Key result
Integrated primary care within polio outreach is linked to full child immunization rising to ~49%.
Why the study?
The integration of essential primary health-care services into the oral polio vaccine programme in hard-to-reach communities in northern Nigeria was evaluated to address underserved populations' health needs.
Does integrating primary health-care services into the polio vaccine programme improve immunization coverage in hard-to-reach communities in Nigeria?
Cross-Sectional (n=7,447)
Yes
Does integrating primary health-care services into the polio vaccine programme improve immunization coverage in hard-to-reach communities in Nigeria?
Absolute Event Rate: 49% vs 17.8%
Integrating routine primary-care services into polio eradication activities significantly improves immunization coverage and access to essential health interventions in underserved communities.
Integration may raise full immunization rates in hard-to-reach Nigerian communities; leaves open causality and generalizability.
Objective: 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. Methods: 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). Findings: 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%). Conclusion: 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.
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Bawa et al. (2018) conducted a cross-sectional in Underserved communities / Immunization coverage (n=7,447). Integrated mobile health teams vs. Pre-intervention baseline was evaluated on Children fully immunized for age. Integrating primary-care services into the polio eradication programme increased the proportion of fully immunized children from 17.8% at baseline to 49.0% at endline.
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