Micro-planning for immunization in Kaduna State, Nigeria: Lessons learnt, 2017.

Area of Science:

• Public Health
• Epidemiology
• Health Services Research

Background:

• Low Oral Polio Vaccine (OPV) 3 coverage in Kaduna State, Nigeria, necessitated increased supplemental OPV campaigns by the Global Polio Eradication Initiatives (GPEI).
• High-risk areas with low vaccine uptake and high refusal rates in Northern Nigeria experienced overestimated denominators for OPV campaigns, using the highest vaccination numbers as targets.
• This practice leads to inefficiencies and resource misallocation in polio eradication efforts.

Purpose of the Study:

• To assess the impact of overestimated denominators on immunization services in Kaduna State, Nigeria.
• To identify solutions for improving immunization planning, delivery, and performance evaluation.
• To address challenges in setting accurate target populations for vaccination campaigns.

Main Methods:

• A cross-sectional study was conducted in Kaduna State, Nigeria.
• Descriptive and quantitative approaches were employed, including household enumeration.
• Target populations for routine immunization (<1 year), polio campaigns (<5 years), and acute flaccid paralysis surveillance (<15 years) were determined.

Main Results:

• Significant differences were found between micro-planning and supplemental vaccination data for the <5 years population (p<0.05).
• Significant discrepancies were also observed between micro-planning and projected census data for the <1 year population (p<0.05).
• These findings highlight substantial overestimation in target populations used for planning.

Conclusions:

• Periodic household-based micro-planning, enhanced by technology for validation, is crucial for addressing immunization planning gaps.
• This approach is effective in developing countries like Nigeria facing challenges with overestimated denominators.
• Implementing robust micro-planning can lead to more accurate immunization service delivery and evaluation.