***I Go 6km On Motorbike To Get My Child Immunized – Caregiver
KANO (North-West, Nigeria) — Away from the old practice in her Jandu community, a hard to reach area in Kiyawa Local Government area of Jigawa State, where caregivers don’t take their infants for immunization, Zakiya Nasiru, a mother of one, Muhsin – 4months old, said she now travel 6km on motorbike to get her only child, immunized.
Zakiya, holding on to her infant at the Andaza PHC in Kiyawa LGA, Jigawa State shares her story with this paper while waiting patiently on queue for her turn to get her only child immunized.
She said she got to know about the live saving vaccine through her ward head and health ambassador, and already feeling the impact as her baby is now growing healthy.
She said having realized the benefit of the immunization to the health of her baby, she hardly forgets immunization days of her baby.
“I came from Jandu, I traveled about 6km and over one hour thirty minutes ride on motorbike from the hard to reach area. I spend up to N1,000 as transport fare.
“I got to know about the immunization through our Health Ambassador (Ward Head). When the day for immunization is drawing nearer, he comes around to remind us but I hardly forget about the day because of the importance and benefit to the health of my child.
“And I see the impact on the health of my child because it work against any form of diseases. That has reduced drastically.
“Although, an NGO is supporting us by giving us N1,000 any time we bring our baby uptil the 5th time and on the last round we will be given N5,000. I don’t come because of the money but because of the health and well being of my child and myself.
“We will still find people who don’t bring their babies for immunization but they are very few. A lot of caregivers were now enlightened and make their children available for the routine immunization,” Zakiya said.
Thanks to the Jigawa Health Ambassadors, also known as “Jakada Lafiya” in Hausa, for their efforts which is bending the curve of routine immunization and uptake in Jigawa State.
Before the Health Ambassadors initiative, immunization coverage in Jigawa was alarmingly low, at just 7% according to the Multiple Indicator Cluster, MIC survey 2016.
Worried by this indices, the Jigawa State government rolled out the special initiative, Health Ambassadors to turn around the ugly trend.
The Health ambassadors were engaged to record the names and immunization status of all new born children in their area. After every immunization session at the health facility they update their registers and identify any children who have missed out on their routine vaccinations and get them immunized.
***Hesitant Parents Now Trooping Out To Get Their Wards Immunized – Health Ambassadors
Mamman Wada, is a dedicated Health Ambassador in Andaza area, Kiyawa Local Government area of Jigawa State, who travels through rugged terrain to reach remote communities.
His mission is to educate parents and caregivers on the importance of immunization and ensure their children receive life-saving vaccines, noting that his efforts and that of his team is recording success as hesitant parents and caregivers now accept to avail their wards for immunization.
Wada said he sacrificed his time doing what he is currently doing as health ambassador because he wants healthy children in his community.
“As Health Ambassadors, we usually go and register all our new born child and ensure they are up to date in the immunization. We do have a monthly review meeting between us and the Routine immunization, R.I providers to compare our notes to ensure no missing child.
“We also collaborate with the Traditional Birth Attendant, TBA who took birth of new born babies in their houses. So we use to check for children who skip the immunization and go house to house in search of such caregivers to educate them on the importance of immunization.
“Some of them in the rural areas are not educated and most of their husband refuse them to bring their children for immunization. So we go and educate them on the importance of the immunization to prevent their children from diseases such as meningitis, yellow fever among others and they are now giving us maximum cooperation. Those who are hesitant before are now accepting to bring their children for the immunization.
“I sacrifice my time to do this for my community because I want all the children in my community to grow up healthy.
“We now have more than 80% of caregivers coming with their children for immunization unlike before where we have like 40%.
“Last two months, we received more than 87 new born babies in this facility which is as a result of efforts of the health ambassadors and town crier to the caregivers to avail their children for immunization,” Wada said.
Similarly, another Health Ambassador in Sakwaya area, Dutse Local Government area who doubles as the Ward Head of Yarsadauje, Suleiman Badaru said to build the confidence of the caregivers against any form of myth, misconception and misinformation about the routine immunization, they also avail their wards for immunization.
“Initially and before we were engaged as health ambassadors, we as traditional leaders educate our wards on their well being and that of their children.
“We go about spreading the gospel message on the importance of immunization in places such as streets, house to house, houses of naming ceremony, wedding ceremony, our mosque among others to avail their children to the facility for immunization.
“Before we record issues around misconception that when people bring support of this nature it has a purpose and side effect. But we are able to change their mindsets and you now find people struggling to get their child immunized.
“We avail our children for the immunization as well to build the confidence of the caregivers that the immunization is safe,” he said.
However, to compliment the efforts of the Health Ambassadors, the midwives were also trained and provided with a befitting accomodations to ensure they render 24 hours service delivery to health seekers and caregivers who brought their children for immunization.
A Registered Nurse and beneficiary, Eucharia Anyansi said they receive more caregivers who troop in with their children for immunization and they counsel them on follow up for the benefit of their children.
Corroborating Anyansi, the Incharge of Sakwaya PHC, Dutse Local Government area, Hassan Zubair gave a breakdown of the progression recorded in the facility with regards to routine immunization coverage as it recorded 49% in June while it rose in July and August to 55% and 59% respectively.
Jigawa state is one of eight states in Nigeria supported by the UNICEF and GAVI MOU project to significantly strengthen health systems at PHC.
***How We Jerk Up Immunization Coverage By 700% – Jigawa State Official
The Jigawa State government through the Permanent Secretary, Ministry of Health, Dr. Kabiru Ibrahim said the state has jerked up it routine immunization coverage by 700 per cent through the Jakada Lafiya initiative and other partner interventions.
Dr. Kabiru who was represented by the Director, Dr. Shehu Sambo said based on the Multiple Indicator Cluster, MIC survey in 2016, the immunization in the state was 7 per cent but has now attained 49 per cent based on the MIC survey 2021 and still aiming higher as it awaits the 2026 MIC survey.
He said based on the initial poor indicator, the state government entered into a Memorandum of Understanding, MoU which is yielding positive results with the successes recorded in the Routine immunization coverage in the state.
According to him, “Jigawa State is one of the eight states that has entered an PHC MoU agreement with GAVI to strengthen the health system especially at the Primary Health Care level. From 2018 to 2019.
“There were pillars we intended to strengthen which includes, Service delivery on immunization among others. The main focus is routine immunization. Our coverage for routine immunization before the MoU was very low. In 2016, Multiple Indicator Cluster Survey, MICS conducted shows that the state has Penta 3 coverage of 7%.
“So the agency which was created newly around that period was saddled with responsibility to come up with initiatives to change the narrative. Along that period, the MoU came with funding. And so we came up with numerous initiatives such as Jakada Lafiya innovation, State outreach of immunization among others to help us reach those children assessing the fund from GAVI.
“In each village or polio settlement, one person is nominated to serve as Jakada Lafiya. And we did that through the five Emirs of Jigawa State. Their duties are: To record any child birth that occurred in community and link them up to the service provider of routine immunization. To record any usual pattern of disease occurrence as well as any maternal mortality in the community. They should cooperate with any health care. And every month, they seat down with the health workers for reconciliation meeting.
“So the Jakada Lafiya platform is the last mile demand creation platform for us in Jigawa State that is unmatched anywhere in Nigeria.
“Luckily for us when the 2021 MICs came, we jerk up 700 per cent increase. We had 49% from 7%. Although for us as an agency we were a bit disappointed because we thought we will reach like 70% to 80% because of the rigour of how we were actually working in the community. But 700 per cent increase is an add up in Jigawa. We never had double digit immunization coverage in Jigawa not until we had all these funding from partners. So we are trying to build on the 49% leveraging on the MoU,” Dr. Kabiru said.
***Our PHC MoU Is A Game Changer – UNICEF
On his part, the Chief of Health, UNICEF, Nigeria, Dr. Eduardo Celades Blanco described the PHC MoU project that as a game changer, stressing that PHC is important because 90 per cent of diseases can be treated at the PHC.
He said based on the importance attached to the PHC, the fund is working to strengthen primary healthcare in Nigeria, particularly in Jigawa State as it has invested over 2 billion naira in Jigawa to support the government’s efforts to extend primary healthcare services to underserved communities.
“Primary healthcare is the foundation of a country’s healthcare system, providing essential services to millions of people. In Nigeria, primary healthcare is the cornerstone of the health sector, treating 90% of diseases and preventing others through services like vaccination and immunization. However, despite its importance, primary healthcare in Nigeria is weak, facing numerous challenges that hinder its effectiveness.
“One of the biggest challenges facing primary healthcare in Nigeria is insufficient funding. The government’s investment in primary healthcare is limited, resulting in inadequate resources, including health workers, equipment, and infrastructure. This shortage of resources makes it difficult for primary healthcare centers to provide quality services, leading to poor health outcomes.
“Another challenge facing primary healthcare in Nigeria is poor data collection and management. Accurate data is essential for planning and decision-making in healthcare, but in Nigeria, data collection is often inadequate, making it difficult to track progress and identify areas for improvement.
“A shortage of health workers is also a significant challenge facing primary healthcare in Nigeria. The country faces a brain drain, with many health workers leaving to work in other countries. This shortage of health workers makes it difficult for primary healthcare centers to provide quality services, leading to poor health outcomes.
“UNICEF is working to strengthen primary healthcare in Nigeria, particularly in Jigawa State. The organization has invested over 2 billion naira in Jigawa, supporting the government’s efforts to extend primary healthcare services to underserved communities.
“One of the key areas of focus for UNICEF in Jigawa is immunization. Immunization is a critical component of primary healthcare, preventing millions of deaths each year. In Jigawa, UNICEF has supported the government’s immunization programs, resulting in a significant increase in immunization coverage.
“In addition to immunization, UNICEF is also supporting other primary healthcare services in Jigawa, including maternal and child health services,” Blanco however stated.
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