Investment strategies to improve routine Immunization in Ondo state, Nigeria.

 

1. National Team

Build the capacity of the staff of Nigeria National Primary Health Development Agency in areas of:

I. Increase knowledge and skills on data driven planning for National Routine Immunization team to increase routine immunization coverage.

II. Strengthen the capacity of the national routine immunization team to use evidenced based data to develop national policy on routine immunization management.

III. Increase advocacy to national leaders(religious and civil society organizations and state chief executives on increasing demand for routine immunizations.

IV. Increase resources for the national routine immunization team to use monitoring and evaluation tools and outcome to increase routine immunization output, outcome and impact.

 

2. Invest in tailored strategies that identify under vaccinated and unvaccinated persons and regularly provide them with the vaccines they need.

I. The state and local government routine immunization(RI) team must use data to plan for adequate vaccine needs, RI coverage level, resources required for adequately providing immunization services and identify hard-to-reach areas militating against sufficient RI coverage. Data obtained from the aforementioned areas will be use to reduce unvaccinated children.

II. Qualitative (Focus Group Discussion) and quantitative methods will be used to generate information on community oriented reasons whether cultural, religious, political and other yet unknown reasons militating against adequate RI coverage. Information generated will be used to plan for reduction in unimmunized children.

III. The perception and practice of health workers especially at the primary health care level will be surveyed in Ondo state using stratified sampling method that will truly be representative of the state population in order to assess their capacity to influence demand for RI and their ability to actually provide RI services. The negative attitude that will discourage uptake of RI will be also be identified and rectified in order to reduce prevalence of unimmunized children.

IV. Use of social context will be adopted especially in identifying communities influencers to build trust between caregivers and vaccinators in order to increase acceptance of care givers to allow their eligible children to receive vaccinations in communities with low RI coverage. In addition, identify ways to improve vaccine management by health workers such as proper storage, reduction in vaccine wastage, use of real-time vaccine usage using electronic data management system-all geared towards increasing efficiency and effectiveness of immunization activities will be developed and used.

V. Routine and supplemented immunization data, including outcome of investigating adverse reactions to vaccinations will be used for data collection, analysis to identify unimmunized children and reasons for it. The health workers involved with RI will be made to interface with Communities and village health workers/influencers in order to achieve reduction in unvaccinated children.

VI. Areas where there are security challenges such as kidnapping and armed robbery that will discourage care givers to take their children for immunization will be identified and necessary securities(using armed escort) will be provided to located those unimmunized children for purpose of vaccinating them.

3. Evidenced based planning with high data quality will be done to ensure workable solution for increasing RI coverage. The plans will include both monthly and annual strategic plans for RI.

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4. Evidence based data to help the state to legislate laws and develop policies that will harness basket of funding for Ondo state RI activities, including creating budget lines in the state annual budget for RI.

5. Regular training and retraining of district RI providers at the local government areas health centres on basic guide to RI will be continuously embarked upon to increase RI coverage.

6. Proper micro planning using true population data will be used to forecast vaccines needs for all eligible age groups in the state. Use of real-time web based integrated supportive supervision for RI and other related services will be developed and used to improve routine immunization coverage.

7. Strengthening health management information system to identify RI defaulters and tracking methods will be used to remind and locate them in order to vaccinate the unimmunized children.

8. Routine immunizations will be fully integrated to the primary health care centres routine health services to ensure adequate coverage for RI. This will help eliminate incidences of miss children seeking RI services.

9. Involvement of the communities fully in the planning, implementation and monitoring of RI activities will be . Market strategies will be use to improve RI coverage e.g. celebrating care givers who has fully immunized their children .

 

 

High priority strategies.

I. Increase resources for the national routine immunization team to use monitoring and evaluation tools and outcome to increase routine immunization output, outcome and impact.

II. The state and local government routine immunization(RI) team must use data to plan for adequate vaccine needs, RI coverage level, resources required for adequately providing immunization services and identify hard-to-reach areas militating against sufficient RI coverage. Data obtained from the aforementioned areas will be use to reduce unvaccinated children.

III. Qualitative (Focus Group Discussion) and quantitative methods will be used to generate information on community oriented reasons whether cultural, religious, political and other yet unknown reasons militating against adequate RI coverage. Information generated will be used to plan for reduction in unimmunized children.

IV. Strengthening health management information system to identify RI defaulters and tracking methods will be used to remind and locate them in order to vaccinate the unimmunized children.

V. Routine immunizations will be fully integrated to the primary health care centres routine health services to ensure adequate coverage for RI. This will help eliminate incidences of miss children seeking RI services.

VI. Involvement of the communities fully in the planning, implementation and monitoring of RI activities will be . Market strategies will be use to improve RI coverage e.g. celebrating care givers who has fully immunized their children .

 

 

 

Rationale.

Poor planning for RI is responsible for poor coverage for RI in Ondo State, Nigeria.