1. Lora Shimp Senior Technical Officer – Immunization John Snow, Inc / MCHIP Learning from Polio Eradication: Community involvement in reaching under-immunized in northern Nigeria Acknowledgement of slides from: Nigeria NPHCDA; USAID’s JSI/ TSHIP project

5. Nigeria national data: cumulative routine immunization coverage for all antigens 2005-2010 Source: Routine Administrative Reports

6. 2005 = 32% 2007 = 59% 2006 = 49% 2005-2010 Routine OPV3 performance at state level Source: Routine Administrative Reports 2008 = 57% 2010 = 69% 2009 = 63% <50% 50-79.9% 80-90% >90%

7. Intensified Ward Communication Strategy Phase 1 (since Nov) Phase 2 (from Jan) Phase 3 (from Feb) Repeat for each round

8. Example: progress in resolving persistent non compliance with a tailored package of interventions Source: IPD Tally Sheet data

9. Trend of children immunized with OPV during IPD Rounds by month in Sokoto State (Jan – Mar 2011) Note: Field reports showed vaccine shortage during Immunization Plus Days (IPDs) in January, resulting in lower coverage compared to February and March. However, the state has been immunizing children above target ( 857,167 estimated children < five in 2011) in every IPD round since the beginning of the year.

11. Summary of traditional leader involvement in monitoring SIAs in Sokoto – Jan to March 2011 Total # Wards in state: 244 Total infants < 12 months: 171,433 Source: TSHIP Record Month Number of Sultanate/Emir in the LGAs Number of Sultanate/Emir involved during this round of IPD Number of district head in the Ward Number of district head involved during this round of IPD Number of Village head in the Ward Number of Village head involved during this round of IPD Number of Settlement head in the Ward Number of Settlement head involved during this round of IPD January 1 0 21 17 177 162 2020 1012 February 1 0 21 18 177 163 2020 1497 March 1 0 21 14 177 132 2020 921 Average 1 0 21 16 177 152 2020 1143

12. Settlements, households and children involved in non-compliance during IPD rounds in Sokoto from January-March 2011 The chart beside shows the number of children involved and resolved in non-compliance during IPD rounds in Jan - March 2011 (Source: TSHIP record – Eight LGAs only)

13. Who helped to resolve non-compliance cases? N= sub-sample of 360 Month # of traditional leaders involved # of LGA task force involved # of Women leader involved # of Community Influencer involved # of political leaders involved # of Religious leader involved January 663 18 67 77 33 172 February 692 17 17 140 24 131 March 755 25 17 213 27 286 Total 2,110 60 101 430 84 589

14. Activities conducted Jan-Mar 2011 Activities January February March Total # of ward coordination meetings planned 105 85 104 294 # of ward coordination meetings Held 89 75 88 252 # of community meetings planned 97 62 85 244 # of influencers’ meetings planned 30 22 42 94 # of influencers’ meetings held 23 18 32 73 # of mosque/church announcements planned 1004 1026 1013 3043 # of mosque/church announcements held 773 821 924 2518 # of RI sessions planned 480 469 468 1417 # of RI sessions supported 194 185 196 575

15. SIA Quality in Polio High Risk States Proportion of wards with >10% Missed Childre n Source : Enhanced Independent Monitoring

16. States with reduction in number of under-immunized (DTP3) – comparison of 2009 and 2010 No of un-immunized

18. Thank you!