BUILDING MOMENTUM FOR IMMUNISATION: 2012 NATIONAL VACCINE SUMMIT IN ABUJA, NIGERIA

In Nigeria, a coalition of immunisation and health partners came together to organise the first-ever National Vaccine Summit to build momentum for achieving the national routine immunisation goals.

Understanding the landscape: challenges and solutions

Nigeria has made great strides to improve immunisation coverage – from 2008 to 2013, national coverage rates of DTP3 (3 doses of diphtheria, tetanus and pertussis) rose from 21% to 38%, and polio increased by 25%. Despite these improvements however, challenges persist. Nigeria, for example, remains one of three countries still battling polio within its borders. Immunisation coverage rates vary from 91% in the South East Zone to just 45% in the North East Zone. In fact, about one in six Nigerian children is not fully vaccinated by his or her first birthday. To address these issues, Nigeria’s Multi-Year Strategy for Immunisation aims to raise DTP3 coverage to 80% and achieve polio eradication.

Building a coalition of advocates and influencers

To help advocate for and bring momentum to these national immunisation goals, a strategic coalition of the International Vaccine Access Center (IVAC) together with the National Primary Health Care Development Agency, the Pediatric Association of Nigeria (PAN), and various Nigerian and international stakeholders came together in 2012 to plan the first-ever National Vaccine Summit for Nigeria. The coalition was determined that the Summit would be an effective platform to address issues surrounding routine immunisation (RI).

This coalition brought together people in positions of power (such as the Nigerian President, the First Lady and Minister of Health) and key advocates for immunisation including various Nigerian and international stakeholders such as UNICEF and WHO.

Determining the strategic goals and objectives

Clearly aimed at achieving the major goals of promoting RI and improving vaccine uptake in Nigeria, the Summit objectives included raising pledges of support for RI from Nigerian leaders in politics, business, and traditional/religious spheres, and a call-to-action for improved universal RI coverage by 2015.

These objectives followed the SMART framework: they focused on a specific target; were measurable or quantifiable, achievable and realistic, relevant, and results-oriented; and had a timeframe clearly outlined. The development of SMART goals made it possible to evaluate the Summit’s success.

Engaging influencers and champions across all sectors

To that end, it was necessary to invite participants who were uniquely positioned to significantly impact various spheres of society. IVAC and its partners identified these influential stakeholders, which included religious and traditional leaders, high level government officials, international organisations already advocating for immunisation, as well as key leaders in health, finance, transportation, power, and education.

Summit speakers were equally diverse. A popular Nollywood movie star spoke personally about her mother’s commitment to vaccinating her children, and youth from orphanages performed a drama to bring attention to the problem of high child mortality rates.

In addition, there was a breakout session on the role of legislators as proponents of immunisation; it featured a panel of international and national experts, representatives from the national and state governments, academia, WHO, and legislators from Sierra Leone and Liberia.

Providing examples of proven solutions

Representatives of grassroots organisations shared nonconventional methods of increasing immunisation in remote communities. For example, the Vaccine Network for Disease Control spoke about organising a fashion show called the Face of Pneumonia in a Fulani-Hausa area of Abuja. By using children as models, the fashion show fostered relationships and built trust among community members, which paved the way for health workers to immunise children in their villages without opposition.

Another speaker, a partner at a leading healthcare consulting firm in Abuja shared the success of USAID’s Tallafi Mata Masu Dubara (“Mothers Club for Savings and Credit”) program. Its micro-financing efforts provided funds for female-owned small businesses, and health advocacy and community awareness programs. The funds also covered transportation costs for poor mothers to access immunisation and other services at primary health centers.

The ASK: a Call-to-Action for change

The Summit also presented a Call-to-Action which galvanised participants to join the movement to increase RI coverage rates. It consisted of several action points that were targeted to specific sectors and had a clearly defined desirable outcome, which facilitated the monitoring and evaluation of these areas.

One action point, for example, was aimed toward health workers which mandated the use of electronic data for planning, forecasting, and surveying vaccination programs. Another action point urged affluent Nigerians, such as businessmen and women, to do their part in promoting vaccination services by volunteering as local Village Health Facility Ambassadors.

In addition, Summit leaders made a call to establish several alliances, such as: the Nigerian Alliance for Vaccines and Immunisation (NAVI), a public-private partnership to raise funds for vaccination programs; the National Immunisation Technical Advisory Group (NITAG) to offer expert advice on vaccination programs; and Journalists for Immunisation, a group of health journalists committed to raising media coverage of vaccination issues discussed at the Summit.

Advocacy for strengthened commitment to immunisation: seeing results

Since the Summit, progress has been made on several fronts. The 2014 National Health Bill outlined the development of a Basic Health Care Provision Fund, of which 20% would be used to provide vaccines for eligible primary health care facilities. This mandate responds to the First Lady’s call to establish a fund to support immunisation programs, including new vaccines.

In addition, the Nigerian government has also successfully introduced new vaccines, such as the pneumococcal, rotavirus, and inactivated poliovirus vaccines in late 2014 and 2015.

Overall, the Summit effectively catalysed a joint action toward improving RI in Nigeria. It built strong partnerships and motivated community ownership from the initial planning stages of the Summit to the execution of the Call-to-Action. With a shared vision to improve RI coverage, various individuals, organisations, and groups harnessed their collective capacity to achieve desired goals. Furthermore, collaborations with notable figures such as the First Lady provided the opportunity to send ambassadors across the nation, thereby promoting ownership for better RI across the diverse spheres of Nigerian society.