Background: Over two decades ago, the global polio eradication effort was launched. It sought to end the disease through an efficacious polio vaccine that is delivered through routine vaccinations and supplementary campaigns among susceptible populations. To date, however, Nigeria is yet to be declared polio free. This is mainly because of the low polio vaccine coverage in northern Nigeria despite the repeated polio campaigns in the region. The main bottleneck was low community acceptance due to misconceptions, distrust and myths around the cause of the disease, the safety of the vaccine, inadequate social mobilization, improper channels of communication, and lack of programme commitment and ownership at the local government level. Thus, to enhance the effectiveness of the intervention, there was a need to actively engage community gatekeepers with a special focus on political, traditional and religious leaders, traditional healers, birth attendants, town criers and traditional surgeons. A pilot trial using a mass media campaign was launched in 2008 in four northern communities within the same local council. This campaign, dubbed the ‘Majigi’ educational intervention, targeted the beliefs about the disease and the negative attitudes towards polio vaccination. Majigi involved a road side film show in communities using mobile vans. Community leaders encouraged attendance and participation in subsequent vaccination activities through their circles of influence. Regular polio supplemental vaccination activities were conducted and the outcomes monitored for six successive months.

Results: The campaign resulted in a 310% increase in polio vaccination uptake and net reduction of 29% of never-vaccinated children in the targeted region. ‘Majigi’s successful innovative contextually- sensitive approach enhanced community ownership and cleared misconceptions around the polio vaccine.

Conclusions: Targeting the community gatekeepers facilitated the implementation as well as the outcomes of the intervention. Furthermore, polio vaccination uptake was enhanced by a locally adapted programme that promoted effective communication with and within the community.

Lessons: To promote a given intervention, communities need to be empowered so that they are able to make informed decisions.