Using the polio programme to deliver primary health care in Nigeria: implementation research

Abstract

ObjectiveTo evaluate a project that integrated essential primary health-care services into the oral polio vaccine programme in hard-to-reach, underserved communities in northern Nigeria.MethodsIn 2013, Nigeria’s polio emergency operation centre adopted a new approach to rapidly raise polio immunity and reduce newborn, child and maternal morbidity and mortality. We identified, trained and equipped eighty-four mobile health teams to provide free vaccination and primary-care services in 3176 hard-to-reach settlements. We conducted cross-sectional surveys of women of childbearing age in households with children younger than 5 years, in 317 randomly selected settlements, pre- and post-intervention (March 2014 and November 2015, respectively).FindingsFrom June 2014 to September 2015 mobile health teams delivered 2 979 408 doses of oral polio vaccine and dewormed 1 562 640 children younger than 5 years old; performed 676 678 antenatal consultations and treated 1 682 671 illnesses in women and children, including pneumonia, diarrhoea and malaria. The baseline survey found that 758 (19.6%) of 3872 children younger than 5 years had routine immunization cards and 690/3872 (17.8%) were fully immunized for their age. The endline survey found 1757/3575 children (49.1%) with routine immunization cards and 1750 (49.0%) fully immunized. Children vaccinated with 3 or more doses of oral polio vaccine increased from 2133 (55.1%) to 2666 (74.6%). Households’ use of mobile health services in the previous 6 months increased from 509/1472 (34.6%) to 2060/2426(84.9%).ConclusionIntegrating routine primary-care services into polio eradication activities in Nigeria resulted in increased coverage for supplemental oral polio vaccine doses and essential maternal, newborn and child health interventions.

Assessing the impact of polio supplementary immunisation activities on routine immunisation and health systems: a systematic review

“…A sustained increase in funding support for integrated delivery of primary healthcare services was reported in another multicountry report from the African region. 32 Workforce is a critical factor in the success of any health programme. We found reports of increased capacity building, training and knowledge-based capacity associated with SIA implementation, often when there was concurrent increased recruitment instead of redeployment of existing staff.…”

“…A sustained increase in funding support for integrated delivery of primary healthcare services was reported in another multicountry report from the African region. 32 …”

Measles outbreak in complex emergency: estimating vaccine effectiveness and evaluation of the vaccination campaign in Borno State, Nigeria, 2019

“…camps and communities in Bama, Gwoza, Dikwa, Damboa, Ngala, Kukawa and Monguno LGAs), "hit and run" vaccination activities have been conducted with military escort to provide immunization and basic health care in the camps in these areas. Additionally, in hard-to-reach settlements, the polio eradication platform was used to reach underserved communities with measles vaccination [21]. Data on measles VE estimations in emergency settings in Nigeria and other countries are limited, and, where available, quite dated.…”

Measles Outbreak in Complex Emergency: Estimating Vaccine Effectiveness and Evaluation of the Vaccination Campaign in Borno State, Nigeria, 2019

“…LGAs), "hit and run" vaccination activities have been conducted with military escort to provide immunization and basic health care in the camps in these areas. Additionally, in hard-to-reach settlements, the polio eradication platform was used to reach underserved communities with measles vaccination [21].…”