Background

Immunization against childhood diseases such as diphtheria, pertussis, tetanus, polio and measles is one of the most important means of preventing childhood morbidity and mortality. Achieving and maintaining high levels of immunization coverage must therefore be a priority for all health systems (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139536/). Developing countries such as Nigeria have done a lot in eradicating polio with little emphasis on Routine Immunization. Many lives were lost due to vaccine preventable diseases.

Current Status

Realizing the importance of Routine Immunization, Kano State Government (KNSG) with support from various International and local development partners has prioritized, provision of cold chain equipment and logistics and awareness creation to ensure the sustainability of RI across the state.

Key Achievements

The KNSG budgetary allocation for RI was released by 100% in 2018 in line with the developed and approved RI work plan. The KNSG has allocated five hundred million naira to cater for RI in 2019 budget and has so far achieved 50% (as releases are made on quarterly basis) releases from the annual budget to cater for RI services.

The state has also set up various structures such as SERRIC and LERRIC at the state and LGA levels respectively to coordinate the Routine Immunization activities in the state. The State had in the last three years developed RI work plan which was fully funded through the Annual budgets. KNSG has adopted all national policies on Routine Immunization and it stand out to be among the best performing states in RI services.

Rationale for Advocacy

Although structures have been put in place to support the operation of routine immunization in Kano state such as state RI work plan, formation of State Emergency on Routine Immunization Coordination Centre (SERRIC), which was replicated in all the 44 Local Government Areas, and expansion of state cold chain store but the state experiences other challenges in meeting the desired coverage. The following are some key challenges facing the full implementation of Routine Immunization Services in Kano State.

• Inadequacy of Human Resource for Health to render effective RI services
• Poor management and reporting of adverse effects and side effect resulting from immunization
• Despite improvement in timeliness and completeness of RI data, quality issues especially regarding discrepancies between administrative and survey data are still a major concern
• Poor implementation of RI work plan activities such as outreaches and integrated supportive supervision during first quarter of every year due to the delay in budget process.
• High wastage rate of vaccines especially BCG

Recommendation

• To accelerate rapid improvement in the service delivery of routine immunization in Kano state, government shall provide a palliative measures ahead of the withdrawal of major donor partners (Dangote Foundation and Clinton Health Access Initiative), through an increase in budgetary allocation in the state annual budgets.
• Implement the state task shifting and sharing policy with emphasis on rigorous training and retraining of health personnel coordinating Routine Immunization services.
• Incorporate federal health institutions, i.e. National Orthopedic Hospital, Aminu Kano Teaching and other private health Institutions into the SERRIC committee in order to ensure effective coordination and harmonization of RI data in the state.
• Provide drugs against adverse effects and side effects of immunization as an emergency intervention within the immunization budget line.

Benefits of Routine Immunization

Public Health Benefits

• Prevention of major child killer diseases
• Reduction in child mortality ratio
• Reduction in cost of treatment and other out of pocket expenses

Socio-political Benefits

• Improved human development index for the state
• A healthy population that could add value to the state’s socio-economic development
• Effective public health system at the grass-root level will reduce general health care spending and thus, other state critical health infrastructural needs can be met.

The Kano PAS Advocacy Coalition This Policy Brief is a product of the Kano State PAS Advocacy Project. The Partnership for Advocacy in Child and Family Health at Scale (PACFaH@Scale) project Nigeria, referred to as PAS is a health advocacy project anchored by the Nigeria non-profit, the dRPC and implemented directly by local NGOs and health professional associations. The project is not service delivery and it is not awareness creation. Its focus is limited to evidence-based advocacy.  The project’s timeline is 2018 to 2022 and the issue areas of the project are: Routine Immunization, Family Planning, Child Killer Diseases, and Primary Health Care Under One Roof. Focal states of the project are Anambra, Enugu, Kaduna, Kano, Niger, Rivers, Taraba and Lagos States. In Kano State, the PAS Advocacy Coalition is made up of various civil society organisations led by Medical Women Association (MWAN), Women in Media Communication Initiative (WIM), National Association of Nurses and Mid-wives Kano State Branch (NANNM), Federation of Muslim Women Association of Nigeria (FOMWAN), Kano Emirate Council Committee on Health & Human Development (KECCoHD), Society of Gynaecologists and Obstetricians in Nigeria (SOGON), The Challenge Initiative (TCI), Accountability Mechanism for Maternal and Child health in Kano State (AMMKaS), Youth Environmental Development Association (YEDA) and Facility Health Committee Alliance (FHCA)