The challenges of insecurity on implementing vaccination campaign and its effect on measles elimination and control efforts: A case study of 2017/18 measles campaign in Borno state, Nigeria

Zero- or missed-dose children in Nigeria: Contributing factors and interventions to overcome immunization service delivery challenges

“… [33] , [38] , [39] , [44] , [46] , [48] , [51] , [52] , [59] Ethnicity 3 Hausa / Fulani ethnic groups (often nomadic or semi-nomadic pastoralists) were less likely to be vaccinated compared to Igbo or Yoruba ethnic groups [59] , [87] , [88] , [89] Conflict and displacement Insurgency and conflict 7 Insurgency and conflict caused internal displacement and prevented access to settlements by vaccination and / or surveillance teams, particularly in Northern Nigeria, resulting in lower vaccination rates. [90] , [91] , [92] , [93] , [94] , [95] , [96] Displacement / migration 3 Rural-to-urban migrants, displaced persons, and recent migrants were less likely to be vaccinated e.g., due to disruption of return visits and challenges to follow-up missed children. [45] , [78] , [97] Health system factors Access to vaccination Access to health facilities 17 Long travel times, difficult terrain, poor or non-existent roads, and perception of the facility being ‘far’ were associated with no or incomplete vaccination, particularly for rural and low-income populations.…”

“… [36] , [69] , [80] , [68] , [95] Vaccination campaign planning 5 Poor vaccination campaign planning, including outdated population estimates and maps; limited community engagement and use of data led to lower coverage rates. [33] , [79] , [91] , [99] , [111] Campaign worker factors 3 Campaign worker factors, including finger marking without vaccination, inflating the number of children vaccinated, not adhering to microplans, and non-screening of home-based records/vaccination cards led to lower coverage in vaccination campaigns. [104] , [112] , [113] Healthcare worker factors 2 Healthcare worker factors, including poor interpersonal skills; lack of motivation; community resistance to healthcare workers; and clinical environments not conducive to health education on vaccination were identified as reasons for lower coverage [102] , [107] COVID-19 pandemic 2 COVID-19 hindered vaccination efforts due to health system disruption; closures of facilities and transport; stay at home orders and fears of contracting disease [80] , [85] Community engagement 1 Poor community engagement, sensitisation and mobilisation created barriers to vaccine uptake [68]

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“… [112] , [113] , [131] , [133] , [134] Using GIS and satellite data 4 Using GIS and satellite data to inform microplanning and team assignments improved identification and coverage of target areas vs hand-drawn maps. [91] , [113] , [129] , [135] Using real-time performance data 4 Using real-time performance data improved coverage of vaccination campaigns (e.g., leveraging existing polio reporting structures; analyzing and report daily campaign data; providing feedback). [99] , [129] , [136] , [137] Coordinating campaign group members 1 Using WhatsApp for campaign group members improved planning, coordination, and data sharing.…”

Exploring the influence of health management processes on health outcomes among internally displaced persons (IDPs)

“…Multiple conflicts in the area, mostly from the Boko Haram insurgency, over a decade resulted in an unprecedented humanitarian crisis, lack of access to essential resources and high demand for health care, which has lasted over a decade ( International Organization for Migration (IOM), 2022 , Ekezie et al., 2019 ). The conflict also threatened the lives of healthcare workers leading to further reductions in human health resources, poor distribution of care, and weak disease surveillance ( Babakura et al., 2021 ). These healthcare shortages affect the general population in the region, who all experience the impact of the disrupted, inadequate, inaccessible and uncoordinated services.…”

“…These healthcare shortages affect the general population in the region, who all experience the impact of the disrupted, inadequate, inaccessible and uncoordinated services. Particular areas affected include vaccination, infectious disease notification and management, maternal services and universal basic care ( Babakura et al., 2021 , Nasir et al., 2016 , Sato, 2021 , Denue et al., 2016 , Anyebe et al., 2019 , Solanke, 2018 , Ager et al., 2015 ). As a result, the most vulnerable populations are faced with limited healthcare services that are often unaffordable.…”