By Rakiya A.Muhammad
To help address the pervasive issue of children not receiving any vaccinations and communities being overlooked, there is now a greater emphasis on monitoring the funding allocated for immunisation, ensuring accountability, and sustainability.
Despite notable advancements in vaccine coverage, the issue of zero-dose children—children who did not receive any routine immunizations—remains a global concern.
The 2023 State of the World’s Children report shows that 48 million out of 67 million children who missed routine immunisation between 2019 and 2022 did not receive a single regular dose.
Zero-dose children account for nearly half of all vaccine-preventable fatalities, according to the United Nations Children Funds (UNICEF).
The data show Nigeria has over 2 million unimmunized children, and Sokoto is one of the states with many of them.
As of December 2022, 122,015 children had not received a single dose of any vaccine on the Routine Immunisation Schedule in Sokoto, with the majority of zero-dose children living in 13 local government areas: Bodinga, Dange Shuni, Gada, Goronyo, Gwadabawa, Kware, Rabah, Sabon Birni, Shagari, Sokoto South, Tambuwal, Wamako, and Wurno.
Against this backdrop, the African Health Budget Network, AHBN, in collaboration with the African Epidemiology Network, AFENET, is implementing the Zero-Dose Learning Hub in Nigeria and has established Communities of Practice (CoP) on Immunisation Budget Tracking, Accountability, and Sustainability to curb the number of zero-dose children in Sokoto, Bauchi, Borno, and Kano.
Mallam Umar Kadi, the focal person for AHBN Sokoto State, explains that the CoP will support the state governments in accelerating progress in improving immunisation coverage, particularly in reaching zero-dose children, by influencing budgetary allocation, releases, and utilisation through advocacy to demand accountability and transparency.
He notes various concerns, including poor immunisation coverage and the high number of zero-dose children in Sokoto State, inadequate funding (budget allocation, release, and cash backing) for the state’s immunisation programme, and a suboptimal fiduciary management system.
Mallam Kadi also identifies system-related factors that contribute to suboptimal childhood immunization, such as poorly arranged and coordinated services, vaccine stocks, and logistical issues.
He emphasises the need for the Community of Practice on Immunisation Budget Tracking, Accountability, and Sustainability to reach zero-dose children and neglected communities.
“Implementation of the Community of Practice in Sokoto State will support the state government and its immunisation partners to continuously analyse and track immunisation budgets based on greed indicators in line with the state-level accountability framework and the state-level MoU targets,’ the AHBN official points out.
“The Community of Practice will also review challenges and proffer key recommendations supporting accountability and transparency amongst state-level partners.’
He pledges their support to the Sokoto government through the CoP to enhance the performance of the state budget for immunisation and, by extension, improve immunisation activities and coverage.
Similarly. Nurudeen Aliyu, team head of the African Epidemiology Network (AFENET) Sokoto, underscores the importance of a community of practice involving multiple stakeholders to monitor the immunization budget, hold officials accountable, and ensure long-term funding and program sustainability for improved immunization coverage in Nigeria, particularly reaching zero-dose children.
He expresses their commitment to ensure that all necessary measures are implemented for the benefit of children aged 0 to 5 years.
Dr. Larai Aliyu, Executive Secretary of the Sokoto State Primary Health Care Development Agency, lauds the initiative, noting that it will provide the state with evidence and advocacy to continue strengthening engagement with its partners and state-level civil society organisations (CSOs) to enhance immunisation coverage.
She believes by ensuring that every child in Sokoto State receives a full immunisation, CoP will contribute to the elimination of zero-dose phenomenon.
For his part, Mallam Ibrahim Yusuf, the CSO Co-Chair of the Community of Practice, makes case for prompt funding releases.
“As the Civil Society leader, I encourage the Sokoto State Government to always ensure the timely release of agreed funds signed in the MoU to promote budget performance, which will positively impact zero-dose children.”
He urges stakeholders in the Community of Practice to promote budget tracking, accountability, and sustainability.
State officials (State Primary Health Care Development Agency and Local Immunisation Officers), civil society organisations, academia, journalists, persons with disabilities, community structures (traditional and religious leaders), ward development committees, and community-based organisations make up the CoP.
