Nigeria: Tracking and reducing immunization dropouts and ensuring availability of vaccines and immunization consumables at all times through the establishment of an efficient immunization defaulter tracking and a robust immunization supply chain

Transformative Investment: Invest in an efficient immunization defaulter tracking while making needed vaccines readily available.

Nigeria has an estimated total population of 150-170 million and a birth cohort of more than 7 million. This population lives in diverse and wide range of geographical settings. The determinants for completing immunization are as varied as the demographic distribution. This poses a big challenge to tracking Routine Immunization defaulters as well as providing vaccines as and when needed.

Nigeria introduced the Expanded Programme on Immunization (EPI) in 1978 (to provide routine immunization to children 0-23 months old) and recorded initial successes of 81.5% for universal childhood coverage. However, the RI coverage has been declining steadily with the latest NICS (National Immunization Coverage Survey 2016) result of 33% for Penta-3 (DPT-containing vaccine) resulting from low access, low utilization and high dropout rates. There is need to mitigate these factors across all the different geographical settings in the country and improve routine immunization coverages through the following top three strategies/priorities:

Establishing and operating a simple but effective defaulter tracking mechanism that is easy to operate in all settings;

Addressing the several factors (reasons) responsible for high immunization dropout rates (at the levels of both health workers and care givers).

Establishing a robust routine immunization supply chain that is able to deliver needed vaccines from the national to the service delivery points.

Others strategies include:

Re-orientation and training of health workers in client friendly IPC skills;

Periodic updating of micro plans to accommodate changing demographic dynamics;

Using every opportunity to identify and immunize unvaccinated children.

Making immunization centres people friendly.