Table 3.

Effective strategies used by VCMs

Strategies	Explanation
House-to-house mobilization	This consists of in-person interactive visits conducted by VCMs to create awareness of and to increase demand for immunization services and other key household practices in their assigned communities.
Naming ceremony	The traditional 7th day naming ceremony, also known as Suna Immunization, is an activity during which a VCM immunizes the newborn child and other children younger than 5 years. This traditional ceremony is organized by the family that invites relatives, friends, and well-wishers. The VCM, with the support of her supervisor (the VWS), collects oral polio vaccine from the health facility and joins the family in the celebration. During the ceremony, the newborn receives the birth dose of OPV as do the other young children who are in attendance.
Meeting of compound members	This is an interactive activity between the VCM, a higher level CGPP program staff member, and members of immunization-resistant families within a household or compound. This meeting targets mainly women but could include men if circumstances permit. During the meeting, the VCM explains the purpose and importance of the Polio Eradication Initiative and the implications of not immunizing.
	Members of the compound can voice their concerns and fears, which most times emanate from myths and misconceptions about immunization. These concerns are passionately addressed by the VCM and the accompanying CGPP staff member. In most cases, the meeting results in the acceptance of immunization services by the vaccine-resistant families.
Community dialogue	This is a meeting between CGPP program staff members and important members of the community to address the challenges to obtaining immunizations and other health-care services and to performing key healthful household practices. A community dialogue is typically organized when there are many non-compliant or resistant families after supplemental immunization activities despite relentless efforts by the VCMs during the house-to-house mobilization to convince them to accept immunization. The meeting is convened in the affected community by the local government area coordinator or a higher level program staff member, with the VCM in attendance. If the challenges are resolved, the immunization teams revisit the households to immunize the children. In some cases, the CGPP team will arrive for follow-up with the health officer who then vaccinates all children younger than five years with OPV and immunizes children younger than 1 year with the other routine vaccines.
Community registers	These registers are maintained by the VCMs. The registers are used to document the vaccination history of all children and track pregnant women and newborns, and are used by mobilizers to encourage parents to seek routine immunization for their children at prescribed intervals. Data from these registers are sent from the local level to the state and secretariat level on a monthly basis. Community registers are, perhaps, the most successful documentation strategy used by Nigeria/CGPP.

CGPP = CORE Group Polio Project; VCM = volunteer community mobilizer.