Multi-level approach in Nigeria

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A concerted effort and careful strategic planning, involving people at many different levels, has tackled a desperate immunisation situation in Nigeria.

31 March 2007

Nigeria 1
Christine Nesbitt/GAVI/2007

People from many sectors and at different levels have been engaged in Nigeria's strategic immunisation programme. In Bauchi state, following increased immunisation, measles incidence was 97% lower in 2006 than in 2005, and the number of deaths from measles in that state decreased from 242 in 2005 to three in 2006, representing a 98.8% drop.

Nigeria 2 Challenges for immunisation
Christine Nesbitt/GAVI/2007

Nigeria presents huge obstacles for immunisation programmes, both in scale and structure. With 145 million people, it is Africa's most populous country. Its people comprise some 200 ethnic groups speaking 500 indigenous languages. There are 774 local government areas, within 36 states and one federal capital territory, spread over 923,768 km².

Nigeria 3 Innovative long-term plans
Christine Nesbitt/GAVI/2007

GAVI required Nigeria’s health ministry to provide detailed proposals for long-term health plans in order to qualify for funding. These proposals drew together partners at different levels of the public infrastructure and beyond to develop a multi-year strategic plan for routine immunisation, resulting in a multi-sector approach reaching out to communities. 

Nigeria 4 Community participation
Christine Nesbitt/GAVI/2007

Influential figures at all levels: local, district, state and federal, have engaged in changing attitudes and beliefs about immunisation and have encouraged parents to get their children vaccinated. Particularly in Nigeria’s northeast, strong cultural and religious resistance had been fuelled by stories that questioned vaccines’ safety. 

Nigeria 5 State level support
Christine Nesbitt/GAVI/2007

Hajia Habiba Sabo Gabarin is a parliamentarian in the Bauchi State House of Assembly. As a legislator she participates in policy-making at state level. When she champions the importance of immunisation her status in the community helps mobilise public demand.

Nigeria 6 Local leaders
Christine Nesbitt/GAVI/2007

At an Immunisation Day Plus held at the fixed immunisation post in Isawa village, Muhammed Sabo Abdulkadir, the district head of Giade (right) and Yaya Abubakar, the village head of Isawa (left), are seen by members of the community to be endorsing vaccination.

Nigeria 7 Access to mothers
Christine Nesbitt/GAVI/2007

Traditional birth attendants such as Talatu Adamu (left) perform multiple primary health care roles. They can help reduce the numbers of women who die in childbirth and promote immunisation and child health during their visits. As a woman, Talatu is able to visit women at home and bring essential health messages.

Nigeria 8 Rewards
Christine Nesbitt/GAVI/2007

As a reward for fully immunising her child, each mother receives a treated bednet to protect her family against malaria, once she has completed her yellow vaccination card. 

Nigeria 9 Broader range of services
Christine Nesbitt/GAVI/2007

The strategic immunisation programme has opened the door to the delivery of many other services such as de-worming pills, nutrition advice, Vitamin A supplements and insecticide-treated bednets. GAVI partners such as UNICEF and WHO continue to work with Nigeria to make sure immunisation services are available and wide-reaching.

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