The Bill and Melinda Gates Foundation in partnership with the Aliko Dangote Foundation has pledged to provide renewed support to states across northern Nigeria to ensure Routine Immunization (RI) of children.
The foundation made this commitment on Tuesday in Abuja at the close-out event of the Northern Nigeria States Routine Immunization Strengthening Project (NNRISP) which was implemented across six states including Bauchi, Boma, Kaduna, Kano, Sokoto, and Yobe.
The project was birthed due to the state RI system in northern Nigeria dogged by significant system challenges contributing to poor health outcomes. National surveys reported low vaccination coverage across many of the northern states which contributed to huge numbers of childhood illnesses and deaths from vaccine-preventable diseases.
Recognizing the need for reforms to galvanize resources and support to address RI performance, the six state governments entered into MOU partnerships with the Aliko Dangote Foundation and Bill & Melinda Gates Foundation.
The Solina Centre for International Development and Research (SCIDaR) provided technical support for the project which lasted from 2013 to 2022. A total of $59.4 million was invested across the states; while Gates and Dangote foundations invested $30 million, the state governments provided the remaining funding.
Yusuf Yusufari, senior programme manager at the Gates Foundation informed that the foundations are working to renew investment, but in a different format that reflects lessons learnt in the implementation of the NNRISP.
“We will revisit the scope, and within the next few weeks, we will launch something, drawn from lessons learnt. We assure you that the Gates and Dangote Foundation will continue to support the states, we are even expanding to other states but these six states remain the core of our work.”
He noted that despite progress made, many more children are still not reached with the life-saving vaccines.
Muyi Aina, principal at SCIDaR stressed that immunization of children must not be seen as a mere medical intervention, but an investment in children for a better future.
Prior to the implementation of the project, RI performance in the north has been characterised by weak cold chain and logistics systems, ineffective supportive supervision for RI, tow quality data, inadequate community mobilization, and weak human resource systems.
At the bottom of these challenges is a lack of political commitment and accountability resulting in weak financial support. Other gaps identified are fragmented control of RI programmes and a high vaccine stock-out rate.
However, the projects successfully institutionalised direct funding to health facilities for RI, improved cold chain infrastructure and institutionalisation direct vaccine delivery, instituted direct funds disbursements, engagement of community leaders to drive immunization, the introduction of review meetings, identification and development training schedules for skilled personnel, among several others. These helped states scale up significantly in RI services.
Mohammed Abubakar, director, of advocacy and communication National Primary Healthcare Development Agency said the project improved RI across the country. He, however, admitted that there is still more work to be done, and called for more support while stressing that the government cannot do the work alone.
Speaking on the impact on his state, Musa Usman, a representative from Yobe said ” The MoU was informed by the poor health indices, weak health system and lack of accountability, so after the implementation of the MoU, the indices have improved. We have seen an increase in immunization coverage from 9 percent in 2013 to 51 percent.
“Now, there is assured funding for critical health activity which hitherto were not available and even if available, were not accounted for, and even if accounted for, there was a lot of mismanagement of the fund.”
“We used to have over 60 percent stock-out of vaccines, but currently we have been on 5 percent for the past four-five years. The MoU is serving as a platform to other different interventions; using the same framework, we are now able to expand it to an integrated Primary Health Care MoU that caters for all PHC activities”, he added.
“Most implementing states used to collect data from partners, now the reverse is the case. We have a data control room for all PHC services in Yobe. Our data is reliable because the quality of the data has improved”, he further said.
The project is also supported by USAID, Gavi, UNICEF, and the Global Fund, among others.