Immunization for the migrant fulani: identifying an under-served population in southwestern Nigeria

Rural populations are often at a disadvantage for receiving health services. Although Nigeria launched its Expanded Programme of Immunization in 1978, and has revised it twice since then, rural immunization coverage is still low. These problems may be compounded when the population is nomadic; thus a study was designed to learn about immunization coverage among a minority group of nomadic Fulani cattle herders living in southwestern Nigeria. It was necessary to conduct a census of the target population first because local government maps and records did not reflect their presence in study area, Ifeloju Local Government Area (LGA) of Oyo State. Sixty Fulani settlements were located and contained 2197 residents, 22.1 percent of whom were below five years of age and 21.5 percent of whom were women of child bearing age. Only 2.6 percent of children below twenty-four months of age (the EPI target group in Nigeria) had received full immunization, compared to an estimated coverage of 48 percent among all target age children in the LGA. Only 2.1 percent of the women had at least two tetanus toxoid immunization contacts. Immunization coverage was associated with proximity to a town, length of residence in the LGA and awareness of the settlement's leader about EPI. The latter factor gave rise to suggestions that greater outreach efforts should be targeted at Fulani leaders, using staff of the local nomadic education center to help design culturally appropriate health education programs.