ivac-landscape-analysis-routine-immunization-nigeria-brief (1)

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  1. 1. Landscape Analysis of Routine Immunization in Nigeria By Chizoba Wonodi, Cecily Stokes-Prindle, Muyi Aina, Gbolahan Oni, Tope Olukowi, Muhammad Ali Pate, Lois Privor-Dumm & Orin Levine Nigeria has succeeded in implementing major improvements in routine immunization (RI) over the past three years; national DTP3 coverage rates reached a high of 69% in 2010.1 However, this progress comes in the context of ongoing vaccine stock-outs, significant coverage heteroge- neity among states, an overall coverage rate below the average for Africa, and an under-five mortality rate of 138 child deaths per 1,000 live birthsthe 18th highest rate in the world.2 Scaling up cover- age for current and future vaccines can reduce mortality from childhood killers like pneumonia, diarrhea and malaria, which account for over 60% of deaths among Nigerian children less than 5 years of age. Vaccines can bring economic benefits as well: according to recent IVAC projections, achiev- ing 90% immunization coverage in the next decade could add $17 billion to the Nigerian economy.3 Given the significant burden of vaccine-preventable diseases in Nigeria, improving RI coverage would reduce child mortality and accelerate progress to- wards the MDG 4 target. So in 2011, IVAC conduct- ed a Landscape Analysis of Routine Immunization in Nigeria, (LARI), to identify key barriers to RI and a range of potential high-impact solutions. LARI was conducted in conjunction with Solina Health and Nigerias National Primary Health Care Development Agency (NPHCDA), with funding from the Bill & Melinda Gates Foundation. The study draws on 126 key informant interviews and 11 focus group discussions in eight representative Nigerian states. This policy brief summarizes the key findings from the study, with the objective of providing on- the-ground feedback relevant to decision-makers. As a project designed to help improve RI in Nigeria, the data and results from this study have been shared with local authorities and communities in Nigeria through a series of meetings and town hall conferences. In the end, the selection of an appropriate mix of interventions and their eventual impact will be determined by local authorities and the communities they represent. 2012 Identifying and addressing barriers to immunization coverage International Vaccine Access Center (IVAC) Johns Hopkins Bloomberg School of Public Health Rangos Bldg, Suite 600 855 N. Wolfe Street Baltimore, MD 21205 www.jhsph.edu/ivac DATA COLLECTION This project draws on three types of informational interviews: Key Informant Interviews with officials, mid-level managers, health care providers, NGOs, and other influencers at the national, state, LGA and community levels (126 interviews) Facility and community-based Focus Group Discussions with mens and womens groups (11 focus groups) Facility-based participant observation and exit interviews to determine core issues facing RI utilization, uptake and demand (14 facilities) STATE SELECTION Selection was based on performance typology and geographic representation Performance typology (DTP3 coverage) Persistently Low coverage (

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