Kwango province spans 14 health zones and 308 health areas, and is home to just over three million people. Reaching every child under five here means more than moving vaccines. It means moving people — chiefs, pastors, governors, teachers, and the children themselves. This notebook records how that mobilisation took shape before and during the polio response campaign.

The campaign opened where authority is felt most directly: with the customary leadership. In an advocacy session, the traditional chief recorded a call to every community under his leadership — that 100% of them bring 100% of children aged 0 to 59 months for vaccination. He then made the commitment visible. Standing with the government team and GPEI partners, he raised a red card: no, and stop, to polio in his community.

Provincial authorities lent the same weight. The Governor chaired the preparatory coordination meeting, and the Vice-Governor, the Provincial Minister of Health and Primary and Secondary Education, and the head of the provincial health division appeared publicly alongside the campaign — a signal of ownership that travelled far beyond the room.

Advocacy with the traditional chief to capture his message of commitment to polio eradication — calling on 100% of the communities under his leadership to have 100% of target children aged 0 to 59 months vaccinated in Kwango province.

Together with the government team and GPEI partners, the traditional chief demonstrated his full commitment by brandishing the red card — saying no, and STOP, to polio in his community.

A preparatory meeting of the provincial coordination committee (CPC), chaired by the Governor of the province, in support of the measles vaccination campaign integrated with yellow fever.

Where refusals were rooted in belief, the response worked through the institutions people trust. A poster reproducing the Democratic Republic of the Congo's child protection law was produced for display in places of worship. And in an advocacy meeting, a senior church leader pledged to carry the message to his peers, so that no Christian denomination in Kwango would be associated with a refusal — in campaigns or in routine immunisation.

Advocacy with the ecclesiastical authority in support of the polio outbreak response campaign. The leader committed to calling on all his fellow church leaders to relay that commitment, so that no Christian denomination in Kwango province would be the subject of vaccination refusals, whether during campaigns or in routine immunisation.

The most visible mobilisation belonged to the children. Under the “Child to child” approach, the province dedicated 24 hours to young people ahead of the campaign launch: a football match between pupils of the CBCO school, a banner carried by players and officials alike, and a trophy presented by the Vice-Governor.

The pupils did more than play. They raised panels naming the diseases vaccination prevents — yellow fever, measles, tuberculosis, whooping cough — showing both a working command of the immunisation schedule and a readiness to become the first messengers in their own households. They then took the message further, rehearsing and staging a play in support of vaccination in the CBCO health area, Kenge health zone.

Group photo with the Vice-Governor of the province, the Provincial Minister of Health and Primary and Secondary Education (EPSP), the head of the provincial health division and the players, holding the banner for the 24 hours in support of the “Child to child” approach, ahead of the launch of the polio campaign in Kwango province. 

The football match between pupils of the CBCO school, organised as part of the 24 hours in support of the “Child to child” approach, ahead of the launch of the supplementary immunisation activities (SIAs) against polio in Kwango province.

The trophy is presented by the Vice-Governor of Kwango province, in a spirit of commitment to and ownership of immunisation activities for the wellbeing of the children of his province.

Pupils raised panels naming several diseases preventable by vaccination — yellow fever, measles, tuberculosis and whooping cough — a way of saying no to all vaccine-preventable diseases. It reflects both their command of the immunisation schedule and their involvement as first messengers to their own families, in support of campaigns and routine immunisation alike.

Preparations for a theatre piece in support of vaccination, staged by pupils of the CBCO primary school in the CBCO health area, Kenge health zone.

The play itself is where the campaign's argument is made most sharply — and it is made entirely by children. Taking the roles of parents, health workers and community members, the pupils stage the decision every household in Kwango has to make, and follow it through to its consequences.

In one scene, pupils playing the head nurse and his team run a vaccination session at the health centre. In another, they portray a family that had resisted vaccination and, after trying several remedies to help their child, finally comes to the health centre seeking care for the child's paralysis — where laboratory analysis confirms the cause is polio. A third scene shows a mother's reaction as she realises her child has been left disabled because vaccination was refused in the household.

The drama does not end there. In the closing scene, pupils play a family that leaves the health centre having learned about immunisation, committing to keep to their child's vaccination schedule and to make full use of free services — and describing the value of vaccination as beyond price for a household with very limited resources.

Performed by children in front of their own community, the two outcomes sit side by side: the family that refused, and the family that chose to protect. Few communication tools land that contrast as directly.

Moments from the performance of the play staged by pupils of the CBCO school, and the head nurse (infirmier titulaire) and his team during vaccination sessions at the health centre.

A scene from the play: at the health centre, the head nurse and his team receive one of the families that had resisted vaccination. After trying several methods to save their child, the family comes to the health centre to seek appropriate care for the child's paralysis. Laboratory analysis shows that the child can no longer walk because of polio.

A scene from the play: the reaction of a mother realising that her child has been left disabled because her husband had refused to have the child vaccinated against polio.

A scene from the play: a family, happy and satisfied at having learned a great deal about vaccination, commits to following their child's immunisation schedule closely in order to benefit fully and easily from free care. They maintain that the value of vaccination is beyond price, particularly as it serves a highly vulnerable group with very limited resources.

Read end to end, the Kwango notebook makes a simple case. Demand is built in layers: a chief's word gives permission, a church leader removes the doubt that belief can create, elected authorities show the province that this matters, and children carry the message across the threshold of the home. And when those same children stage the consequences of a refusal in front of their neighbours, the stakes stop being abstract — which is precisely the point.

Supervision of the house-to-house teams during the polio vaccination campaign.