Low routine immunization coverage rates remain a major problem in Nigeria. Over 40 percent of under-5years old deaths in the country are attributable to vaccine preventable diseases (VPDs). Furthermore, the country remains one of only three polio endemic countries in the world, alongside Afghanistan and Pakistan. Unless drastic measures are taken to improve coverage of routine immunization urgently, Nigeria cannot adequately reduce child mortality or accelerate progress towards the achievement of MDG 4 goal. (Nigeria has been declared Polio free from September 25, 2015)
In recent years, the National Primary Health Care Development Agency (NPHCDA), state governments and development partners including GAVI Alliance have taken steps to improve RI coverage in Nigeria. In 2010, DTP3 coverage reached a high of 69 percent. However, subsequent coverage surveys have shown that these gains have not been sustained.3 Results from the 2013 Nigerian Demographic and Health Survey revealed a national DTP3 coverage of 38 percent.
Several assessments and diagnostics of the RI (Routine Immunization) system have been carried out to understand the drivers of poor performance in Nigeria. One key problem that has been consistently identified in the RI program is failure of the cold chain and vaccine logistics systems. Vaccine cold chain storage capacity is inadequate at the National, State and LGA levels and almost non-existent at in health facilities. Much of the existing cold chain infrastructure is non functional due to poor maintenance.
In April 2013, NPHCDA launched a transformation of the vaccines supply chain in Nigeria, focused rapid modifications of the National operations and re-designs of vaccine flows from State cold stores to service delivery points. Towards filling some of the cold chain infrastructure gaps, NPHCDA received approval for re-programming of GAVI Health Systems Strengthening and other funds for the procurement of cold chain equipment to be deployed across the 36 states and Federal Capital Territory.
NPHCDA, State government and development partner GAVI Alliance undertook to successfully procure and install solar refrigerators between third quarter 2013 and the first quarter 2015, using re-programmed GAVI Health System Strengthening funds.