Ondo, 8 July, 2022 - In a bid to shore up vaccination coverage and give eligible children second chance to be fully vaccinated, WHO is working with Ondo State to implement targeted interventions with the aim of reducing missed opportunities for vaccination (MOV).

 ‘I was given this coupon after I delivered my baby in a private facility, my baby has now received vaccines preventing tuberculosis, hepatitis B and polio”, says  Mrs. Elizabeth Adeniran

The mother of two had previously missed the opportunity to get her eligible children vaccinated even though she had regularly visited the health facility in her locality for treatment of minor ailment, always with her children.
Mrs. Adeniran is a beneficiary of the MOV reduction strategy which is based on a system through which any child/person eligible for vaccination who comes to a health facility/mobile health service (for whatever reason) receives the needed vaccines during their visit.

Presently, the package of interventions to reduce MOV in Ondo include provision and training on the use of job-aids, such as an immunization wheel, posters, immunization schedule, and referral coupons for screening of vaccination cards and referral of eligible children for vaccination which are being piloted in three Local Government Areas (LGAs) (Akure South, Odigbo, and Owo) in Ondo State. Officers from the State Government, and District health teams have been trained as facilitators to cascade training at the health facility level. 
Other strategies employed by Ondo State to close the coverage gap include the transmission of media channels such as bulk SMSs, Radio and TV jingles, video recordings aimed at sensitizing mothers to retain vaccination records. Monthly stakeholder meetings comprising all state and LGA actors are also held to provide technical support and brainstorm on strategies to improve the intervention.

The MOV became necessary because in Ondo, one of the six states in South West Nigeria, routine immunization coverage over the past two years had stagnated. Based on the trends from the Districts Health Information System (DHIS-2) platform, NICS, Multiple Indicator Coverage Survey (MICS) and Lots Quality Assurance Sampling Survey (LQAS) immunization coverage is below the national and global acceptable level of ≥ 90% 

Following this negative fallout, the State with technical and funding support from WHO engaged and trained over 2,014 health workers – 619 vaccination personnel and 1,395 non-vaccination personnel from 200 public and private health facilities, drawn from the three priority LGAs to implement targeted activities.

One of the participants in the training, Mrs Caroline Akinboboye a vaccination personnel in Akure South district said, “As the routine immunization focal person in Comprehensive Health Centre Arakale, I have been practicing for over 16 years…the MOV training has improved my knowledge on what to do when immunization doses are delayed, especially in the second year of life.” 

Another clinician, Mrs Helen Ogunniyi, a maternity nurse who has been working for about 8years commented thus: I have gained knowledge on checking for vaccination status, I have personally referred more than 20 clients from the maternity unit to the immunization clinic to be vaccinated since being trained’. 

Speaking on preliminary results of the intervention, WHO State Coordinator, Dr Dele David says, “Since intervention implementation began in October 2021, a total of 2, 348 children aged 0-23 months have been identified and caught up on missed vaccinations. A screening exercise also found that 99% of children referred, have completed the circle of recommended vaccinations.” 

In a mid-term review meeting held on June 23, 2022, to identify best practices and strengths, determine persistent gaps/challenges and lessons learnt, Ondo Director of Disease Control & Immunization, OSPHCDA, Dr Victor Akinpelumi Adefesoye, said, “I am very much interested in this intervention, and I appreciate all stakeholders, including WHO,  for ensuring that this is being successfully implemented. We can see how far we have gone and will do much better in the coming months.” 
Vaccination is a key component of primary health care and an indisputable human right. WHO will continue supporting Ondo to run the structures put in place to improve and strengthen routine immunization in the State.  

Technical Contacts:

DELE DAVID, Sunday Omoniyi; Email: abidoyes [at] who.int (abidoyes[at]who[dot]int)
DOSUMU, Modupeola Oluwakemi; Email: dosumum [at] who.int (dosumum[at]who[dot]int)