Despite some progress in Nigeria’s immunization program, the country still struggles with low coverage, achieving only 57%, far below the Global Vaccine Action Plan target of 80%. Moreover, Nigeria accounts for the highest number of zero-dose children in Africa, highlighting the need for urgent intervention to improve immunization rates.
The barriers to achieving adequate vaccination coverage are complex, and a more targeted and comprehensive approach was needed to address these challenges. To strengthen routine immunization (RI) services and tackle the issue of zero-dose and under-immunized children, USAID Nigeria, through the MOMENTUM Routine Immunization Transformation and Equity (MRITE) project, commissioned Sydani and Brooks Insights to conduct a baseline assessment.
The assessment was aimed at providing detailed, state-specific insights into routine immunization performance and uncovering the underlying barriers hindering immunization services in Bayelsa, Edo, Imo, Jigawa, and Lagos states.
Action (Assessments/MEL/Data Management):
Sydani conducted a baseline assessment between February 2023 to May 2023 to generate a comprehensive overview of the routine immunization landscape in the five selected states. The assessment focused on:
1. Identifying barriers to immunization coverage within the routine immunization (RI) and primary healthcare (PHC) domains.
2. Providing up-to-date insights on each state’s strengths and weaknesses in delivering immunization services.
3. Auditing and geo-mapping the availability and distribution of human resources for health (HRH) in public primary healthcare facilities.
The assessment encompassed various levels of data collection, including the state, LGA, health facility, and community levels. A total of 10 LGAs (two LGAs per state), 50 primary healthcare facilities (five per LGA), and 50 communities (one per healthcare facility) were assessed. Both qualitative and quantitative data were collected, utilizing tools to measure the availability, demand, and delivery of immunization services.
The data collection process also included secondary data analysis of MRITE-specific indicators, as well as detailed audits of healthcare facilities.
One of the key outputs of this assessment was the development of an interactive GIS map that visually captured the distribution of HRH across all public healthcare facilities in the selected states, enabling stakeholders to better understand HRH allocation and identify areas with critical shortages.
Result:
The baseline assessment yielded valuable findings that informed the design of targeted interventions to improve routine immunization services. The interactive GIS map highlighted gaps in HRH distribution, revealing areas with critical shortages that needed immediate attention.
The audit of immunization services provided actionable recommendations aimed at addressing barriers to immunization coverage. The comprehensive data from the baseline also helped stakeholders pinpoint specific areas where immunization efforts were lagging, offering insights into the root causes of under-immunization, such as logistical challenges, inadequate staffing, and community-level barriers to vaccine acceptance.
These findings laid the foundation for high-impact, tailored interventions aimed at increasing equitable immunization coverage and ensuring sustainable improvements across the MRITE-supported states.
