Nigeria: Partnership for Organized Immunization and Surveillance Services for Every Child's Health Activity. - Although the Government of Nigeria (GoN) has made significant effort to reduce the incidence of vaccine preventable diseases (VPD), progress remains as outbreaks continue. In 2021, there was a resurgence of Vaccine Derived Polio Virus Type 2, which the World Health Organization attributed to suboptimal population immunity. The same year, Nigeria reported over 10,000 cases of measles. Immunization rates remain alarmingly low in Nigeria. Coverage rates for Penta 3 and OPV 3, for example, are just 57% and 56%, respectively. About 44% of children nationally are not vaccinated and only 36% are fully vaccinated. The situation is worse in northern regions, where conflict has reverted progress and exacerbated pre-existing health disparities. With over eight million people in need of assistance, needs are increasing as health infrastructure deteriorates. The GoN will need to strengthen its routine immunization and primary healthcare systems, including improving surveillance capability, to halt these outbreaks. Across the country, vaccine hesitancy and misinformation also drive low demand, demonstrating the need to engage more directly with communities to boost vaccine demand and confidence. To address these challenges, Catholic Relief Services (CRS) proposes the “Partnership for Organized Immunization and Surveillance Services for Every Child's Health Activity,” or “POISED Health Activity,” a five-year, $50 million project, to support the Government of Nigeria to increase its immunization program capacity. Following an initial analysis of epidemiological data, CRS has designed POISED to intervene in five states in northern Nigeria, but CRS remains flexible to choosing final target locations with CDC after award. CRS will work with government actors at all levels, surveillance networks, healthcare workers, and communities to employ the five strategies, contributing to: increased vaccination coverage rates in a sustainable and equitable manner; VPD control, elimination, and eradication targets; and a reduction in mortality and morbidity rates from VPDs. To accomplish this, CRS has convened a strong set of both international and local partners, including Pro-Health International and Results for Development. POISED’s design leverages previous learning among its consortium members, including CRS’ work implementing the CORE Group Partners project, a 10-year, $11.5 million project focused on polio eradication in Nigeria, in close collaboration with the GoN, immunization partners, and local healthcare workers; Pro-Health International’s nearly 30 years of experience as a leading local organization committed to addressing critical health needs in remote or underserved areas, including immunization programming; and Results for Development’s leadership in the Linked Immunisation Action Network, a Gavi-funded collaborative learning network that brings together practitioners, policymakers and partners to discuss and troubleshoot common immunization program challenges. The consortium members’ experience successfully implementing large immunization and public health projects in Nigeria, deep local knowledge, and strong existing relationships with federal, state, and local governments in Nigeria will allow for meaningful collaboration with the CDC, the Government of Nigeria, and its partners to achieve the project’s outcomes.
