Immunization in Nigeria- Cooperation with GAVI

At theGAVI Board Meeting, Abuja Nigeria

4th December 2004

Background Information on Nigeria

• Total Population 133 million• Under 1 population 5.1million• Under 5 population 40,539,739 • Administrative Structure:

States (36) + FCT

LGA (774)

Political wards (9,572

Zonal Map of Nigeria

Abia

Adamwara

Akwalbom

Anambra

Bauchi

Bayelsa

Benue

Borno

Cross RiversDelta

EbonyiEdo

Ekiti

Enugu

FCT

Gombe

Imo

Jigawa

Kaduna

Kano

Katsina

Kebbi

Kogi

Kwara

Lagos

Nasarawa

Niger

Ogun Ondo

Osun

Oyo

Plateau

Rivers

Sokoto

Taraba

YobeZamfara

National Immunization Policy

• It is the Policy of the Federal Government of Nigeria to provide immunization services and potent vaccines, free to all populations at risk of vaccine preventable diseases (VPDs).

• Government shall therefore ensure the use of a national immunization schedule in order to attain optimal protection for eligible children and women of child bearing age.

• The immunization policy also provides guidelines on injection safety standards and practices, AEFIs, Surveillance systems, Advocacy/Social Mobilization as well as Partner Collaboration

• These are achieved through the National Programme on Immunization as the implementing agency

NPI Vision

• To achieve sustainable immunization service delivery through community ownership, as well as a community operated and community driven strategy

NPI’s Mission Statement

The National Programme on Immunization is committed to the

reduction of morbidity and mortality arising from vaccine preventable diseases through the provision of

potent vaccines, technical, cold chain and logistics supports to States and

Local Government Areas”

Nigeria’s Immunization Schedule

Age Vaccine

At birth BGC OPV0 HBV1

6 weeks DPT1 OPV1 HBV2

10 weeks DPT2 OPV2

14 weeks DPT3 OPV3 HBV3

9 months MV YF Vit A1

15 months Vit.A 2

Collaborations with GAVI• In year 2002, Nigeria obtained conditional approval for GAVI

Support funds in the area of Immunization Support Services as well as New and Under-Utilized Vaccines (Yellow Fever)

• Subsequently, 37 GAVI Consultants were appointed in October 2002 with the responsibility of giving technical support to the 36 States and the Federal Capital Territory, Abuja to develop State and LGA proposals for GAVI funding in line with the country’s 5-Year Strategic Plan for Strengthening Routine Immunization Service Delivery.

• In May/June 2003, the GAVI Award Review Committee comprising of NPI and Partners received and reviewed State proposals, out of which only 15 States and 186 LGA plans were found satisfactory and recommended for GAVI funding.

• The States include: Anambra, Enugu, Ebonyi, Imo, Ekiti, Kogi, Kwara, Rivers, Bayelsa, Akwa Ibom, Edo, Kano, Sokoto, Borno and Yobe.

Components of GAVI support in the 15 States

Advocacy/social mobilization/information: support to mobilization activities through town and radio/TV announcements, sensitization meetings, awareness campaigns, etc

Capacity building of health providers: training of immunization service providers at State/LGAs using standardized training modules

Monitoring, Supervision & Evaluation: provision of imprest for fueling of vehicles and generators as well as support for the conduct of monthly review meetings.

GAVI funding disbursement guidelines for States and LGAs

• Opening of State and LGA GAVI Operational Accounts

• Payment of at least 10% counterpart funding of the approved funds by the respective States and LGAs to demonstrate ownership of the programme

• Forwarding of account numbers to national levels to enable disbursement of approved funds

State and LGA Current funding status

• Receipt of GAVI funds approved for disbursement to States and LGAs: N108,119,850

• Total funds disbursed to States and LGAs at date N67,537,849

• Amount awaiting disbursement to States and LGAs yet to comply with disbursement guidelines N39,711,769:30

% of LGAs that received funds

0.00

20.00

40.00

60.00

80.00

100.00

120.00

States

% % LGAs

% LGAs that received GAVI funds

Current status of payments to GAVI Consultants

• Part-Payment to 16 GAVI Consultants in July 2003 to the tune of N12,150,000

• Payment to 26 GAVI Consultants in March 2004 to the tune of N24,436,000

Major achievements in GAVI supported States

• Increased utilization of GAVI funds at State and LGA levels

• Improved Social Mobilization with high political commitments at the highest levels.

• Improved awareness of immunization activities at community levels, thereby fostering partnerships within an increased network

• Improved human resource development through Cascade Training of

immunization service providers using the standardized immunization modules

• Strengthening of monitoring, surveillance and evaluation structures State, LGA and ward levels, as well as increased implementation of M&E activities.

Challenges to Routine Immunization

• Strengthening the primary health care system• Improving immunization service delivery at HF levels

with high standard of practice and minimal risk• Improving technical skills of health workers through

continued training and capacity building• Improving inter-personal communication (IPC) skills

of health workers• Increased social mobilization and advocacy at all

levels• Improved monitoring and evaluation of immunization

services, including programme quality and efficiency of service delivery

• Improved data management at all levels

Way forward• Continued implementation of our 5-Year Strategic Plan and in

particular the Year 2005, Annual POA, which has been circulated to the GAVI Board members today.

• Continued implementation of the 5 Year Cold Chain rehabilitation plan• Improved vaccine distribution through the PSVD• Strengthening partnership collaboration through the Inter-Agency

Coordinating Committee (see next slide for ICC Governance Structure).

• Increased Technical support to GAVI desks at the NPI HQ and zonal offices

• Initiation of Exchange programmes for NPI staff with countries that are also recipients of GAVI support

Structure of ICC Governance for Immunization in Nigeria

National Council on Health Hon. Minister for Health

ERC

ICCSecretariat: NPI

Committee: Finance

Core Group

Operations (NPI) Working Group

Social Mobilization Group (UNICEF)

Logistic Working Group (WHO)

Training Working

Group (EU Prime)M & E Working Group (WHO)

Zones & States

Appreciation

• The Federal Government of Nigeria wishes to extend its appreciation to the Global Alliance for Vaccines and Immunization (GAVI) for its continued support to the immunization programme in Nigeria.

• We look forward to strengthening our collaborative opportunities, especially in the area of Injection safety support.

• I wish the GAVI Board fruitful deliberations.