You need a plan: Successfully immunising zero-dose children in Nigeria

Bosede Ologunola will not forget March 2021 in a hurry. In that fateful month, the Ondo State Government implemented a lockdown to combat the dreaded COVID-19 pandemic. As Bosede is a market woman in rural Ogbese, it meant she would no longer have access to the information she needed for the immunisation of her newly born child.

“Though COVID-19 caused problems, I’m still able to immunise my child.”

“I had just given birth and we’re poor, so we can’t afford a mobile phone connected to the internet. As a result, I couldn’t get any information about my child’s next vaccination appointment and I couldn’t get access to health workers. I was afraid because some older women had told me what happens if a child is not immunised,” she says.

Taiwo Adesanya, another new mother, faced the same situation. 

“I had just arrived from Kogi State,” she says. “I’m from the interior of the state, the rural part of it. I didn’t go to school because my father didn’t have the means to send me. However, I knew a little about routine immunisation. I know it is good for my child, but at the time I had her, COVID-19 struck and I didn’t have the means to get further information about immunising her.”

Omodele Sobowale shows a marked difference from Taiwo and Bosede. With a university degree in history, she was ready to have her child immunised. However, the lockdown provided a challenge. The information around accessing routine immunisation became scarce and even if she could find out where and when it was happening, Omodele could not access it as transport facilities had ground to a halt.

She says, “Education about immunisation is very important. It takes place at antenatal clinics. Information is also obtained at postnatal clinics. But this was before COVID-19. At the height of the lockdown period, all information about routine immunisation got pushed to the background, and therefore, I could not immunise my child.”

With women unable to immunise their children, the possibility of outbreaks of vaccine-preventable diseases in Ondo State heightened. According to the World Health Organization (WHO), in 2021, many mass immunisation campaigns were postponed in at least 50 countries, putting around 228 million people – mostly children – at the risk of diseases such as measles, yellow fever and polio.

Fortunately, Nigeria had developed a ten-year national immunisation and primary health care plan, which has the sensitisation and education of families embedded in it. According to Dr Afiong Oboko Oku, a researcher at the University of Calabar, to increase routine immunisation amongst both zero-dose children and children who haven’t completed their immunisation schedule, it is imperative that nursing mothers are regularly sensitised about it.
  
Professor Faisal Shuaid, the Executive Director of the National Primary Health Care Development Agency (NPHCDA) is in agreement, which he highlighted at a weekly media briefing on COVID-19 last year.

Backed by the provisions in the ten-year plan, the Ondo State Government reactivated the plan in 2021.

As soon as COVID-19 vaccines arrived in the state in March 2021, it intensified immunisation education at the antenatal clinics and postnatal clinics as well as on radio, television and in newspapers. It also evolved special immunisation outreach services in its primary health facilities with the support of traditional rulers and opinion and church leaders. Eventually, Bosede got the information she needed about the restarting of routine immunisation.

“I got the information about routine vaccination again through the radio,” she says at a primary health centre at Isikan in Akure. “I’m very satisfied with the service. I also see that health workers are good to us, smiling at us. If not for the radio, I wouldn’t be here.”

At the Specialist Hospital in Akure, Omodele Sobowale grins as she holds her child.

“My friends were right,” she says. “I benefitted a lot from the routine immunisation sensitisation and education campaign after the lockdown. I also got a lot at the postnatal clinics. Though COVID-19 caused problems, I’m still able to immunise my child.”

Taiwo expresses the same opinion after she had vaccinated her child.

“I accessed a lot of information from the radio and the mass media after the lockdown. So I came for the vaccination. The health workers didn’t make me feel poor. When I go to see my mother in Kogi State, I’ll tell my friends about the importance of routine immunisation.”

Under the plan, Professor Shuaid feels confident that immunisation rates in the country will be improved to 80% coverage by the year 2028.