Using data to guide action in polio health communications: experience from the Polio Eradication Initiative (PEI).

Health communication is increasingly considered a priority element of investments and interventions intended to improve personal and public health (Piotrow et al., 1997). But a prevailing focus in health communication on information, education, awareness, and knowledge--and their assumed relation to changing behaviour among target individuals or households--can underestimate the complexity of wider ecological conditions that influence and limit individual, household, and even community choices and capacity to choose. Experience from the Polio Eradication Initiative (PEI)--drawing on evidence from the India and Nigeria country programmes--provides some insights into how the health communication interventions can be strengthened through the adoption of a more holistic ecological model of people and their health-related behaviours analysed in the context of larger social, economic, political, and cultural forces (see, for example, Kelly et al., 2008). In particular, polio eradication health communication offers useful lessons in the importance of generating and using data of sufficient quality to enable a more ecological analysis--combining and measuring specific communication inputs and epidemiological "outputs."