Using the polio programme to deliver primary health care in Nigeria: implementation research

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...

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Bibliographic Details
Published in:	Bulletin of the World Health Organization 2019-01, Vol.97 (1), p.24-32
Main Authors:	Bawa, Samuel, McNab, Christine, Nkwogu, Loveday, Braka, Fiona, Obinya, Esther, Galway, Michael, Mirelman, Andrew J, Hammanyero, Kulchumi Isa, Safiyanu, Garba, Chukwuji, Martin, Ongwae, Kennedy, Mkanda, Pascal, Corkum, Melissa, Hegg, Lea, Tollefson, Deanna, Umar, Sani, Audu, Sunday, Gunda, Hassan, Chinta, Modu, Jean Baptiste, Anne Eudes, Bagana, Murtala, Shuaib, Faisal
Format:	Article
Language:	eng
Subjects:	Adolescent Adult Antenatal Child, Preschool Childbearing Childbearing age Children Children & youth Childrens health Cross-Sectional Studies Diarrhea Dosage Drug delivery systems Emergency procedures Eradication Female Health Health care Health Knowledge, Attitudes, Practice Health services Health Services Accessibility - statistics & numerical data Health services utilization Health status Households Humans Illnesses Immunity Immunization Immunization - statistics & numerical data Immunization Programs - methods Implementation Infant Infant, Newborn Insurgency Intervention Interviews as Topic Literature reviews Malaria Management Maternal & child health Maternal characteristics Middle Aged Mobile Health Units Morbidity Mortality Mothers Nigeria Pneumonia Poliomyelitis Poliomyelitis - prevention & control Poliomyelitis - psychology Poliovirus Vaccine, Oral - administration & dosage Polls & surveys Primary care Primary Health Care - methods Primary Health Care - statistics & numerical data Privileges & immunities Random Allocation Rebellions Research transfer Teams Telemedicine Underserved populations Vaccination Vaccines Vector-borne diseases Young Adult
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Summary:	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.
ISSN:	0042-9686 1564-0604