Ensuring accountability in implementation of supplementary immunisation activities: A case study of the 2017/2018 measles vaccination campaign in Nigeria

Momoh, Jenny; Oteri, Avuwa Joseph; Mogekwu, Fred; Onwu, Nneka; Dieng, Boubacar; Bawa, Samuel; Braka, Fiona; Nsubuga, Peter; Shuaib, Faisal

doi:10.1016/j.vaccine.2021.02.068

Cited by 3 publications

(1 citation statement)

References 7 publications

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“…To bridge this gap the country introduced innovative strategies in the 2017/18 MVC to improve the performance of states. One of these strategies was changing the two-phase National approach and increasing the number of streams of the campaign to regional levels [11]. At the state level, a staggering approach of the vaccination campaign was adopted in some states to take care of the resources gaps.…”

Section: Introductionmentioning

confidence: 99%

“Campaign Staggering” a Way to Bridge Resources Gaps in Supplemental Immunization Activities-Lagos State 2018 Measles Vaccination Campaign’s Experience

2022

J Community Med Public Health

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Introduction:The availability of qualified Health Workers (HW) and Cold Chain Equipment (CCE) has been one of the major challenges faced in all countries implementing Supplemental Immunization Activities (SIAs) including Nigeria. This challenge has been found to contribute to the country's inability to reach the set targets. This paper describes how Lagos state staggered its 2018 measles vaccination campaign to mitigate the resources gaps of health workers and cold chain equipment. It also highlights the effectiveness of staggering as it relates to campaign outcome, looking at the number of children reached during the campaign. Methods: The microplanning process was followed by a 2 (two) step verification of the states micro-plans. These processes helped Lagos state to identify gaps in qualified health workers and CCEs. Data was analyzed and presented using MS Excel and Statistical Package for Social Sciences version 20 (SPSS). Results: Findings showed inadequate health workers and CCEs across all LGAs in the state to implement the SIAs at the same time. A total of 8,948 health workers were required to reach the target population. For CCEs a total of 752 cold boxes, 9050 vaccine carriers, and 90,448 ice packs (0.3/0.4 & 0.6) were required. However, only 3,769 health workers, 640 cold boxes, 4985 vaccine carriers, and 56,971 icepacks (CCEs) were available for the 2018 MVC in the state. This left a gap of 44 cold boxes, 4065 vaccine carriers and 33477 ice-packs. Following the staggering of the campaign where the measles vaccination campaign was implemented in phases (phase 1 and phase 2), the shortfall was reduced. The outcome of the campaign in terms of the number of targeted children reached when compared to previous measles vaccination shows modest improvement. Conclusion: The staggering approach introduced by the National Measles Technical Coordinating Committee during the 2017/2018 measles vaccination campaign helped Lagos

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Section: Introductionmentioning

confidence: 99%

“Campaign Staggering” a Way to Bridge Resources Gaps in Supplemental Immunization Activities-Lagos State 2018 Measles Vaccination Campaign’s Experience

2022

J Community Med Public Health

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Country ownership as a guiding principle for IA2030: A case study of the measles and rubella elimination programs in Nepal and Nigeria

Wonodi,

Crowcroft,

Bose

et al. 2024

Vaccine

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Stakeholders' Perspectives on Internal Accountability Within a Sub-National Immunization Program

Ogbuabor¹,

Ghasi²,

Nwangwu

et al. 2022

Nigerian Journal of Clinical Practice

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Background: Weak accountability hinders the effectiveness of routine immunization (RI) systems in low- and middle-income countries, yet studies on accountability of immunization programs are scarce. Aim: The study explored stakeholders' perspectives on the functioning of internal accountability within the National Program on Immunization in Enugu State, southeast Nigeria. Subjects and Methods: We used semi-structured in-depth interviews to collect data from RI officials at state government, local government, and health facility levels (n = 35) in Enugu State between June and July 2021. We adopted maximum variation sampling to purposively select individuals with roles in immunization. The interview guide was developed based on an accountability framework with three dimensions—the axes of power, ability, and justice. Data were analyzed thematically using NVivo software (version 11). The major themes were role clarity, performance standards, supervision, data use, human resources, funding, motivation, sanctions, political influence, and community engagement. Results: Performance targets for immunization coverage and reporting timeline were not always met due to multiple accountability failures. Weaknesses in the formal rules that distribute roles among the immunization workforce comprise a lack of deployment letters, unavailability of job descriptions, and inadequate staff orientation. Local officials have a narrow decision space regarding staff posting, transfer, and discipline. Performance accountability was constrained by staff shortages, uneven staff distribution, absenteeism, infrequent supervision, weak data monitoring system, and underfunding. Despite being motivated by job recognition and accomplishments, low motivation from an insecure working environment and lack of financial incentives undermined the constructive agency of service delivery actors. The sanctions framework exists but is weakly enforced due to fear of victimization. Political commitment to the immunization program was low. Yet, political decision-makers interfered with staff recruitment, distribution, and discipline. Community engagement improved resource availability through paid volunteer health workers and maintenance of facilities. However, health facility committees were poorly resourced, non-functional, and lacked the power to sanction erring health workers. Conclusions: Immunization service delivery actors can be held accountable for program performance when there are sufficient formal instruments that provide roles and responsibilities, needed resources, motivated and supervised staff, an effective sanctions framework, genuine political participation, and strong community engagement.

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Ensuring accountability in implementation of supplementary immunisation activities: A case study of the 2017/2018 measles vaccination campaign in Nigeria

Cited by 3 publications

References 7 publications

“Campaign Staggering” a Way to Bridge Resources Gaps in Supplemental Immunization Activities-Lagos State 2018 Measles Vaccination Campaign’s Experience

“Campaign Staggering” a Way to Bridge Resources Gaps in Supplemental Immunization Activities-Lagos State 2018 Measles Vaccination Campaign’s Experience

Country ownership as a guiding principle for IA2030: A case study of the measles and rubella elimination programs in Nepal and Nigeria

Stakeholders' Perspectives on Internal Accountability Within a Sub-National Immunization Program

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