Assessing the capacity of primary health care centres to provide routine immunization services amidst COVID-19 lockdown in Kaduna state, Nigeria

Abstract

Background: The COVID-19 pandemic continues to disrupt health systems across the globe, preventing access to essential health services. Lockdown measures against the virus may impact negatively on immunization services. This study aimed to ascertain the capacity of primary health care centres in Kaduna North senatorial district to provide routine immunization services amidst a state-wide lockdown.Methods: Cluster sampling was used to select four among eight local Government areas in the district. Facility in-charges and RI focal persons were interviewed using service availability and readiness assessment tool, restricted to immunization tracer items. Paired sample t-test was used to compare the mean number of vaccine doses given in the first quarter of 2020 (pre-lockdown) and the number of doses given in the second quarter (lockdown period).Results: Forty four PHCs were selected from Zaria (29.6%), Sabon Gari (25.0%), Makarfi (22.7%) and Kudan (22.7%). In addition to well-trained RI focal persons, most facilities had vaccines and commodities available. Shortages were noted for EPI guidelines (46%), Meningitis-A vaccine (36%) and certain cold chain equipment (up to 18%). Tetanus-diphtheria (Td-1) doses given during lockdown period were significantly lower than pre-lockdown doses (Mean difference=-45.58, 95% CI: -74.78 to -16.38, d=0.48). No significant difference exists for infant doses.Conclusions: Despite widespread availability of PHC facilities, trained personnel, vaccines and commodities, gaps still exist in service delivery, cold chain practices and vaccine supply management. Lockdown measures significantly disrupted immunization services and effective risk communication was key to achieving sustained utilization.