Mobilizing political support proved critical to a successful switch from tOPV to bOPV in Kano, Nigeria 2016

Abstract

BackgroundKano is one of the high-risk states for polio transmission in Northern Nigeria. The state reported more cases of wild polioviruses (WPVs) than any other state in the country. The Nigeria Demographic and Health Survey of 2013 indicated that OPV3 coverage in the routine immunization (RI) programmewas 57.9%. Additionally, serial polio seroprevalence studies conducted from 2011 to 2015 in the eightmetropolitan LGAs indicated low immunity levels against all three polio serotypes in children below one year. Areas with sub-optimal RI coverage such as Kanothat fail to remove all tOPV during the tOPV-bOPV switchwill be at increased risk of VDPV2 circulation.MethodsWe assessed the impact of political leadership engagement in mobilizing other stakeholders on the outcomes of the bOPV-tOPV switch in Kano State from February to May 2016 using nationally-selected planning and outcome indicators.ResultsA total of 670 health facilities that provide RI services were assessed during the pre-switch activities. Health workers were aware of the switch exercise in 520 (95.1%) of the public health facilities assessed. It was found that health workers knew what to do should tOPV be found in any of the 521 (95.2%)public health facilities assessed. However, there was a wide disparity between the public and private health practitioners’ knowledge on basic concepts of the switch.There was 100% withdrawal of tOPV from the state and the seven zonal cold stores. Unmarked tOPVwas found in the cold chain system in 2 (4.5%) LGAs. Only one health facility (0.8%) had tOPV in the cold chain. No tOPVwas identified outside the cold chain without the “Do not use” sticker in any of the health facilities.ConclusionThe engagement of the political leadership to mobilize other key stakeholders facilitated successful implementation of the tOPV-bOPVswitch exercise and provided opportunity to strengthen partnerships with the private health sector in Kano State.

Zero- or missed-dose children in Nigeria: Contributing factors and interventions to overcome immunization service delivery challenges

“… [38] , [39] , [40] , [48] , [57] , [58] , [75] , [76] , [36] Community factors Perception of vaccination Fears and misconceptions 14 Fears and misconceptions over vaccine safety and efficacy were associated with vaccination refusal and missed or incomplete schedules. [36] , [37] , [40] , [56] , [65] , [66] , [74] , [77] , [78] , [79] , [80] , [81] , [82] , [83] Community disapproval of vaccination 6 Vaccination refusal often clustered in settlements with similar ethnic and religious profiles. [45] , [53] , [62] , [66] , [84] , [85] Geographical factors Region (North vs South) 7 Northern Nigerian communities were less likely to be vaccinated compared to Southern Nigerian communities.…”

“…Studies suggested this was driven by higher levels of education and wealth in the South, higher proportions of Muslim households in the North, and greater insecurity in the North. [39] , [48] , [53] , [59] , [60] , [68] , [86] Setting (rural vs urban) 5 Rural areas typically had lower vaccination rates, and higher drop-out rates, compared to urban areas, although one sub-national study found the opposite [78] . [37] , [39] , [46] , [48] , [59] , [78] Cultural factors Religious affiliation 9 Muslim households were less likely to be vaccinated compared to Christian households.…”

“… [39] , [48] , [53] , [59] , [60] , [68] , [86] Setting (rural vs urban) 5 Rural areas typically had lower vaccination rates, and higher drop-out rates, compared to urban areas, although one sub-national study found the opposite [78] . [37] , [39] , [46] , [48] , [59] , [78] Cultural factors Religious affiliation 9 Muslim households were less likely to be vaccinated compared to Christian households. [33] , [38] , [39] , [44] , [46] , [48] , [51] , [52] , [59] Ethnicity 3 Hausa / Fulani ethnic groups (often nomadic or semi-nomadic pastoralists) were less likely to be vaccinated compared to Igbo or Yoruba ethnic groups [59] , [87] , [88] , [89] Conflict and displacement Insurgency and conflict 7 Insurgency and conflict caused internal displacement and prevented access to settlements by vaccination and / or surveillance teams, particularly in Northern Nigeria, resulting in lower vaccination rates.…”

The regulation of liver gene expression by carbohydrates is mouse strain specific

“…Analyses of high carbohydrate diets on genome wide gene expressions in animal models have provided valuable information on gene changes in response to excessive sugar intake, important for better understanding mechanisms at the molecular level [6][7][8][9][10][11]. Yet, the designs and/or the technologies used in most of reported investigations are limited.…”

A multilevel analysis of the determinants of missed opportunities for vaccination among children attending primary healthcare facilities in Kano, Nigeria: Findings from the pre-implementation phase of a collaborative quality improvement programme

“…In Kano, which is one of the states in the North West zone, full immunization coverage is only 10% and coverage with the third dose of pentavalent vaccine is 16% [8]. Kano is highly populated, and the persistently poor coverage level has made it a high-risk state for polio transmission [9, 10]. Several factors contribute to low immunization coverage among which are missed opportunities for vaccination (MOV) in health service settings [11–14].…”