Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #111292

Bolaji M. Fapohunda, PhD, MEASURE Evaluation, John Snow, Inc., 1616 N. Forth Myer Drive, 11th Fl, Arlington, VA 22209, 703.528.7474, bfapohunda@jsi.com, Robert Steinglass, MD, MPH, IMMUNIZATION Basics, John Snow, Inc, 1616 N. Forth Myer Drive, Arlington, VA 22209, Abimbola Sowande, MBBS, MPH, Making Medical Injection Safer(MMIS), John Snow, Inc, Plot 858 Oshogbo Close, Area 11, Garki, Abuja, Nigeria, and Gregory E. Osubor, MBBS, Monitoring & Evaluation, COMPASS/USAID Project, Plot 1456 Hon. Justice Sowemimi Street, Asokoro, Abuja, Nigeria.

Background: As part of an overall strategy to assist Nigeria's transition to socioeconomic and political stability, USAID/Nigeria supported community-based child health interventions (routine immunization, nutrition, malaria prevention) in Nigeria between 1999 and 2003 through BASICS II project. This paper presents the program M&E approaches and demonstrates how study data catalyzed changes in the National policy on immunization that improved vaccine security in the country.

Method: Program evaluation utilized a combination of monitoring and rapid assessment approaches, including household, community, and facility-based health information systems, exit interviews, health facility assessments and household surveys. Baseline and follow on assessments of program activities yielded data to assess program outcomes.

Findings: Results showed improvements in many aspects of the program but also some outcomes that worsened, which resulted in policy changes. For example, trend analysis of immunization data from 2000, 2002 to 2003 showed that DPT3 coverage decreased by 38% on average between 2000 and 2003(p<.05). Although declines varied by State, a child eligible for immunization was 1.6 times more likely to receive DPT3 vaccination in 2000 than in 2003. Some of the changes to immunization policy engendered by data include:

• Government's senior officials became more pro-active, issuing public health statements supporting immunization quality of care at the PHC level.

• Coordination and collaboration improved among donors, partners and government agencies.

• UNICEF took over vaccine procurement from government appointed private sole suppliers.

• Private sector companies hired to handle vaccine distribution.

• Polio Supplemental Immunization Days used to promote routine immunization messages.

Learning Objectives: