Planning for supplemental immunization activities using the readiness assessment dashboard: Experience from 2017/2018 Measles vaccination campaign, Nigeria.

INTRODUCTION: Globally, supplemental immunization activities (SIAs) are known to be a major strategy for attainment of the global measles elimination goal of less than one measles case per million population within a geographic area by the year 2020. Adequate planning is critical to the success of a vaccination campaign. To achieve a quality SIA implementation for effective interruption of measles transmission, the World Health Organization introduced the SIA Readiness Assessment Tool, which includes the readiness dashboard. It is a strategic planning tool used to ensure critical activities are completed before SIAs. Nigeria implemented a phased measles SIA in 2017/2018 and used the readiness assessment tool in the planning for the campaign. In this article, we report the use of the readiness assessment dashboard in the 2017/2018 measles SIA, we also reviewed its contributions to the outcome of the campaign looking at the post campaign coverage survey results for the states. METHODS: We conducted a retrospective review of the readiness assessment dashboard used during the 2017/2018 measles vaccination campaign in Nigeria. The readiness dashboard tool was designed using Microsoft Excel 2016. We reported results in frequencies and proportions using charts and tables. RESULTS: The states with 100% readiness a week prior to the campaign scored a post campaign coverage survey result of 84.6 - 96.5% with just one out of the eight states in this category getting a score below 90%. In the same vein, of the eight states that their readiness score at one week to the campaign was below 85%, six had post campaign coverage survey score of less than 90% with the highest score in this category being 92.3%. Some states with good readiness scores also had poor post campaign coverage survey which has been attributed to other factors other than readiness. CONCLUSION: The readiness assessment dashboard for the measles vaccination campaign provided a platform for tracking states readiness. It is our view that a link between readiness assessment and coverage should be examined in future studies.

The challenges of insecurity on implementing vaccination campaign and its effect on measles elimination and control efforts: A case study of 2017/18 measles campaign in Borno state, Nigeria.

Conflict has a negative effect on immunization outcomes leading to epidemics of measles and other vaccine preventable diseases. Borno state, located in the North-Eastern parts of the country, started experiencing insurgency since 2009 by a militant group commonly referred to as "Boko Haram", leading to displacement of numerous persons from their homes. The state government created internally displaced persons (IDPs) camps with an estimated 600,000 persons and over 100,000 children aged 9 - 59 months. We explored the challenges in implementing the measles campaign in 2017 and its effect on measles elimination and control efforts in Borno State. METHODS: We conducted a retrospective review of the measles surveillance data from the Integrated disease surveillance and response (IDSR), the early warning alert and response system (EWARS), Measles SIA implementation strategy reports and the Post campaign evaluation survey data. RESULT: Seven (26%) of the 27 LGAs had security challenges in Borno state in November 2017. Following the measles campaign, 30 EAs were surveyed as part of the post campaign evaluation with a coverage validation of 72%, the lowest reported state level coverage in the country. Reported measles cases in the age cohort <1Year increased in 2018 by 14.3% compared to 2017. CONCLUSION: Despite the security challenges in Borno state, the 2017 measles SIA was conducted with the post campaign evaluation highlighting some areas of suboptimal performance. There remains a need to review the required strategies for successful implementation in Borno and other states affected by security challenges. The reestablishment of holding camps and vaccination posts at all entry points into IDP camps and host communities to ensure new entrants are screened and vaccinated with the measles vaccines, as has been successful in the polio programme in Nigeria will promotes efforts towards Measles control in the state.