1. APPLYING LESSONS LEARNED TO FOLLOW-UP CAMPAIGNS, NIGERIA
A 8th Annual Meeting of Partners for Measles Advocacy. Washington DC, USA By
FMOH/NPHCDA
- Dr. Emmanuel. I. Odu

2. Nigeria Political Map . Country State LGA Ward North West North East
Admin Levels
Country
State
LGA
Ward
Community .
North West
North East
North Central
South East
South West
South South

3. Administrative coverage results of measles Catch-up Campaign, 2005/2006; Nigeria.
North – Dec 2005
South – Oct 2006
Overall coverage; 83%
Overall coverage; 95.3%
< = 84%
85 – 94%
95 – 100%

4. SUMMARY FEATURES OF MEASLES CATCH-UP CAMPAIGN, NIGERIA; 2005/2006
Parameter
North
South
Implementation dates
06-12 Dec. 2005
03-09 Oct. 2006
Age Category involved (Measles Vaccine)
9months-15YRs
# of States &
(T-Population) 19
(29,877,057) 17
(31,630,011)
Reported Coverage
95%
83%
LGAs with => 95% Coverage.
211/419
138/355
Key Challenges

5. Measles trends, 2005-2008, Nigeria
Measles catch up
campaign
in Southern states
Measles catch up
campaign
in Northern states
2007
2008
2005
2006

6. Age & vaccination status of confirmed measles cases, Nigeria, Jan – Jul 2008 (n=8,887)

7. Surveillance
Measles case-based surveillance implemented in all states.
Good performance
rate of suspected measles cases reported with blood specimens >3 / 100,000 population, of which
>95 have had blood specimen collection, and results available.

8. Zonal location of Measles Labs; Nigeria

9. Lesson learned – 1
Government Funding. Readiness of government to provide funds.
Phased Implementation ensured optimum use of limited skilled personnel
Partnership. Technical resources in-country partners & Support international partners, including Measles Partnership – Valuable.
Involvement of other Ministries, Religious, Traditional & Community leaders – helpful.
Use of Volunteers helpful.

10. Lesson Learned – 2: Controversial population estimates
Planning. Commenced late; more time needed for micro-planning and verification
Procurement of vaccine not ‘bundled’ created logistic problems.
Delays in clearing & forwarding
Training. Quality decreased on cascading to operational levels.
Duration of implementation. Five days were not sufficient.

11. Lesson Learned – 3:
Timing of implementation. Rainy season in the south; affected vaccination activities & quality of supervision.
Late release of funds by partners.
Mobilization messages not focused on fixed post vaccination.
Coordination. Weak coordination capability at LGA level.
LLINs Integration; concept and practice need to be managed well.
Mop-up Plans. Necessary to have contingency (Mop-up) plans.
Gains registered after the catch-up campaign were not sustained throughout the country due to failure to achieve reasonable RI coverage levels.

12. 2008 Follow-up Campaigns

13. Goal and Objectives Goal
Contribute to Measles Mortality reduction by by building on the gains of 2005 and 2006 catch-up campaigns
Objective
to Vaccinate 95% of all children aged 9 – 59, months in Nigeria, against Measles (regardless of their previous immunization status) by December 2008.
To use the opportunity to deliver other CS interventions.
Scope: 36 states plus FCT

14. Interventions
Measles Vaccine: Children aged 9-59 months irrespective of previous immunization status (target coverage 95%): target population 25,348,212.
Oral Polio Vaccine (OPV): Children aged 0-59 months irrespective of previous immunization status (target coverage 95%): target population 29,821,426.
Vitamin A Supplementation: Eligible Children aged 6-59 months (target coverage 95%): target population 26,839,285.

15. Roles & Responsibilities; Key Stakeholders.
Responsibility Area
Remarks
FGN/NPHCDA
Procurement of vaccines (‘Bundled’)
50% & Operational funds.
Payment made, order placed.
States/LGAs
Cold Chain Strengthening,
Injection Safety/AEFI
Monitoring & Supervision
Provision of AEFI kits, Buckets for running water, Soap, Cups and hand towels, Waste Management.
Funding available
Partners; WHO, UNICEF, etc.
Social Mobilization, Logistics/CC, Monitoring & S
Measles Partnership.
Advocacy/Mobilization, Funding Support.
2 visits conducted

16. Planning Commenced early, 2006 Census figures used.
National POA developed > 1year ahead
National Budget prepared > 1 year ahead
Partners mobilized
International Support; MP

17. Activity Timelines, IMC 2008; Nigeria.
S/N
Date
Activity
Responsible
Comments 1
16-8 Sept.
Zonal Level Training of Trainers (TOT) on Micro-planning
National Trainers and Partner agencies’ Zonal Consultants 2
23-24 Sept.
State TOT on Micro-planning
State Officials, consultants, partners. 3
07-08 Oct.
Ward level Training on Micro- planning
LGA Team, WFPs 4
13-17 Oct.
Development of Ward Micro-plans. 5
20-22 Oct.
National TOT for Implementation
NMC, National Trainers 6
27-29 Oct.
Zonal Level TOT for Implementation 7
03-05 Nov
State Level TOT for Implementation 8
13-15 Nov
Ward Level training on Implementation
State & LGA Teams, WFps. 9
19-24 Nov
10-14 Dec
Implementation
North
South

18. Timing of Implementation & Evidence

19. Communication/IEC POA distributed to stakeholders States informed
Consultative Meetings – North & South
Information sharing
Views/inputs
IEC materials finalized.
Mobilization messages address fixed posts.
social mobilization messaging for the different target groups clarified

20. Training
Training materials and schedules are standardized for the operational levels to ensure that content and messages do not get diluted while cascading,
Lessons from previous measles SIAs are incorporated at all training levels
Mapping
part of the training and micro-planning exercises,
vaccination teams understand the operational use of these maps
to delineate their catchment areas,
for community mobilization purposes and
For Monitoring & Supervision
National & Zonal TOT for Micro-planning - conducted

21. Logistics/Cold Chain Procurement of Vaccines (MV, OPV) by FGN.
‘Bundles’ MV, Sufficient quantities ordered
Expected Date of Delivery
15/10 (for North)
24/10 (for South)
Vitamin A – available.
Syringes/Needles being cleared at the ports.
Cold Rooms & Dry Stores (National, Zonal States, LGAs).
Waste Mgt options being explored and included in Micro-plans.
Distribution Plan – in place.

22. M & E
M & E tools finalized and harmonize for the various interventions at different levels
With instructions on their use.
Training on supervision and operational support for supervision duly included in implementation training.
Strategy in place for monitoring of zero dose measles vaccine recipients outcome for
advocacy
programmatic use for strengthening RI
Planning, Implementation & Monitoring/Supervision Templates/Forms - finalised.

23. Implementation Phased. Duration – 5 days.
Scheduled for Dry Season (Nov/Dec) in both North & South.
Intervention to delivered at fixed Posts.
Supervision highly prioritized. To be addressed during implementation training. Active participation by LGA team
Supervisors/Monitors to be used extensively.
Nationwide Distribution of LLINs suspended, possibility of distributing in 2-3 States, final decision to be reached.

24. Conclusion
The Catch-up campaign implemented in Nigeria 2-3 years ago achieved significant impact on measles morbidity & mortality, in view of low disease incidence post-SIA.
Outbreak events affected unvaccinated Children < 5 Yrs.
Gaps in routine vaccination of recent birth cohorts
Gaps in campaign coverage.
Campaign coverage gaps to be eliminated with mop-ups.
Follow-up campaign to contribute to RI Strengthening.
We so value and count on your support & advice for which we ‘say thank you’.

25. THANK YOU