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INTRODUCTION: All WHO regions have set measles elimination objective for 2020. To address the specific needs of achieving measles elimination, Nigeria is using a strategy focusing on improving vaccination coverage with the first routine dose of (monovalent) measles (MCV1) at 9 months, providing measles vaccine through supplemental immunization activities (children 9-59 months), and intensified measles case-based surveillance system.METHODS: We reviewed measles immunization coverage from population-based surveys conducted in 2010, 2013 and 2017-18. Additionally, we analyzed measles case-based surveillance reports from 2008-2018 to determine annual, regional and age-specific incidence rates.FINDINGS: Survey results indicated low MCV1 coverage (54.0% in 2018); with lower coverage in the North (mean 45.5%). Of the 153,097 confirmed cases reported over the studied period, 85.5% (130,871) were from the North. Moreover, 70.8% (108,310) of the confirmed cases were unvaccinated. Annual measles incidence varied from a high of 320.39 per 1,000,000 population in 2013 to a low of 9.80 per 1,000,000 in 2009. The incidence rate is higher among the 9-11 months (524.0 per million) and 12-59 months (376.0 per million). Between 2008 and 2018, the incidence rate had showed geographical variation, with higher incidence in the North (70.6 per million) compare to the South (17.8 per million).CONCLUSION: The aim of this study was to provide a descriptive analysis of measles vaccine coverage and incidence in Nigeria from 2008 to 2018 to assess country progress towards measles elimination. Although the total numbers of confirmed measles cases had decreased over the time period, measles routine coverage remains sub-optimal, and the incidence rates are critically high. The high burden of measles in the North highlight the need for region-specific interventions. The measles program relies heavily on polio resources. As the polio program winds down, strong commitments will be required to achieve elimination goals.

Background The global polio eradication initiative has made giant stride by achieving a 99% reduction in Wild poliovirus (WPV) cases, with Nigeria on the verge of being declared polio-free following over 36 months without a WPV. The initiative has provided multiple resources, assets and lessons learnt that could be transitioned to other public health challenges, including improving the quality and vaccination coverage of measles campaigns in order to reduce the incidences of measles in Nigeria. We documented the polio legacy and assets used to support the national measles campaign in 2017/2018. Methods We documented the integration of the measles campaign coordination with the Polio Emergency Operation Centre (EOC) at national and state levels for planning and implementing the measles SIA. Specific polio strategies and assets, such as the EOC incident command framework and facilities, human resource surge capacity, polio GIS resource These strategies were adapted and adopted for the MVC implementation overcome challenges and improve vaccination coverage. We evaluated the performance through a set process and outcome indicators. Results All the 36 states and Federal Capital Territory used the structure and resources in Nigeria and provided counterpart financing for the MVC 2017/ 2018. The 11 polio high-risk states deployed the use of GIS for microplanning process, while daily call-in data were tracked in 99.7% of the LGAs and 70,846 reports were submitted real-time by supervisors using Open data kit (ODK). The national coverage achieved was 87.5% by the post-campaign survey with 65% of states reporting higher coverage in 2018 compared to 2015. Conclusion Polio eradication assets and lessons learned can be applied to measles elimination efforts as the eradication and elimination efforts have similar strategies and programme implementation infrastructure needs. Leveraging these strategies and resources to support MVC planning and implementation resulted in more realistic planning, improved accountability and availability of human and fiscal resources. This approach may have resulted in better MVC outcomes and contributed to Nigeria’s efforts in measles control and elimination.

Introduction Globally, supplemental immunization activities (SIAs) are known to be a major strategy for attainment of the global measles elimination goal of less than one measles case per million population within a geographic area by the year 2020. Adequate planning is critical to the success of a vaccination campaign. To achieve a quality SIA implementation for effective interruption of measles transmission, the World Health Organization introduced the SIA Readiness Assessment Tool, which includes the readiness dashboard. It is a strategic planning tool used to ensure critical activities are completed before SIAs. Nigeria implemented a phased measles SIA in 2017/2018 and used the readiness assessment tool in the planning for the campaign. In this article, we report the use of the readiness assessment dashboard in the 2017/2018 measles SIA, we also reviewed its contributions to the outcome of the campaign looking at the post campaign coverage survey results for the states. Methods We conducted a retrospective review of the readiness assessment dashboard used during the 2017/2018 measles vaccination campaign in Nigeria. The readiness dashboard tool was designed using Microsoft Excel 2016. We reported results in frequencies and proportions using charts and tables. Results The states with 100% readiness a week prior to the campaign scored a post campaign coverage survey result of 84.6 – 96.5% with just one out of the eight states in this category getting a score below 90%. In the same vein, of the eight states that their readiness score at one week to the campaign was below 85%, six had post campaign coverage survey score of less than 90% with the highest score in this category being 92.3%. Some states with good readiness scores also had poor post campaign coverage survey which has been attributed to other factors other than readiness. Conclusion The readiness assessment dashboard for the measles vaccination campaign provided a platform for tracking states readiness. It is our view that a link between readiness assessment and coverage should be examined in future studies.

Conflict has a negative effect on immunization outcomes leading to epidemics of measles and other vaccine preventable diseases. Borno state, located in the North-Eastern parts of the country, started experiencing insurgency since 2009 by a militant group commonly referred to as "Boko Haram", leading to displacement of numerous persons from their homes. The state government created internally displaced persons (IDPs) camps with an estimated 600,000 persons and over 100,000 children aged 9 - 59 months. We explored the challenges in implementing the measles campaign in 2017 and its effect on measles elimination and control efforts in Borno State. METHODS We conducted a retrospective review of the measles surveillance data from the Integrated disease surveillance and response (IDSR), the early warning alert and response system (EWARS), Measles SIA implementation strategy reports and the Post campaign evaluation survey data. RESULT Seven (26%) of the 27 LGAs had security challenges in Borno state in November 2017. Following the measles campaign, 30 EAs were surveyed as part of the post campaign evaluation with a coverage validation of 72%, the lowest reported state level coverage in the country. Reported measles cases in the age cohort

Introduction:the COVID-19 outbreak was declared a public health emergency of international concern by the WHO on the 30thJanuary 2020. The occurrence of measles outbreaks in the context of COVID-19, both highly infectious respiratory illnesses, impacts additional challenges to the health system in a state with an ongoing humanitarian crisis. This article documents the implementation of an outbreak response immunization (ORI) during the COVID-19 pandemic and the implementation of global guidelines for mass vaccination. Methods:a retrospective review of the response to measles outbreak implemented in Borno state across six local government areas (LGAs) in 2019 was conducted. This review assessed the utilization of the World Health Organization (WHO) decision making framework, measles and COVID-19 epidemiological reports and the measle's vaccination response data. Results:an outbreak response immunization was implemented in six LGAs in BornoState, with a validated post campaign coverage of 96.3% (95% CI: 93.0 - 98.1). In total, 181,634 children aged 9 months-9 years were vaccinated with 27,961 (15.4%) receiving the measles vaccine for the first time. Prior to the interventions, 20 COVID-19 cases were reported in the six LGAs while only seven suspected cases were reported with only two cases confirmed in one of the six LGAs four weeks after the ORI. Conclusion:the WHO decision-making framework for implementing mass vaccinations in the context of the COVID-19 Pandemic was utilized for the outbreak response immunization in Borno State, Nigeria with 181,634 children aged 9 Months-9 years vaccinated with the measles vaccine. The use of the WHO decision-making framework to assess risk benefits of initiating mass vaccination campaigns remains a very important practical tool. These types of responses in Nigeria and other low and middle income countries (LMICs), with hitherto suboptimal immunization coverage and weak health systems and other settings, affected by humanitarian emergencies is essential in the achievement of the regional measle's elimination targets.

'Zero-dose' refers to a person who does not receive a single dose of any vaccine in the routine national immunization schedule, while 'missed dose' refers to a person who does not complete the schedule. These peopleremain vulnerable to vaccine-preventable diseases, and are often already disadvantaged due to poverty, conflict, and lack of access to basic health services. Globally, more 22.7 million children are estimated to be zero- or missed-dose, of which an estimated 3.1 million (∼14 %) reside in Nigeria.We conducted a scoping review tosynthesize recent literature on risk factors and interventions for zero- and missed-dosechildren in Nigeria. Our search identified 127 papers, including research into risk factors only (n = 66); interventions only (n = 34); both risk factors and interventions (n = 18); and publications that made recommendations only (n = 9). The most frequently reported factors influencing childhood vaccine uptake were maternal factors (n = 77), particularly maternal education (n = 22) and access to ante- and perinatal care (n = 19); heterogeneity between different types of communities - including location, region, wealth, religion, population composition, and other challenges (n = 50); access to vaccination, i.e., proximity of facilities with vaccines and vaccinators (n = 37); and awareness about immunization - including safety, efficacy, importance, and schedules (n = 18).Literature assessing implementation of interventions was more scattered, and heavily skewed towards vaccination campaigns and polio eradication efforts. Major evidence gaps exist in how to deliver effective and sustainable routine childhood immunization. Overall, further work is needed to operationalise the learnings from these studies, e.g. through applying findings to Nigeria's next review of vaccination plans, and using this summary as a basis for further investigation and specific recommendations on effective interventions.

Background Yellow fever outbreaks are documented to have a considerable impact not only on the individuals but on the health system with significant economic implications. Efforts to eliminate yellow fever outbreaks globally through the EYE strategy remains important following outbreaks in Africa, Nigeria included. The outbreaks reported in Nigeria, since 2017 and the response efforts provide an opportunity to document and guide interventions for improving future outbreaks in Nigeria and other countries in Africa. Methods We reviewed the available yellow fever surveillance and vaccination response data between September 2017 and September 2019 across the 36 states across Nigeria. We described the epidemiology of the difference outbreaks and the periods for all interventions. We also documented the emergency vaccination responses as well as preventive mass vaccinations implemented towards improving population immunity and limiting epidemic potentials in Nigeria. Results A total of 7894 suspected cases with 287 laboratory-confirmed cases were reported in Nigeria between September 2017 and September 2019 with a mean age of 19 years and a case fatality of 2.7% amongst all reported cases. Outbreaks were confirmed in 55 LGAs with most of the outbreaks across four major epicentres in Kwara/Kogi, Edo, Ebonyi and Bauchi states. In response to these outbreaks, eight reactive vaccination campaigns, supported through ICG applications, were implemented. The duration for responding to the outbreaks ranged from 15 to 132 days (average 68 days) and a total of 45,648,243 persons aged . Conclusions Nigeria experienced intermediate outbreaks of yellow fever between September 2017 and 2019 with vaccination responses conducted to control these outbreaks. However, there are delays in the timeliness of responses and more efforts required in improving reporting, response times and preparedness to further prevent morbidity and mortality from the yellow fever disease outbreaks. These efforts, including improving routine yellow fever coverage, contribute towards improving population immunity and other activities related to achieving the goals of the EYE strategy.

In Cote d'Ivoire, the Family Approach to Counseling and Testing (FACT) program began in 2015 and provides facility-based HIV testing to the sexual partners, children and other household family members of HIV-positive index cases. We evaluated whether the FACT program is an effective approach to HIV case finding. We reviewed 1762 index patient charts to evaluate outcomes of the FACT program, held across 36 facilities in Abidjan. Index cases enumerated a total of 644 partners, 2301 children and 508 other family members including parents and siblings. Among the partners tested for HIV, the positivity rate was 21%; for children the positivity rate was 5% and for all other family members the positivity rate was 11%. Offering HIV testing services to the family members of HIV positive index cases is an effective approach to case finding in Cote d'Ivoire. Particularly, offering HIV testing to the partners of positive women index cases can be key to identifying previously undiagnosed men and linking them to treatment.

Background: From January to May 2019, large measles outbreaks affected all states in Nigeria and the Federal Capital Territory. Borno state was the most affected by the measles outbreak recording 15,237 suspected cases with the state capital of Maiduguri having 1,125 confirmed cases by March 2019. Twenty-two Local Government Areas (LGAs or Districts) and 37 internally displaced persons (IDPs) camps had been affected. In response to the situation, outbreak response immunization (ORI) was conducted. In addition to conventional vaccination teams, special teams were deployed in security compromised areas, areas with migrants, and for nomadic and IDPs. Here we describe the ORI and estimated the vaccine effectiveness (VE) for measles-containing vaccine (MCV) to assess the population-level impact. A post-campaign coverage survey (PCCS) was also carried out to assess the vaccination coverage.Methods: We reviewed the outbreak response-associated immunization activities, and conducted an analysis of the surveillance and the outbreak investigation reports. We evaluated VE of MCV by applying the screening-method using data from the measles outbreak and the latest mass vaccination campaign. The PCCS was conducted after completion of the ORI through a quantitative survey assessment in 1,800 households in 12 LGAs involved in the response.Results: Of the total 15,237 reported measles cases, 2,002 cases were line-listed and investigated, and 737 were confirmed for measles as at epidemiological week 9. Of the investigated cases 67.3% (n = 1,348) were between 9 and 59 months of age. Among the 737 confirmed cases, only 9% (n = 64) stated being vaccinated with at least 1 dose of MCV. The median VE for MCV is 96.7% (95%CI: 94.7 – 98.1), and 87.3% (95%CI: 71.0 – 95.2) when vaccine was received at 9 – 11. The aggregated weighted vaccination coverage is 85.7% (95%CI: 79.6 – 90.1).Conclusion: The experience in Borno demonstrates that adequate VE can be obtained in conflict-affected areas. In complex emergency affected by measles outbreaks, health authorities may consider integration with other health strategies and the engagement of security personnel as part of the ORI activities.

Introduction An Adverse event following immunization (AEFI) is an untoward medical occurrence following immunization and which may not have a necessary causal relationship with the usage of a vaccine. The World Health Organization categories AEFI into two; serious and non-serious. An AEFI is considered serious if it is life-threatening, requires inpatient hospitalization or results in death. The measles vaccine is safe and effective however because it is a live-attenuated injectable vaccine it is more prone to AEFI as compared to non-injectable vaccines when given in large numbers over a short period as is the nature of measles mass vaccination campaigns (MVC). This article describes Nigeria’s experience on AEFI reporting during the 2017/2018 Measles vaccination campaign (MVC). Methods We reviewed various materials which included the Open Data Kit (ODK) which is an open source smartphone-based data collecting tool, operations room reports, measles campaign tally sheets, AEFI line listing forms, the post measles campaign coverage survey report and the report of the AEFI national expert committee review of the 2017/2018 Nigeria measles MVC. Results A total of 6,214 suspected cases of AEFI were line listed from all 36 states and the Federal Capital Territory(FCT) during the 2017/2018 MVC with Fever(38%) and pain at injection site the (30%)most common reports. Overall, 99.7% AEFIs were reported to be non-serious AEFIs, with almost all cases resolved fully with no long-term sequalae.. The national incidence of suspected AEFI per 100,000 population was 16.3 with subnational incidence highest in Kebbi state (101.3/100,000) and lowest in Bayelsa state (0.8/100,000). Conclusion Adequate AEFI reporting, Investigation and management remains important in managing the risk of a disruption of mass campaigns. The deployment of supervisors during campaign may play an important role in improving the identification and reporting of suspected AEFI. Further inquiries about AEFIs during the post campaign coverage evaluation also played a role in improving AEFI reporting and documentation. The real-time, on the spot, follow up by the national operations team helped with decision making and intervention including AEFI investigations and assessments.

Introduction The measles supplemental immunisation activity is an effective strategy that improves vaccination coverage and reduces measles-related morbidity and mortality. However, the lack of compliance with microplanning processes, contributes to improper estimation of resources needed for a good SIA in Nigeria. We described the microplanning verification process for 2017/2018 measles vaccination campaign and highlighted the contribution of selected variables to the output of the microplan. Methods We conducted microplanning verification in 2 phases. In Phase 1, we verified at least 30% of randomly selected microplans to assess compliance with the steps and processes of developing good microplans. In Phase 2 we conducted desk review of the entire states micoplans and verified some selected variables at the ward level to corroborate the findings of the microplans. We collected data using open data kit and verification checklist. We conducted data analysis using SPSS and Microsoft Excel version 2016. Results All states in Nigeria verified their wards’ microplans, 21 states (57%) verified more than 30% ,16 states (43%) verified less than 30%, Kebbi State verified the lowest (5.3%). Over 90% of microplans verified complied with the microplanning processes. We observed that overall, there was no significant difference in the number of target population, vaccination teams and qualified vaccinators after the verification process. Conclusion The microplans for 2017/2018 measles vaccination campaign were developed according to the required procesesses, the target population, vaccination teams and qualified vaccinators were physically and realistically estimated. Adherence to microplanning processes is critical to the success of immunization programs.

Introduction Globally, knowledge of health workers has been documented to be key in effective immunisation service delivery. The parenteral route of drug administration is a vital healthcare procedure used in the administration of medicines using needle and syringe. Despite the importance of this procedure, improper handling of the device has resulted in an unsafe practice among health workers who attend to patients receiving injectable medications. A phased measles vaccination campaign (MVC) was conducted in 2017/2018 with a key objectives of training health workers on injection safety. This paper examines the association between improvement on knowledge of health workers through improved training curriculum and their practice on injection safety. Methods We reviewed information on handling and administration of the measles vaccine from the open data kit (ODK) platform finalised microplans and the training curriculum used during the 2015/2016 and 2017/2018 MVC. We analysed our results using paired t-test analysis, SPSS and Microsoft Excel spreadsheet and reported results in frequencies and proportions using charts and tables. Results Our findings revealed more health workers were trained during the 2017/2018 MVC as compared to 2015/2016 MVC. The curriculum adopted during the 2017/2018 MVC showed that multiple techniques were adopted during training compared to only class lectures used during the 2015/2016 MVC. A paired t-test analysis comparing the impact of training on the knowledge of the health workers during 2015/2016 and 2017/2018 MVC revealed significant improvement across five states during the 2017/2018 MVC, with mean ranging from 6.5% in the FCT to 23.7% in Nassarawa state. Conclusion The review of training curriculum and use of multiple training styles during the 2017/2018 MVC improved the knowledge of health workers. Immunisation programmes will benefit from adopting the training curriculum to meet the specific needs of the health workers.

To evaluate a project that integrated essential primary health-care services into the oral polio vaccine programme in hard-to-reach, underserved communities in northern Nigeria.In 2013, Nigeria's polio emergency operation centre adopted a new approach to rapidly raise polio immunity and reduce newborn, child and maternal morbidity and mortality. We identified, trained and equipped eighty-four mobile health teams to provide free vaccination and primary-care services in 3176 hard-to-reach settlements. We conducted cross-sectional surveys of women of childbearing age in households with children younger than 5 years, in 317 randomly selected settlements, pre- and post-intervention (March 2014 and November 2015, respectively).From June 2014 to September 2015 mobile health teams delivered 2 979 408 doses of oral polio vaccine and dewormed 1 562 640 children younger than 5 years old; performed 676 678 antenatal consultations and treated 1 682 671 illnesses in women and children, including pneumonia, diarrhoea and malaria. The baseline survey found that 758 (19.6%) of 3872 children younger than 5 years had routine immunization cards and 690/3872 (17.8%) were fully immunized for their age. The endline survey found 1757/3575 children (49.1%) with routine immunization cards and 1750 (49.0%) fully immunized. Children vaccinated with 3 or more doses of oral polio vaccine increased from 2133 (55.1%) to 2666 (74.6%). Households' use of mobile health services in the previous 6 months increased from 509/1472 (34.6%) to 2060/2426(84.9%).Integrating routine primary-care services into polio eradication activities in Nigeria resulted in increased coverage for supplemental oral polio vaccine doses and essential maternal, newborn and child health interventions.Évaluer un projet qui intégrait des services de soins de santé primaires essentiels au programme d'administration du vaccin antipoliomyélitique oral au sein de communautés difficiles à atteindre et mal desservies au nord du Nigéria.En 2013, le centre d'intervention d'urgence pour la lutte contre la poliomyélite du Nigéria a adopté une nouvelle approche visant à augmenter rapidement l'immunité contre la poliomyélite et à réduire la morbidité et la mortalité néonatales, infantiles et maternelles. Nous avons sélectionné, formé et équipé quatre-vingt-quatre équipes sanitaires mobiles afin d'offrir des services de vaccination et de soins primaires gratuits dans 3176 zones de peuplement difficiles à atteindre. Nous avons mené des enquêtes transversales avant et après l'intervention (en mars 2014 et novembre 2015, respectivement) auprès de femmes en âge de procréer dans des familles comptant des enfants âgés de moins de 5 ans, au sein de 317 zones de peuplement sélectionnées aléatoirement.Entre juin 2014 et septembre 2015, les équipes sanitaires mobiles ont fourni 2 979 408 doses de vaccins antipoliomyélitiques oraux et déparasité 1 562 640 enfants âgés de moins de 5 ans; elles ont tenu 676 678 consultations anténatales et soigné 1 682 671 maladies affectant des femmes et des enfants, parmi lesquelles la pneumonie, la diarrhée et le paludisme. L'enquête initiale a révélé que sur 3872 enfants âgés de moins de 5 ans, 758 (19,6%) avaient des fiches de vaccination systématique et 690 (17,8%) avaient reçu toutes les vaccinations correspondant à leur âge. L'enquête finale a révélé que 1757 enfants sur 3575 (49,1%) avaient des fiches de vaccination systématique et que 1750 (49,0%) avaient reçu toutes les vaccinations correspondant à leur âge. Le nombre d'enfants ayant reçu 3 doses ou plus de vaccins antipoliomyélitiques oraux est passé de 2133 (55,1%) à 2666 (74,6%). Le nombre d'utilisations par les familles des services de santé mobiles au cours des 6 mois précédents est passé de 509 sur 1472 (34,6%) à 2060 sur 2426 (84,9%).L'intégration des services de soins primaires systématiques dans les activités d'éradication de la poliomyélite au Nigéria a entraîné une augmentation du nombre de bénéficiaires de doses supplémentaires de vaccins antipoliomyélitiques oraux et des interventions essentielles en santé maternelle, néonatale et infantile.Evaluar un proyecto que integró los servicios esenciales de atención primaria en el programa de vacunación oral contra la polio en comunidades de difícil acceso y desatendidas del norte de Nigeria.En 2013, el centro de operaciones de emergencia contra la polio de Nigeria adoptó un nuevo enfoque para aumentar rápidamente la inmunidad a la enfermedad y reducir la morbilidad y la mortalidad de recién nacidos, niños y madres. Se identificaron, formaron y equiparon ochenta y cuatro equipos sanitarios móviles para proporcionar servicios gratuitos de vacunación y atención primaria en 3176 asentamientos de difícil acceso. Se realizaron encuestas transversales de mujeres en edad fértil en hogares con niños menores de 5 años, en 317 asentamientos seleccionados al azar, antes y después de la intervención (marzo de 2014 y noviembre de 2015, respectivamente).Entre junio de 2014 y septiembre de 2015, los equipos sanitarios móviles administraron 2 979 408 dosis de la vacuna oral contra la polio y desparasitaron a 1 562 640 niños menores de 5 años, realizaron 676 678 consultas prenatales y trataron 1 682 671 enfermedades de mujeres y niños, incluidas la neumonía, la diarrea y el paludismo. La encuesta de referencia concluyó que 758 (19,6 %) de 3872 niños menores de 5 años tenían tarjetas de vacunación de rutina y 690/3872 (17,8 %) estaban totalmente inmunizados para su edad. La encuesta final reveló 1757/3575 niños (49,1 %) con tarjetas de vacunación de rutina y 1750 (49,0 %) totalmente inmunizados. Los niños vacunados con tres o más dosis de la vacuna oral contra la polio aumentaron de 2133 (55,1 %) a 2666 (74,6 %). El uso de los servicios sanitarios móviles por parte de los hogares en los seis meses anteriores aumentó de 509/1472 (34,6 %) a 2060/2426 (84,9 %).La integración de los servicios de atención primaria de rutina en las actividades de erradicación de la polio en Nigeria dio lugar a un aumento de la cobertura de las dosis suplementarias de la vacuna oral contra la polio y de las intervenciones esenciales de salud materna, neonatal e infantil.تقييم مشروع يقوم بدمج خدمات الرعاية الصحية الأولية الضرورية في برنامج لقاح فموي لشلل الأطفال في المجتمعات التي يصعب الوصول إليها والتي تفتقر إلى الخدمات في شمال نيجيريا.في عام 2013، اتبع مركز عمليات الطوارئ في مجال شلل الأطفال في نيجيريا نهجاً جديداً لرفع المناعة ضد شلل الأطفال بشكل سريع سريع، وخفض المراضة والوفيات بين المواليد والأطفال والأمهات. قمنا بتحديد أربعة وأربعين فريقاً صحياً متنقلاً، وتدريبهم وتجهيزهم، وتوفير خدمات التلقيح والرعاية الأولية مجاناً في 3176 مستوطنة يصعب الوصول إليها. أجرينا مسوح مقطعية على النساء في سن الإنجاب في الأسر التي لديها أطفال تقل أعمارهم عن 5 سنوات، في 317 مستوطنة تم اختيارها عشوائياً، ما قبل وما بعد التدخل (مارس/آذار 2014 ونوفمبر/تشرين ثاني 2015، على التوالي).من يونيو/حزيران 2014 إلى سبتمبر/أيلول 2015، قدمت الفرق الصحية المتنقلة 2979408 جرعة من اللقاح الفموي المضاد لشلل الأطفال، وساعدت في تخليص 1562640 طفلاً أصغر من 5 سنوات من الديدان، وأجرت 676678 استشارة سابقة للولادة، وعالجت 1682671 حالة مرضية في النساء والأطفال، بما في ذلك الالتهاب الرئوي والإسهال والملاريا. وجد المسح الأساسي أن 758 (19.6٪) من 3872 طفلاً أصغر من 5 سنوات كان لديهم بطاقات تحصين روتينية، وتم تحصين 690/3872 (17.8٪) بالكامل طوال أعمارهم. وجد المسح النهائي 1757/3575 طفلاً (49.1٪) لديهم بطاقات تحصين روتينية، و1750 (49.0٪) محصنين بالكامل. ازداد عدد الأطفال الذين تم تطعيمهم باستخدام 3 أو أكثر من جرعات لقاح شلل الأطفال الفموي، من 2133 (55.1٪) إلى 2666 (74.6٪). زاد استخدام الأسر للخدمات الصحية المتنقلة في الأشهر الستة السابقة من 509/1472 (34.6٪) إلى 2060/2426 (84.9٪).أدى دمج خدمات الرعاية الأولية الروتينية في أنشطة استئصال شلل الأطفال في نيجيريا، إلى تغطية متزايدة للجرعات الإضافية من اللقاح الفموي المضاد لشلل الأطفال، والتدخلات الصحية الضرورية للأمهات والمواليد والأطفال.旨在评估一项在尼日尼亚北部难以到达、缺乏服务的社区开展的，将基本的初级卫生保健服务纳入口服脊髓灰质炎疫苗计划中的项目。.2013 年，尼日利亚小儿麻痹症急诊手术中心采用了一种新方法，以迅速提高脊髓灰质炎免疫力，从而降低新生儿、儿童和孕产妇的发病率和死亡率。我们确定，84 个接受过培训、配备装备的流动医疗队，在 3176 个难以到达的定居点提供免费疫苗接种和初级卫生保健服务。干预前和干预后（分别为 2014 年 3 月和 2015 年 11 月），我们随机选择 317 个定居点，并对在家中抚养 5 岁以下儿童的育龄妇女进行了横断面调查。.从 2014 年 6 月至 2015 年 9 月，流动医疗队为其接种 2979408 剂口服脊髓灰质炎疫苗，并为 1562640 名 5 岁以下儿童驱虫；进行了 676678 次产前咨询，治疗了 1682671 例妇女和儿童的病例，包括肺炎、腹泻和疟疾。基线调查发现 3872 名年龄小于 5 岁的儿童中有 758 名（占 19.6％）拥有常规免疫接种卡，3872 名儿童中的 690 名（占 17.8％）完全免疫。底线调查发现 3575 名儿童中的 1757 名 （占 49.1％）拥有常规免疫接种卡，其中 1750 名（占 49.0％）完全免疫。接种 3 剂口服脊髓灰质炎疫苗或更多剂量的儿童人数从 2133 例（占 55.1％）增至 2666 例（占 74.6％）。过去 6 个月，使用移动医疗服务的家庭从 509 户（占 1472 户的 34.6％）增至 2060 户（占 2426 户的 84.9％）。.将常规初级卫生保健服务纳入尼日利亚的脊髓灰质炎根除活动，可以增加补充口服脊髓灰质炎疫苗剂的覆盖率，增加基本孕产妇、新生儿和儿童卫生干预措施的覆盖率。.Оценка проекта по включению основной первичной медицинской помощи в программу распространения пероральной полиомиелитной вакцины для труднодоступных и плохо охваченных обслуживанием общин на севере Нигерии.В 2013 г. Нигерийский центр неотложной помощи больным полиомиелитом внедрил новый подход в отношении быстрого повышения уровня иммунитета к полиомиелиту и сокращения заболеваемости и смертности среди новорожденных, матерей и детей. Авторы выявили, обучили и оснастили восемьдесят четыре мобильные бригады медиков для бесплатной вакцинации и оказания первичных медицинских услуг в 3176 труднодоступных поселениях. В 317 поселениях, выбранных случайным образом, до и после мероприятий (в марте 2014 года и в ноябре 2015 года соответственно) были проведены перекрестные обследования женщин детородного возраста в семьях с детьми младше 5 лет.С июня 2014 года по сентябрь 2015 года мобильные бригады медиков предоставили населению 2 979 408 доз пероральной вакцины от полиомиелита и провели глистогонную терапию 1 562 640 детям младше 5 лет; они также провели 676 678 дородовых консультаций и вылечили 1 682 671 заболевание у женщин и детей, включая пневмонию, диарею и малярию. Исходный опрос выявил, что у 758 детей младше 5 лет (19,6%) из 3872 были карточки регулярных прививок и 690 из 3872 (17,8%) были полностью привиты соответственно возрасту. В итоговом обследовании выяснилось, что 1757 из 3575 детей (49,1%) имели карточки регулярных прививок и 1750 детей (49%) были полностью привиты. Количество детей, получивших 3 и более дозы пероральной вакцины от полиомиелита, возросло с 2133 (55,1%) до 2666 (74,6%). Количество семей, использовавших услуги мобильных медицинских бригад за последние 6 месяцев возросло с 509 из 1472 (34,6%) до 2060 из 2426 (84,89%).Объединение услуг первичной медицинской помощи с усилиями по искоренению полиомиелита в Нигерии привело к увеличению охвата дополнительными дозами поддерживающей пероральной вакцины и важными мероприятиями по охране здоровья детей, матерей и новорожденных.

Background The mandate and unique experience of the World Health Organization (WHO) globally, enables over 190 countries, Nigeria inclusive, to depend on the technical support provided by the organization to define and mitigate the threats to public health. With other emerging health actors competing for scarce donors’ resources, the demand for visibility has invariably equaled expectations on WHO’s expertise and technical support. However, the inability to systematically document activities conducted by WHO personnel before 2013 overshadowed most of its invaluable contributions due to poor publicity. The inauguration of the Communications Group in December 2013 with a visibility plan necessitated a paradigm shift towards building a culture of documentation to engender visibility. Methods We used a pre-post design of activities to evaluate the effectiveness of specific interventions implemented to improve visibility from 2013 to 2016. The paper highlights how incorporating communication strategies into the accountability framework of staff contributed in changing the landscape as well as showcasing the activities of WHO in Nigeria for improved donor relations. Results With the specific interventions implemented to improve WHO’s visibility in Nigeria, we found that donor relations improved between 2013 and 2015. It is not a mere coincidence that the period corresponds with the era of incorporation of documentation into the accountability framework of technical staff for visibility as locally mobilized resources increased to record 112% in 2013 and 2014. The intervention assisted in the positive projection of WHO and its donors by the Nigeria media. Conclusion Despite several interventions, which worked, made WHO ubiquitous and added awareness and visibility for donors who funded various projects, other factors could have contributed towards achieving results. Notwithstanding, incorporating documentation component into the accountability framework of field staff and clusters has significantly improved communication of WHO’s work and promoted healthy competition for increased visibility.