Assessing the capacity of primary health care centres to provide routine immunization services amidst COVID-19 lockdown in Kaduna state, Nigeria (original) (raw)
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Research Square (Research Square), 2024
Background The development of the COVID-19 vaccine in uenced the discussion on the importance of exploring the interaction between COVID-19 vaccination and routine immunization. Subsequently, the WHO Strategic Advisory Group Experts (SAGE) on immunization plausibly advised countries to leverage the COVID-19 vaccination rollout as a transformative opportunity to establish a resilient immunization system, through the integration of routine immunization, resulting in strengthened primary healthcare services. Objective This study assesses the enablers and barriers to integrating COVID-19 vaccination and routine immunization in Ekiti state, Nigeria. Methods This study adopted a qualitative research approach to obtain information from 40 participants selected purposively across the primary healthcare facilities, LGA, and state levels. A three-tier approach was used in selecting the LGAs. At the same time, In-depth interviews were conducted to elicit relevant information on the assessment of enablers and barriers to integrating COVID-19 vaccination and routine immunization through an interview guide. All audio interview les were transcribed in the English language, coded, and presented using a thematic approach (inductive and deductive approaches) Results A total of 40 healthcare workers across Ekiti state were selected to participate in this study. Our study found the enablers of integrating COVID-19 into routine immunization to include demand generation and social mobilization, health education, health workers training, data validation, nancing, and supervision. However, rumors, demand for palliatives, Adverse Events Following Immunization (AEFI), manpower shortage, poor network services, and bad road networks were reported as barriers to integrating COVID-19 vaccination and routine immunization in Ekiti state. Conclusion While the enablers of integrating COVID-19 and routine immunization may outweigh its barriers, it is pertinent to know that the efforts towards integrating COVID-19 vaccination on RI is a call to all stakeholders. The identi ed barriers in the study must be addressed to ensure a strengthened health system. Therefore, achieving a successful integration and uptake of vaccination/immunization is anchored on driving demand generation, social mobilization, health education, availability of healthcare workers, integrated supervision, and nancing. Contributions to Literature Text Box 1: Contributions to Literature This paper described the enablers and barriers to integrating COVID-19 vaccination and routine immunization in primary health care facilities in Ekiti state, Nigeria Clients' demand for incentives, the fear of adverse events following immunization, poor internet services, and road networks are hurdles to vaccine uptake Demand generation, social mobilization, and health education for caregivers are essential to integrated service delivery Health workers' training and improved data reporting structure aided quality service delivery Background The outbreak of COVID-19 in December 2019 (China CDC, 2020), propelled into a multifaceted health challenge within three months of its emergence across the globe (Sorbello and Greif, 2020), subsequently resulting in its declaration as a pandemic in March 2020 by the World Health Organization (WHO, 2020; Cucinota and Vanelli, 2020). Aside from being an unknown threat to the global populace at the onset, it equally orchestrated the disruption of several existing public health interventions (Pley et al, 2021; Sacco and De Domenico, 2021), especially in low and middle-income countries (LMICs) (Aranda et al, 2022; Okereke et al, 2020). This disruption was particularly in uenced by the non-pharmaceutical intervention (NPI) measures adopted by several countries in the world on the recommendation of the World Health Organization including social distancing, public spaces and facilities closure, travel restrictions, use of face masks, and more signi cantly relative total lockdown (Topriceanu et al, 2021; Siedner et al, 2020). One of many health programs affected by the COVID-19 menace was the immunization services offered to children 0-59 months (Ota et al, 2021; Sharma et al, 2021), also called Routine Immunization (RI). This spawned as a result of movement restrictions in many countries, that reduced accessibility to health facilities for healthcare services (Haider et al, 2021). RI is considered the hub of healthcare services for children, and a preventable channel for reducing underve mortality rates, by preventing them from various infectious diseases (Glass et al, 2021; Hora et al, 2020; do Carmo et al, 2011). The World Health Organization (2020) and Adamu et al, (2020) predicted that the halting of RI services increased the susceptibility of about 80 million children across 68 countries to various vaccine-preventable diseases including diphtheria, measles, and polio, thereby endangering the lives of these children. For instance,
African Journal of Health Sciences, 2021
INRODUCTION In the wake of the novel COVID-19 pandemic the health service disruption with the resultant widespread health consequences associated with the virus has become abundantly clear to all. Our primary objective was to determine the impacts of the COVID-19 epidemic on primary health care performance indicators in Katsina state. MATERIAL AND METHODS Data was pulled and analyzed for trends and coverage of selected performance indicators from Quarter 1, 2019 to Quarter 2, 2020. Data sources were administrative data from District Health Information Software. An indicator each was analyzed from the following health thematic areas: Child health, Routine Immunization, Family planning, HIV/AIDS Care and Treatment, Labor and Delivery, Malaria and Antenatal Care (ANC). Descriptive and inferential statistical analyses were carried out using Statistical Package for Social Sciences version 20. Time series analysis with Auto-Regressive and Integrated Moving Average (ARIMA) modeling on indicators was used to study trends of performance over time. Simple Linear Regression (SLR) analysis was used to report coefficients of relationships at intercept and period points. RESULTS ANC 4 th visit decreased abysmally from 65% to 46%, pentavalent vaccine 3 also declined consistently from 83% to 74% during the active lock down period. The study was also able to identify rising numbers of <5 mortality rate (from 2% to 19%) and a corresponding decrease in Pentavalent vaccine 3 coverage over time. These finding were significant (P = 0.01) across periodic quarters of 2019 and 2020. CONCLUSION The current study was able to demonstrate, using ARIMA and SLR modeling, the decline in ANC 4 th visit and pentavalent vaccine coverage in Katsina state, Nigeria during the active lock down phases.
Journal of Advances in Medicine and Medical Research
The COVID-19 pandemic spread to Nigeria, resulting in a nationwide lockdown from 30th March 2020. Consequently, there was enormous impact on the health and socio-economic facets of life affecting individuals, families, and communities. A key component of primary health care that was affected was routine childhood immunisation which is one of the fundamental pillars of the Nigerian government’s child health care policy. The study aimed at evaluating the impact of the pandemic on routine immunization, as well as, make recommendations to strengthen routine immunization during a pandemic based on lessons learnt. Primary data were collected using semi-structured questionnaires administered to 150 parents or caregivers across the childcare and wellness clinics of four selected secondary health facilities in the Federal Capital Territory (FCT) from January to June 2020 (January to March representing the pre-lockdown period while April to June, the lockdown period). Secondary data were coll...
Early Impact of SARS-CoV-2 Pandemic on Immunization Services in Nigeria
Vaccines
Background: By 11 March 2022, there were 450,229,635 Coronavirus disease (COVID-19) cases and 6,019,085 deaths globally, with Nigeria reporting 254,637 cases and 3142 deaths. One of the essential healthcare services that has been impacted by the pandemic is childhood routine immunization. According to the 2018 National Demographic and Health Survey, only 31% of children aged 12–23 months were fully vaccinated in Nigeria, and 19% of eligible children haven’t received any vaccination in the country. A further decline in coverage due to the pandemic can significantly increase the risk of vaccine-preventable-disease outbreaks among children in Nigeria. To mitigate such an occurrence, it is imperative to urgently identify how the pandemic and the response strategies have affected vaccination services, hence, the goal of the study. Methods: The research method is qualitative, including in-depth interviews of healthcare workers and focus group discussions (FGD) with caregivers of children ...
COVID-19 outbreak: a potential threat to routine vaccination programme activities in Nigeria
Human Vaccines & Immunotherapeutics
COVID-19 is an infectious disease caused by the most recently discovered coronavirus (SARS-CoV-2). The virus and disease were unknown before the outbreak began in the city of Wuhan, China, in December 2019. Nigeria and other sub-Sahara Africa countries like the rest of the world introduced several lockdown measures as part of their public health response to mitigate the spread of the virus. This, however, was not without the likelihood of consequences considering the weak health systems. The access and supply side of vaccination was more likely to have been affected by the lockdown measures. When vaccination services are disrupted even for brief periods during emergencies, the risk of outbreakprone vaccine-preventable diseases increases, leading to excess morbidity and mortality. This highlights the importance of maintaining essential services such as vaccination in times of emergency. There is therefore an urgent need to ensure that children are protected against those diseases for which vaccines already exist. The COVID-19 outbreak has posed a new hindrance to vaccination activities in Nigeria and across Sub-Saharan Africa with associated threat to surveillance of vaccine-preventable diseases. Achieving and sustaining high levels of vaccination coverage during this period must, therefore, be a priority for all health systems.
Impact of covid-19 lockdown on immunization at a public tertiary care teaching hospital
Current Pediatric Research, 2021
Background: COVID-19 has disrupted immunization activities across the world. There is lack of data from India about the impact of COVID-19 on vaccination ,particularly at the ground level.Hence we aimed to study the impact of COVID-19 on immunization at a public tertiary care teaching hospital. Methods: This is a pre and post lockdown data analysis study. The data analyzed included period before lockdown from 1st January 2020 to 24th March 2020 ("Period 1") and during lockdown from 25th March 2020 to13th May 2020("Period 2") from the immunization OPD of a public tertiary care teaching hospital from Western India. Cumulative doses of vaccines given at weekly intervals during two periods (period 1 and period 2) were tallied. The reduction in number of vaccines given during the two time periods in three vaccine groups viz. vaccines given at birth,vaccines given in infancy and under five children(except MR) and MR vaccine. Results: Our study shows that there was some decline in the number of vaccines given to newborns in hospital, however, this was not statistically significant (p>0.05). Compared to this, there was a major impact on number of vaccines given in infancy and under five children (p <0.005). We specifically studied impact on the MR vaccine and found there was statistically significant decline in number of children immunized (p <0.007). Conclusions: There was a major impact of COVID-19 lockdown on vaccines given to infants and children.
Assessment Monitoring of an Expanded Program on Immunisation's Activities in Northern Nigeria States
Journal of Virology and Mycology
Over two million deaths are delayed through immunization each year worldwide. Despite this, vaccine preventable diseases remain the most common cause of childhood mortality. With an estimated three million deaths each year, this field work summarises the main activities and findings of polio eradication activities in Nigeria, from 1 st Feb to 30 th April 2012. 33 health facilities and 3 hospitals were visited in order to assess the immunisation activates and surveillance system. The keys activities included technical support in Feb and March IPDs, community sensitization by visiting community leader to solve Non-Compliances (NC), training personnel, validating and reviewing micro plan in ward and Local Government Authorities (LGAs)level, reviewing high risk operational plan in high risk LGA. The main key finding includes Poor quality of training in ward level, there was no training material for Oral Polio Vaccine (OPV), absenteeism and non-comfortable place for training, missed children and missed settlements reported in Immunisation Plus Days (IPDs)in some ward due to inadequate number of teams, dishonest teams and poor close supervision. The main recommendations include State team should continue advocate for political engagement to support the successes polio eradication activities, Intensified monitoring and supervision at field level during the IPDs by all level of supervisors is great solution for improving team performance and reach the missed children, Generalize the pilot team to the rest of LGAs in the state especially in improving the program, team performance, coverage and reducing non-compliance and missed children, Intensify supportive supervision to the surveillance site by the State, WHO officers and the LGA Facilitator.
Texila International Journal of Academic Research, 2023
The COVID-19 pandemic has placed tremendous burdens on healthcare workers (HCWs), accounting for over 1.4 million HCW infections and 10% of global fatalities. HCWs faced elevated infection risk, psychological distress, long working hours, fatigue, stigma, and violence. While vaccines are pivotal in reducing severe illness, HCW vaccine hesitancy, given their role as advocates, jeopardizes vaccination coverage global goals and healthcare systems. Addressing this vaccine uptake is imperative through education, transparent communication, and support to safeguard HCWs' safety and pandemic containment. This study assessed COVID-19 vaccination uptake among frontline HCWs in Kaduna State, Nigeria, and its impact on morbidity and mortality. Utilizing a descriptive crosssectional approach, we analyzed secondary data from the Surveillance Outbreak Response Management and Analysis System (SORMAS). The study encompassed HCWs in Kaduna State, excluding pregnant and lactating individuals, following national guidelines. Among 8095 HCWs tested for COVID-19, most were aged 31-40 years (35%), female (60.2%), and urban residents (70.3%). COVID-19 vaccination uptake was low at 17.4%, with 82.6% unvaccinated. COVID-19 infection was significantly associated with vaccination (p = 0.039). Although unvaccinated participants exhibited a higher mortality rate (60%) than vaccinated ones (40%), this difference was not statistically significant (p = 0.209). In conclusion, this study unveiled insufficient vaccination uptake among HCWs, potentially impeding pandemic response. While vaccination seemed to positively impact disease outcomes, it didn't 1 significantly affect the infection risk. Addressing HCW vaccine hesitancy remains critical for achieving immunization goals and ensuring healthcare system safety.
Pan African Medical Journal, 2020
Introduction: following the declaration of the COVID-19 pandemic on 11 March 2020, countries started implementing strict control measures, health workers were redeployed and health facilities re-purposed to assist COVID-19 control efforts. These measures, along with the public concerns of getting COVID-19, led to a decline in the utilization of regular health services including immunization. Methods: we reviewed the administrative routine immunization data from 15 African countries for the period from January 2018 to June 2020 to analyze the trends in the monthly number of children vaccinated with specific antigens, and compare the changes in the first three months of the COVID-19 pandemic. Results: thirteen of the 15 countries showed a decline in the monthly average number of vaccine doses provided, with 6 countries having more than 10% decline. Nine countries had a lower monthly mean of recipients of first dose measles vaccination in the second quarter of 2020 as compared to the first quarter. Guinea, Nigeria, Ghana, Angola, Gabon, and South Sudan experienced a drop in the monthly number of children vaccinated for DPT3 and/or MCV1 of greater than 2 standard deviations at some point in the second quarter of 2020 as compared to the mean for the months January-June of 2018 and 2019. Conclusion: countries with lower immunization coverage in the pre-COVID period experienced larger declines in the number of children vaccinated immediately after the COVID-19 pandemic was declared. Prolonged and significant reduction in the number of children vaccinated poses a serious risk for outbreaks such as measles. Countries should monitor coverage trends at national and subnational levels, and undertake catch-up vaccination activities to ensure that children who have missed scheduled vaccines receive them at the earliest possible time.
2020
Background: Among the strategies of the Polio Eradication Initiative, the landmark interventions are routine immunization (RI) and supplementary immunization activities (SIAs). RI is the provision of vaccination service at the health facility and conducted year-round. SIAs are a community-based intervention targeting large numbers of an eligible population within a short period. Hence, the study aimed to assess the contributions of SIAs on access and utilization of RI services. Methods: We conducted the study in 10 local government areas in Kebbi State, northwestern Nigeria. We analyzed RI data