Demand Creation for Polio Vaccine in Persistently Poor-Performing Communities of Northern Nigeria: 2013–2014

Abstract

Introduction. Poliomyelitis remains a global threat despite availability of oral polio vaccine (OPV), proven to reduce the burden of the paralyzing disease. In Nigeria, children continue to miss the opportunity to be fully vaccinated, owing to factors such as unmet health needs and low uptake in security-compromised and underserved communities. We describe the implementation and evaluation of several activities to create demand for polio vaccination in persistently poor-performing local government areas (LGAs).Methods. We assessed the impact of various polio-related interventions, to measure the contribution of demand creation activities in 77 LGAs at very high risk for polio, located across 10 states in northern Nigeria. Interventions included provision of commodities along with the polio vaccine.Results. There was an increasing trend in the number of children reached by different demand creation interventions. A total of 4 819 847 children were vaccinated at health camps alone. There was a reduction in the number of wards in which >10% of children were missed by supplementary immunization activities due to noncompliance with vaccination recommendations, a rise in the proportion of children who received ≥4 OPV doses, and a decrease in the proportion of children who were underimmunized or unimmunized.Conclusions. Demand creation interventions increased the uptake of polio vaccines in persistently poor-performing high-risk communities in northern Nigeria during September 2013–November 2014.

Stopping circulatory vaccine-derived poliovirus in Kaduna state by scaling up special interventions in local government areas along rivers of interest- kamacha basin experience, 2013–2015

“…These interventions included revision of household based micro plans (involved listing of all major and minor settlements and enumeration of all under-5 years old children), scaling up of transit vaccination (for examples motor parks, check points, markets vaccinations), scaling up of youth engagement as well as intensified supportive supervision (youth accompanied vaccination teams working in volatile or security compromised settlements). Others were scaling up of Directly Observed Polio Vaccination (DOPV) (immunization outside the households two to 3 days before the vaccination teams commence house-to-house vaccination) and in-between rounds vaccination activities (vaccination immediately after a campaign targeted at under-performing settlements) [17][18][19].…”

A mixed method approach for the assessment of demand creation intervention strategy for polio eradication on exclusive breast feeding in Northern Nigeria

“…The World Health Assembly at its sixty-fifth session of May 2012 declared polio eradication as a public health emergency of global significance (Warigon et al, 2016a). In response, Nigeria which is one of the three polio endemic countries that is yet to interrupt its transmission developed the National Polio Eradication Emergency Plan (NPEEP) as a strategic priority for 2013, 2016 and 2018.…”

Micro-planning for immunization in Kaduna State, Nigeria: Lessons learnt, 2017

“…The last Wild Polio Virus (WPV) isolated in a paralyzed child in Nigeria, was in September 2016, despite robust and vigorous certification standard Acute Flaccid Paralysis (AFP) surveillance [19] . The successes recorded in Nigeria’s effort to interrupt poliovirus transmission is driven largely by aggressive and high quality Oral Polio Vaccine (OPV) Supplemental Immunization Activities (SIAs), robust surveillance and outbreak response, and Routine Immunization (RI) [20] , [21] , [22] . The OPV 3 coverage for Kaduna State, 12–23 months old children was 34.4% (2017, National Immunization Coverage Survey for Routine antigens, NICS).…”

“…Caregivers for many reasons do not go to health facilities for routine antigens, including OPV. The low OPV 3 coverage, due mainly to weak demand for routine antigens and the need to rapidly boost population immunity against the disabling Wild Polio Virus (WPV), led the Global Polio Eradication Initiatives (GPEI) to increase supplemental OPV campaigns in Kaduna State, despite the huge cost and great burden on personnel [21] , [22] , [23] . The OPV campaigns, especially in high risk (low vaccine uptake, <80% OPV3 coverage and high vaccines refusal rate) states of northern Nigeria with poliovirus transmission has led to several campaigns which inadvertently resulted in overestimated denominators.…”

“…Subsequently, the overestimation of target populations has led to huge financial losses. Planning parameters for vaccines and pluses depend on the highest <5 years vaccinated with OPV in the last three campaigns as the denominator [11] , [19] , [21] , leading to high vaccines wastages from overestimated coverages and and a significant drain of limited human and material resources [6] , [16] , [23] . Pluses are additional incentive given to children and caregivers after vaccination, for example, sachet milk, sweet, balloon and so on.…”