In line with the Government of Nigeria’s vision of integrating all Primary Health Care (PHC) services under one plan, one team, and one budget to optimize resources and efficiently deliver all services by one team, the National Primary Health Care Development Agency (NPHCDA) is integrating COVID-19 vaccination with the non-Polio supplementary immunization activities (NPSIAs) campaigns, Routine Immunization (RI) services and Vit A supplementation.
The integrated campaigns started in 3 States (e.g., Lagos, Ogun, Gombe) in June 2022. Additionally, recognizing that many children missed-out on RI, the NPHCDA, World Health Organization (WHO), UNICEF, Gavi and partners collaborated with the States in deploying a Zero dose (children who never received any vaccination) reduction operational planning (ZDROP).
Integrated approach
In Lagos State, the immunization campaign targets to reach over 5,4 million children aged 0-59 months with the oral polio vaccine (bOPV), over 4 million aged 9-59 months for measles and nearly 5 million with Vitamin A while over 18 million people aged 18 years and above for the COVID-19 vaccines.
Mrs Ope A, 39 years old mother of three residing in Alimosho Local Government Area (LGA), is passionate about children’s health and was grateful that all the vaccines were available and could be administered during the campaign.
Sighting the vaccinators, she called other mothers in the neighborhood to bring out their children out for vaccination.
“Bringing all the vaccines to our doorsteps is a good strategy as parents will no longer have excuses for not presenting their children for vaccination.
I have come across many mothers who have not taken their children to the clinic for immunization, and I always advise them that immunization keeps the child healthy,” she said.
In addition to providing children with RI, the team gave out COVID-19 vaccines to those over 18 years old.
For instance, Mr Oluwademilade, a father of two children residing in Yaba LGA, Lagos State, was one of the parents who leveraged the integrated campaign and received the COVID-19 vaccine.
“My wife and I had no excuse because the vaccinators brought the COVID-19 vaccine alongside with other essential childhood vaccines,” he said.
Similarly, Mrs Favour, a mother of two residing in Kosofe LGA, Lagos State, said “I like that they brought the COVID-19 vaccine to us this time with children’s vaccination because, in previous years, it was only the children that were considered.
Having received all the complete doses of the COVID-19 vaccine before the campaign, Mrs Favour said the initiative would encourage adults who are yet to receive their shots to do so.
Buttressing the importance of effective immunization activities across the state, Mrs Shagari, an official with the NPHCDA, said “the reason for integration is to reach every community and hard-to-reach areas while offering them the best services in terms of immunization both for adult and children. The objective of the integration is being achieved as records and data collated during the campaign, especially on COVID-19 vaccination indicated that many first timers were being vaccinated,” she said.
Keeping polio at bay
While the focus of the campaign is measles, opportunity was presented to administer polio vaccines to eligible children across the states, to contain the spread of the circulating vaccine-derived poliovirus (cVDPV2).
As of December 2021, Nigeria had recorded a total of 1,028 confirmed cVPV2 from different sources across 31 states. This accounted for over 70% of the cases in the African Region.
In Gombe State, the immunization campaign targets to reach over 700,000 children aged 0 – 59 months with the bivalent oral polio vaccine (bOPV), over 700 thousand aged 6 months – 59 months for measles and Vitamins A and 2 million people 18 years and above for the COVID-19 vaccines.
Mr Musa Muhammed, a resident of Funakaye LGA, Gombe state, and father of five, lauded the tenacity of the government and partners for keeping the children in their locality safe.
“The vaccination teams visit our community regularly as they were also here less than two months ago. Conducting the children vaccination with COVID-19 vaccination is also a welcome intervention because it will encourage those who are yet to receive the vaccine to accept it”, he said.
Coordinated partnership
“The integration of the NPSIAs (e.g., measles, Yellow Fever, Meningitis) with PHC and other services, including COVID-19, will enable us to utilize one activity to capture a wide range of the population, says the Executive Secretary, Gombe State Primary Health Care Development Agency (GSPHCDA)”, Dr AbdulRahman Shuaibu.
Dr Shuaibu also buttressed that the innovative approach will maximize the cost of conducting the campaign.
Furthermore, Dr Adamu Haruna Ismaila, WHO Northeast Zonal Coordinator, explained that the integrated approach “is critical as the country needs to ensure that all eligible children get vaccinated in line with the ZDROP funded by Gavi through WHO.
The ZDROP Implementation
As part of the process on addressing equity issues and linking with the Gavi 5.0 and Immunization Agenda 2030 (IA2030), the campaign focused on using SIAs to reach zero-dose children. The ZDROP has been integrated into these campaigns to further improve vaccination reach, especially in 313 poorly performing, underserved and Hard-to-reach settlements of 59 Wards in 13 LGAs in Lagos, Gombe and Ogun states. A total of 39,659; 49,633; and 91,699 zero-dose children were reached with bOPV, Measles Vaccine, and Yellow Fever Vaccine respectively in the 3 states between 17 June and 06 July 2022.
WHO supported the planning activities by conducting trainings at both national and state level, and by supervising the implementation activities?