Maternal and Child Survival Program (MCSP) Nigeria ~ Routine Immunization Program Year 4 Annual Report

Agency for International Development (USAID) cooperative agreement aimed at introducing and supporting high-impact health interventions in 24 priority countries, including Nigeria. The ultimate goal of MCSP is to prevent maternal and child deaths. The program engages governments, policymakers, private sector leaders, health care providers, civil society, faith-based organizations, and communities in adopting and accelerating proven approaches to address major causes of maternal, newborn, and child mortality. MCSP has launched multiple activities in Nigeria, including a routine immunization (RI) technical assistance program in Bauchi and Sokoto States. The program aims to strengthen the RI system to increase and sustain immunization coverage and reduce childhood illness and death. MCSP/Nigeria provides strategic technical support at the national level and at scale across all of Bauchi state's 20 Local Government Areas (LGAs) and Sokoto's 23 LGAs. The program objectives of MCSP/Nigeria RI are to support State-led and State-owned efforts to achieve >80% RI coverage in every ward of Bauchi State by the end of December 2017, and in Sokoto State by the end of December 2018. The program also aims to support State-led and State-owned efforts to expand the availability and quality of RI services by providing technical assistance in the areas of capacity building and training, supportive supervision, monitoring and use of data, supply/cold chain, and community engagement. MCSP/Nigeria RI has been supporting implementation of the Bauchi SPHCDA's quadripartite RI strengthening memorandum of understanding (MOU) since January 2015, and the Sokoto SPHCDA's quadripartite RI strengthening MOU since October 2015. The program has been tasked by each state's SPHCDA, and by the three remaining MOU signatories—USAID, the Bill & Melinda Gates Foundation (BMGF), and the Dangote Foundation—to provide four areas of technical assistance: 1) monitoring and use of data; 2) supportive supervision (SS); 3) community partnership; and 4) capacity building and training. The program has made significant progress in achieving its objectives. In Bauchi State, the program has supported the implementation of the quadripartite RI strengthening MOU, which has resulted in an increase in RI coverage from 55% in 2015 to 75% in 2018. In Sokoto State, the program has also supported the implementation of the quadripartite RI strengthening MOU, which has resulted in an increase in RI coverage from 45% in 2015 to 65% in 2018. The program has also made progress in providing technical assistance in the areas of capacity building and training, supportive supervision, monitoring and use of data, supply/cold chain, and community engagement. The program has provided training to over 1,000 health workers in Bauchi and Sokoto States, and has supported the implementation of supportive supervision in all LGAs in both states. The program has also made progress in community partnership and engagement. The program has established community-based health volunteers in all LGAs in Bauchi and Sokoto States, and has supported the implementation of community-based RI campaigns in all LGAs in both states. The program has also made progress in monitoring and use of data. The program has established a data management system in all LGAs in Bauchi and Sokoto States, and has supported the implementation of data-driven decision-making in all LGAs in both states. Overall, the program has made significant progress in achieving its objectives and has contributed to the improvement of RI coverage and quality in Bauchi and Sokoto States. The program has also established a strong foundation for sustainability and has laid the groundwork for continued progress in the future. The program has also faced several challenges, including inadequate funding, lack of capacity, and inadequate infrastructure. However, the program has been able to overcome these challenges through the provision of technical assistance and support to the state governments and other stakeholders. The program has also made several recommendations for the final quarter of project implementation, including the need for continued technical assistance and support to the state governments and other stakeholders. The program has also recommended the need for increased funding and resources to support the implementation of the program's objectives.