Nigeria is one of the remaining polio endemic countries. Nigeria’s routine immunization (RI) program is weak as is its health system. This study investigates the positive and negative impact of Polio Eradication Initiative (PEI) activities on RI and health systems in three Northern Nigerian states (Jigawa, Katsina and Zamfara) and provides recommendations to strengthen RI during and after PEI. A literature review was conducted to assess previous studies. An ecological study was then conducted using Demographic Health Survey (DHS) and Demographic Health Information System (DHIS) data to analyze differences in immunization coverage possibly linked to PEI activities.
Both DHS and DHIS show a consistently high coverage of Oral Polio Vaccine and low coverage of other vaccines given through RI. DHS data show that BCG, DPT and measles coverage has remained almost unchanged between 1999-2013. Analysis of DHIS show that PEI activity likely has had a negative impact on RI coverage in LGAs at high-risk of polio transmission and targeted by PEI. There were positive and negative impact of PEI on different elements of RI and the health system.
Nigerian is under pressure to eradicate polio and increase RI coverage. It is therefore difficult to gain a clear picture of immunization coverage. The findings confirm positive and negative impact found in the other studies and provide in-depth results for Nigeria. The literature also yielded recommendations on strengthening RI in Nigeria by building on PEI experience and addressing systemic weaknesses in RI nationwide.