Reinforced Media Communication Improves Turnout in Pulse Polio National Immunization Days: “Findings from a Grounded Theory Approach” from an Immunization Clinic in Odisha, India

Abstract

Background: To maintain India's polio-free status since March 27, 2014, periodic Pulse Polio National Immunization Days (NIDs) continue to be critical for preventing resurgence, especially in states in the north and east of the country, given their proximity to neighboring nations, wherein cases of Polio persist. However, participation in these campaigns has declined, potentially due to reduced media reinforcement. Objectives: To explore how reinforced media communication influences community participation in NID pulse polio campaigns during the elimination phase. Methods: According to the grounded theory methodology, a survey was conducted at an urban immunization clinic in Bhubaneswar, Odisha, during the January 2024 NID, and the performance was compared to that of the 2022 NID. Thirty caregivers were interviewed using semi-structured guides for in-depth impressions. Data was analysed through open, axial, and selective coding to generate themes, develop an emergent theory, and matched against the actual quantitative figures reported in the years of the campaign being considered i.e. 2022 and 2024. Results: Three major themes emerged: A. Reinforced Media as an enabling behavioural trigger; B. Trust through repetitive authoritative messaging; and C. Normalization via community behaviour. The core theory suggests that reinforced media communication fosters a sense of urgency and collective responsibility, which improves turnout. Using the media dissemination for 2024, a nearly 99% increase was seen in the recipients of the Polio vaccine in 2024 as compared to 2022. Conclusion: Reinforced and culturally sensitive media communication remains crucial even in the polio elimination phase. Sustained investment in strategic media messaging should be integral to NID planning and micro-implementation.