IntroductionImmunization is the world’s most successful and cost-effective public health intervention as it prevents over 2 million deaths annually. However, over 2 million deaths still occur yearly from Vaccine preventable diseases, the majority of which occur in sub-Saharan Africa. Nigeria is a major contributor of global childhood deaths from VPDs. Till date, Nigeria still has wild polio virus in circulation. The objective of this study was to identify the individual and socioeconomic factors associated with immunization coverage in Nigeria through a secondary dataset analysis of Nigeria Demographic and Health Survey (NDHS), 2013.MethodsA quantitative analysis of the 2013 NDHS dataset was performed. Ethical approvals were obtained from Walden University IRB and the National Health Research Ethics Committee of Nigeria. The dataset was downloaded, validated for completeness and analyzed using univariate, bivariate and multivariate statistics.ResultsOf 27,571 children aged 0 to 59 months, 22.1% had full vaccination, and 29% never received any vaccination. Immunization coverage was significantly associated with childbirth order, delivery place, child number, and presence or absence of a child health card. Maternal age, geographical location, education, religion, literacy, wealth index, marital status, and occupation were significantly associated with immunization coverage. Paternal education, occupation, and age were also significantly associated with coverage. Respondent's age, educational attainment and wealth index remained significantly related to immunization coverage at 95% confidence interval in multivariate analysis.ConclusionThe study highlights child, parental and socioeconomic barriers to successful immunization programs in Nigeria. These findings need urgent attention, given the re-emergence of wild poliovirus in Nigeria. An effective, efficient, sustainable, accessible, and acceptable immunization program for children should be designed, developed and undertaken in Nigeria with adequate strategies put in place to implement them.

The strengthened requirement for nonprofit hospitals to complete a community health needs assessment and implementation plan in the Affordable Care Act, concurrent with a new voluntary accreditation process for local health departments that requires collaborative community health assessments and community health improvement plans, have led to a resurgence of interest in assessment and improvement planning. This study provides baseline data that will help determine whether the Affordable Care Act and public health accreditation will result in more collaborative community assessment and community health improvement activity by describing trends in collaborative community health assessment and community health improvement plan activities. Data sources include the National Profile of Local Health Departments studies and a database of community health assessment, community health needs assessment, community health improvement plan, and other implementation planning reports from across the country. The study finds that collaborative community assessment activity is positively associated with population size, governance type, and local health department and coalition-led efforts.

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