Abstract
BackgroundThe year 2014 was a turning point for polio eradication in Nigeria. Confronted with the challenges of increased numbers of polio cases detected in rural, hard-to-reach (HTR), and security-compromised areas of northern Nigeria, the Nigeria polio program introduced the HTR project in four northern states to provide immunization and maternal and child health services in these communities. The project was set up to improve population immunity, increase oral polio vaccine (OPV) and other immunization uptake, and to support Nigeria’s efforts to interrupt polio transmission by 2015. Furthermore, the project also aimed to create demand for these services which were often unavailable in the HTR areas. To this end, the program developed a community engagement (CE) strategy to create awareness about the services being provided by the project. The term HTR is operationally defined as geographically difficult terrain, with any of the following criteria: having inter-ward/inter-Local Government Area/interstate borders, scattered households, nomadic population, or waterlogged/riverine area, with no easy to access to healthcare facilities and insecurity.MethodsWe evaluated the outcome of CE activities in Kano, Bauchi, Borno, and Yobe states to examine the methods and processes that helped to increase OPV and third pentavalent (penta3) immunization coverage in areas of implementation. We also assessed the number of community engagers who mobilized caregivers to vaccination posts and the service satisfaction for the performance of the community engagers.ResultsPenta3 coverage was at 22% in the first quarter of project implementation and increased to 62% by the fourth quarter of project implementation. OPV coverage also increased from 54% in the first quarter to 76% in the last quarter of the 1-year project implementation.ConclusionsThe systematic implementation of a CE strategy that focused on planning and working with community structures and community engagers in immunization activities assisted in increasing OPV and penta3 immunization coverage.
Highlights
The year 2014 was a turning point for polio eradication in Nigeria
The systematic implementation of a community engagement (CE) strategy that focused on planning and working with community structures and community engagers in immunization activities assisted in increasing oral polio vaccine (OPV) and penta3 immunization coverage
We conducted a descriptive, retrospective study that reviewed HTR data from June 2014 to June 2015 to determine the contribution of CE interventions to increasing oral polio vaccine (OPV) and the third dose of the pentavalent vaccine coverage
Summary
Confronted with the challenges of increased numbers of polio cases detected in rural, hard-to-reach (HTR), and security-compromised areas of northern Nigeria, the Nigeria polio program introduced the HTR project in four northern states to provide immunization and maternal and child health services in these communities. The project aimed to create demand for these services which were often unavailable in the HTR areas. To this end, the program developed a community engagement (CE) strategy to create awareness about the services being provided by the project. With the Alma Ata Declaration in 1978, community engagement (CE) (or participation, as interchangeably used) has become a cardinal principle in primary healthcare (PHC) in Nigeria. If CE is not performed systematically in primary-care programs or is seen as a useful but nonessential companion to the delivery of treatments and preventive health education, it is bound to fail in achieving its objectives [7, 9]
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