Routine Immunization: We’re Committed To Aligning Our Programmes With Nigerian Laws, Policies – INGO Assured

By Joseph Edegbo

An international NGO, New Incentives – All Babies Are Equal Initiative has assured that it will continue to align its programs with Nigerian Federal and State laws and policies, including routine immunization plans and priorities.

It will also continue to support demand creation and other components of routine immunization in the four States of Katsina, Sokoto, Zamfara and Jigawa, as well as the national level

The assurance is contained in a Communique issued at the end of a Joint Stakeholders meeting in Kano, co- hosted by the States Primary Health Care Agencies.

The Stakeholders identified Immunization as one of the most effective public health interventions, saving 2 to 3 million lives yearly (WHO) and there is evidence that suggests a 27 percentage points increase in the likelihood that children would be fully immunized by a conditional cash transfer for routine immunization program (NI-ABAE RCT Impact Assessment 2017-2020).

According to the Communique, the Stakeholders agreed to provide New Incentives – All Babies Are Equal Initiative the necessary support to expand the conditional cash transfers for routine immunization programs to more LGAs, health facilities, and infants.

The meeting which was a build up from the earlier one held last May, also stated that health authorities in the four States agreed to greater ownership of the conditional cash transfers for routine immunisation program, confirming that the program is in line with its routine immunisation and public health plans and priorities.

Other resolutions by the Stakeholders are that New Incentives – All Babies Are Equal Initiative will among others:

○ Continue to provide transparent and regular updates to all stakeholders; and

○ Provide support on routine immunisation, health, and social protection.

• The State Ministry for Health, through the office of the Commissioners of Health, will

○ Continue to provide the needed support to NI-ABAE programs at all levels;

○ Facilitate meetings between the Governors of their State and NI-ABAE representatives;

○ Encourage the Governors of their States to present the NI-ABAE program gains and successes at the federal level; and

○ Engage the Governors to speak to the relevant national health stakeholders to support the NI-ABAE program before the end of the 3rd quarter of 2021.

• The State Primary Health Care Development Agencies through the office of the Executive Secretaries will continue to support and defend the NI-ABAE program at all levels, provide the needed support to ensure the expansion of the NI-ABAE program to at least 35 LGAs in Katsina, Jigawa, Zamfara, and Sokoto States (to exceed this target), ensure adequate vaccine supply and health worker discipline in all health facilities, engage all relevant state actors to ensure successful conditional cash transfers programming, ensure accountability among health workers, and correct reporting of vaccine utilisation. In addition, they agreed to assess their cold chain facility status and request improvement to ensure vaccine efficacy.

NEXT STEPS

• Facilitate meeting between NI-ABAE and the State Governors – Zamfara & Sokoto SMoH
• Advocate to Governors of the benefiting state to arrange meetings among themselves to share success stories as well as challenges as it relates to immunisation coverage.
• To ensure uninterrupted vaccine supply so as to avoid continuous vaccine runout and stockout at the Clinics/LGAs – Zonal NPHCDA, All States SPHCDA
• Continue to support NI-ABAE’s CCT program in order to improve routine immunization coverage – All Implementing States SPHCDA
• NI-ABAE to develop a sustainability framework in collaboration with implementing states to be presented in the next meeting”, the Communique concludes

The Meeting had earlier given a vivid back ground of the International NGO and its program as well as the indepth discussion by the Stakeholders

1. Organization and Program: New Incentives (NI) is an international non-government organization that aims to reduce child mortality through cost-effective and evidence-based health interventions. In Nigeria, the organization operates as the All Babies Are Equal Initiative and implements the conditional cash transfers (CCT) for routine immunization (CCTs for RI) program.
2. Program Components: The flagship CCTs for RI program operated by ABAE disburses cash incentives to caregivers conditional on infants receiving four vaccines: BCG (against tuberculosis), PENTA (against diphtheria, tetanus, whooping cough, hepatitis B and Haemophilus influenzae type b), PCV (against pneumococcal disease), and MCV (against measles).

These vaccinations are part of the routine schedule for infant immunizations in Nigeria and are provided at no cost to the caregiver through government-supported clinics. Upon confirmation of their infant receiving a vaccine, the caregiver receives ₦500 for the first four routine immunization visits and ₦2,000 for the fifth visit.

The cash transfers compensate for transport, lost trading income, and waiting time while creating behavioural change through awareness of routine immunizations.

3. Evidence of Impact: The CCTs for RI Program has been implemented in the states of Katsina, Zamfara, 2017 while Jigawa in 2018. To date, the program has enrolled over 390,000 infants whose caregivers have received over 1 billion naira in conditional cash transfers. An independent impact assessment of NI-ABAE’s CCTs for RI program (2017 – 2020) found that the program increases the likelihood that children would be fully immunized by 27 percentage points, and increases rates of individual vaccinations by 14 to 21 percentage points.

Beyond vaccination, the assessment found that the program contributed to improved knowledge about vaccination among caregivers in the catchment areas served by the program.

4. Partnerships: The New Incentives – All Babies Are Equal Initiative (NI-ABAE) works closely with the State Ministries of Health (SMOHs), State Primary Health Care Development Agencies (SPHCDAs), and State Emergency Routine Immunization Coordination Centers (SERICCs) in Katsina, Zamfara, and Jigawa States. These partnerships help to improve demand generation for routine immunization and other supply-side supports for the routine immunization system.

5. Future Plans: NI-ABAE has received commitments of over $29 million of funding over the next 3 years to reach over 1 million caregivers and their infants in Jigawa, Katsina, Zamfara, and Sokoto States. This covers expansion to 35 LGAs with continued operations through Dec 2023.

ABOUT MEETING

• A meeting of stakeholders of the NI-ABAE program in Katsina, Jigawa, Zamfara and Sokoto States was held on 16th September, 2021 at the Tahir Guest Palace, Kano State. A total of 33 participants were in attendance, including:
  • a. Commissioners of Health from Katsina and Sokoto States, HC Women Affairs Katsina State,
  • Permanent Secretary of SMOH Jigawa and his counterpart from Zamfara State,
  • NPHCDA North West Zonal Cold Chain Officer,
  • Directors of Health Planning, Research and Statistics of the SMOHs from Katsina, Jigawa and Zamfara
  • Executive Secretaries of SPHCDAs Katsina, Zamfara and Jigawa,
  • Primary Health Care Directors of SPHCDAs
  • Program Managers of SERICCs in Jigawa, Katsina and Zamfara States.
  • media organizations, NI-ABAE Government Relations Advisors, and staff from NI-ABAE.

2. The meeting was Chaired by the Commissioner of Health, Katsina State, moderated by the Stakeholder Relations Director of NI-ABAE, and supported by the PRO Katsina SPHCA.
3. The objectives of the meeting were to provide programmatic updates and expansion plans to stakeholders, obtain their buy-in into the next phase of expansion, and agree on joint-mission strategies to resolve the mixed levels of support for the program at the national level.

4. The meeting received stakeholder relations and program updates with ongoing and future expansion plans from NI-ABAE’s Stakeholder Relations Director and Operations Coordinator. The Health Commissioners and Executive Secretaries made presentations that spoke to the meeting agenda. General discussion ensued followed by a resolution and presentation of the communique to the media.