WHERE DO YOU WORK (COUNTRY, DISTRICT, CITY) AND WHAT DOES YOUR WORK CONSIST OF?

I work in Nigeria, at the Abuja headquater and Owerri country office of Afrihealth Optonet Association <www.afrihealthcsos.org> – a a civil society organizations [CSOs] network/coalition and think-tank of more than 600 (six hundred) rural NGOs/CSOs, community-based organizations, groups and stakeholders in the 36 States of Nigeria and the Federal Capital Territory and global south, involved in promoting and having Health [including Community and Health/Development systems strengthening in for HIV/AIDS, TB and Malaria or ATM, Maternal and Newborn Child/Adolescent Health (MNCH) including Vaccinations/Immunizations and Female Genital Mutilation/Cutting (FGM/C)]; Energy/Environment; Nutrition/Food Security and addressing Poverty, Empowerment, Gender/Good Governance/Human Rights or HENG - as areas of focus. My work consists of providing overall management and supportive supervision of partnerships building and coordination, advocacy and social mobilization, research and evidence-generation, capacity development and resource mobilization, outreach interventions and monitoring and evaluation (M&E) for the realization of the corporate and social mandates of AFRIHEALTH.

WHAT DO YOU KNOW ABOUT THE SITUATION OF EQUITY AND COVERAGE? WHAT ELSE WOULD YOU NEED TO FIND OUT?

Equity and coverage are two critical factors that determine access to immunization services and commodoities especially in resource-poor settings in Nigeria and the developing world. Deliberate and consistent efforts and policies are required to achieve equity and coverage. Nigeria has emphasised immunization as a critical focus for universal health coverage (UHC) but has not been able to achieve immunization covergae and equity through the life course of her citizens, not even through managed care/health insurance. What Nigeria need to do are to provide enough funds in governments’ budgets to accomplish equity and coverage throughout life course, ensure diligent and full implementation of immunization programmes including integration, while routinely and effciently monitoring the implementations and human capital development issues around immunization. Achieving immunization equity and coverage in Nigeria will therefore require providing enough budgetary resources to address issues around ‘Reducing missed opportunities for immunization (MoV)’, ‘Strengthening immunization in the second year of life (2YL)’, ‘Integrating immunization across the life course and with other health interventions’ and ‘Promoting Urban immunization and other targeted strategies to reduce inequities’

OF THE FOUR GUIDELINES THAT YOU HAVE REVIEWED, WHICH IS MOST LIKELY TO BE RELEVANT AND USEFUL TO HELP YOU IMPROVE THIS SITUATION? WHY?

The most likely guildelines to be relevant and useful to help improve this situation is ‘Integration: Working together to provide for immunization services throughout the life course’. This is because integration proffers holistic and cross-cutting approaches beyond immunization, is all-encompassing and includes missed opportunities, addresses urban immunization and strengthens immunization in the second year of life. Integration also promotes, supports and leads to a high population coverage.

REFERRING TO THIS GUIDELINE, WHAT CAN BE DONE TO IMPROVE EQUITY AND COVERAGE?

In order to improve equity and covergae, immunization policies at all levels should promote and emphasise the use of other priority programmes as a platform for delivering immunization. Every contact with the health sector should be used as an opportunity to verify immunization status and provide immunization where indicated. Immunization shall have to be provided according to a schedule with multiple contact points, which overlap with other interventions for the same target populations such as Vitamin A supplementation and deworming. Also, improving coverage and equity shall require using every possible platformto reach people with additional interventions especially thoseunder 2 years of age. Certainly, equity and coverage would be improved by integration of immunization into other services to reduce MOVs and facilitate delivery throughout the life course such as ANC for maternal immunization, school health for adolescents.