Papers & Articles

Papers & ArticlesRoutine Immunization Surveys

Explaining socio-economic inequalities in immunization coverage in Nigeria


Globally, in 2013 over 6 million children younger than 5 years died from either an infectious cause
or during the neonatal period. A large proportion of these deaths occurred in developing countries,
especially in sub-Saharan Africa. Immunization is one way to reduce childhood morbidity and
deaths. In Nigeria, however, although immunization is provided without a charge at public facilities,
coverage remains low and deaths from vaccine preventable diseases are high. This article
seeks to assess inequalities in full and partial immunization coverage in Nigeria. It also assesses inequality in the ‘intensity’ of immunization coverage and it explains the factors that account for disparities in child immunization coverage in the country. Using nationally representative data, this
article shows that disparities exist in the coverage of immunization to the advantage of the rich.
Also, factors such as mother’s literacy, region and location of the child, and socio-economic status
explain the disparities in immunization coverage in Nigeria. Apart from addressing these issues,
the article notes the importance of addressing other social determinants of health to reduce the disparities in immunization coverage in the country. These should be in line with the social values of
communities so as to ensure acceptability and compliance. We argue that any policy that
addresses these issues will likely reduce disparities in immunization coverage and put Nigeria on
the road to sustainable development.

By John E. Ataguba, Kenneth O. Ojo  and Hyacinth E. Ichoku

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Papers & ArticlesReports

Cost of Routine Immunization in Nigeria


Background: With the active collaboration of development partners and governments, there have been progressive increases in immunization coverage in Nigeria, but the challenges of sustaining these gains is yet to addressed.   It is within this context that EU-PRIME[1] assisted to facilitate the establishment of an enduring and sustainable immunization financing system in Nigeria, with particular reference to the EU-PRIME focal States.  At the Local Government Area level, effective resource mobilization is constrained by lack of detailed cost estimate of immunization services in Nigeria.  This study was therefore, commissioned by the EU-PRIME in collaboration with the National Primary Health Care Development Agency (NPHCDA) to determine the cost of a fully immunized child in Nigeria. The outcome of the study would provide evidence on resource needs, availability and gaps; which are required for planning an appropriate and sustainable immunization financing strategy beyond the lifespan of the EU-PRIME Project.  The objectives of the study are to:

  1. Determine the total cost per fully immunized child in Nigeria.
  2. Develop cost projections for routine immunization at federal, EU-PRIME focal states[2] and LGAs from 2007 to 2010.
  3. Analyse the current and anticipated financing of routine immunization at all levels against projected costs, determining funding gaps and their implications for routine immunization at national, EU-PRIME focal states and the LGAs.

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 Kenneth Ojo, Centre for Health Economics and Development, Abuja, Nigeria
Ibrahim Yisa, Partnership for Transforming Health System II, Abuja, Nigeria
 Adedoyin Soyibo, Health Policy Training And Research Programme Department of Economics, University of Ibadan, Ibadan, Nigeria
 Lekan Olubajo, National Primary Health Care Development Agency (NPHCDA)
Paul Schoen,  Economic Development Group, Hubconsult Ltd, UK


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