it is offered. • IPV is safe and effective • It is safe to give multiple vaccine injections in one visit. In many countries, children receive more than three vaccines in one visit. • It is better for the child to experience one brief moment of discomfort from multiple vaccines, than pain on two separate days/visits. • By listening patiently, understanding, encouraging and communicatingeffectively with caregivers, health workers can ensure that children receive vaccines and return for future vaccinations.

24. End of module Thank you for your attention!