Impact of COVID-19 pandemic on immunization services in Nigeria; A preliminary report by Paediatric Association of Nigeria (PAN)

Background: Since the onset of the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic also known as Coronavirus disease 2019 (COVID-19) beginning in Wuhan, China in December 2019 and spreading to Nigeria in February 2020 (as well as the rest of the world), there have been enormous resultant impact on health, social, emotional and economic aspects lives and services. The disease as well as its mitigation measures have negatively affected other aspects of lives and health services. This paper aims to assess the preliminary effects on immunization services, blow the whistle and suggest measures to limit these effects. Methods: Data was obtained by interviews and use of a structured proforma from Immunization Field Experts/Consultants working with national and international agencies in four states, heads of immunization units, officers in charge of immunization centres and facility immunization records from seven sites across Nigeria. Results: There were disrupted immunization services with total absence of outreach services and campaigns, limited fixed sessions, disease outbreaks, general drop in number of immunized children. These were thought to be due to the lockdown effects, fears, rumours and panic among others. Outright routine vaccines amongst rejections were also reported. Conclusion: Reports suggest that the pandemic and its mitigation measures are affecting immunization services in terms of demand/ access (physical and economic), services and logistics with overall drop in coverage and rise in dropout rates. The effects are still unfolding. It does not appear that health facilities are monitoring and interrogating their data with a view to making specific response action plans. All stakeholders in immunization (Government, non- governmental and professional organizations, the media, traditional / religious institutions) should work to flood the mainstream / social media with positive messages on immunization; monitor immunization progress by ongoing data collection, collation, analysis, interpretation and action; actively counter rumours and anti- vaccine messages and plan for post COVID 19 intensification/ catch- up

A 4 Year Review of Neonatal Outcome at the University of Benin Teaching Hospital; Benin City

Background: Neonatal morbidity and mortality rates reflect a nation's socio-economic status; the efficiency and effectiveness of health care services. This important indicator is useful in planning for improved healthcare delivery. A four year review of neonatal outcome was therefore conducted in the special care baby Unit (SCBU) of University of Benin Teaching Hospital (UBTH). Methods and Subjects: The study was done between 2003 and 2006 and sought to review the morbidity; mortality; salvage rate of low birth weight babies and outcome of all inborn and outborn babies admitted into the SCBU of UBTH. The biodata; birth weight; sex; APGAR scores and reasons for admissions and outcome were abstracted from case notes/admission records. Result: A total of 3075 babies were admitted to the unit during the period under review. 2602 (84.6) were inborn while 473 (15.4) were out-born. There were more males 1676 (54.6). There were 855(27.8) preterm babies of which 803(26.1) were low birth weight babies. Neonatal sepsis; severe birth asphyxia; pre-maturity and neonatal tetanus were the most common morbidities suffered by the neonates. Mortality was recorded amongst 625 (20.3) babies. Mortality rate was significantly higher amongst the out-born than in born babies; P value 0.0001. Conclusion: The neonatal mortality rate in this study is high. The morbidity profile observed in the study is attributable to preventable causes. Of note is the contribution of NNT to morbidity and mortality. Strengthening of linkages in perinatal care; improving maternal emergency obstetric care and neonatal resuscitation skills are proposed measures to reduce neonatal mortality