BackgroundThe year 2014 was a turning point for polio eradication in Nigeria. Confronted with the challenges of increased numbers of polio cases detected in rural, hard-to-reach (HTR), and security-compromised areas of northern Nigeria, the Nigeria polio program introduced the HTR project in four northern states to provide immunization and maternal and child health services in these communities. The project was set up to improve population immunity, increase oral polio vaccine (OPV) and other immunization uptake, and to support Nigeria’s efforts to interrupt polio transmission by 2015. Furthermore, the project also aimed to create demand for these services which were often unavailable in the HTR areas. To this end, the program developed a community engagement (CE) strategy to create awareness about the services being provided by the project. The term HTR is operationally defined as geographically difficult terrain, with any of the following criteria: having inter-ward/inter-Local Government Area/interstate borders, scattered households, nomadic population, or waterlogged/riverine area, with no easy to access to healthcare facilities and insecurity.MethodsWe evaluated the outcome of CE activities in Kano, Bauchi, Borno, and Yobe states to examine the methods and processes that helped to increase OPV and third pentavalent (penta3) immunization coverage in areas of implementation. We also assessed the number of community engagers who mobilized caregivers to vaccination posts and the service satisfaction for the performance of the community engagers.ResultsPenta3 coverage was at 22% in the first quarter of project implementation and increased to 62% by the fourth quarter of project implementation. OPV coverage also increased from 54% in the first quarter to 76% in the last quarter of the 1-year project implementation.ConclusionsThe systematic implementation of a CE strategy that focused on planning and working with community structures and community engagers in immunization activities assisted in increasing OPV and penta3 immunization coverage.
A weak AFP surveillance system constitutes a major threat to Nigeria's polio free certification status. This study investigates the factors that have affected AFP surveillance, case detection along the international border settlements of Oyo state, Nigeria. A cross-sectional survey was conducted between 26 th -31 th December 2018 using structured questionnaires uploaded onto Open Data Kit-collect (ODK) mobile software in 4 LGAs in Oyo state. Overall, 427 respondents (community members=420, community informants=7) participated in this study. On the average, 10% and 46% of the community members and informants could identify the various aspects of the AFP case definition. Majority of the community members weren't aware of AFP surveillance neither were they aware of their AFP focal person/DSNO or where to report AFP cases. Barriers to case reporting include, irregular movements of commercial vehicles, swampy roads during rainy seasons, rocky roads during dry seasons; poor communication networks; and poor modes of transportation. The accessibility and difficulty of terrain along these international boarders has greatly hindered surveillance activities in their corresponding communities. If steps are taken to improve accessibility in such areas, we believe that AFP case detection and reporting would also improve.
The uptake of Routine immunization services continues to decline in Oyo State despite best efforts to improve Routine Immunization (RI) services. This study aims to investigate the root cause of poor routine immunization uptake in the State using Ibadan north and Kajola Local Government Areas (LGAs) as sentinel study sites in Oyo state, Nigeria. A crosssectional Community survey was conducted between 26 th -30 th November 2018 using structured questionnaires uploaded onto Open Data Kit-collect (ODK) mobile software in the 2 LGAs namely Kajola and Ibadan North LGAs, Oyo state. Majority of the respondents Local Immunization Officers, RI Focal Persons, Other Health Workers and Community Members were fully aware of RI services, its benefits/importance and were mostly satisfied with the services they received at their community health facility. However, 95% of the respondents stated that they were not part of the RI planning processes in their communities neither were they actively involved in selecting the date, time or venue for RI in their communities. Also 76% of the respondents stated that Health workers neither rescheduled RI sessions for missed children neither did they visit /track the missed children. Functional Village Development Committees (VDCs) and updated Reaching Every Ward (REW) micro-plan was not present in 67% and 62% of the visited facilities respectively. World Health Organization (WHO) was mostly responsible for funding of immunization activities. Funding and poor engagement with members of the communities have been discovered to be a major contributing factor to poor immunization uptake in these LGAs. We advise that this gap be bridged for the purposes of improved RI uptake in the state.
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