Engaging Policy Makers and Stakeholders on Sustainable Vaccine Financing in Imo State and Increasing Demand Creation for Immunisation in four Pilot Target Communities in Ehime Mbano LGA Imo State Nigeria

Period Covered: October 15th – 15th December 2017

This is an extract from the activity report sent to the funder at the end of the project. We implemented this project with Better Community Life Initiative (Lead Partner).

“I could not pay the sum of 200 naira demanded of me to get my daughter immunized at the primary health care” – feedback from Dioka Nzerem

“A child was immunized and he died that is why most mothers do not take our children for immunization” feedback from Umueze 1

Project objectives:

• Overall objective:  To sustain vaccine financing on the national/ state levels and strengthen household/ community -driven vaccine demand in Nigeria to improve maternal/ child health and economic prosperity in the area.

• Specific objectives

• To urge the Federal Government to expand the federal vaccine budget


• To urge states to cost share with the federal government on central procurement of vaccines.


• To urge State government to provide sufficient budget line for immunization.


• To mobilize the 4 target communities to access immunisation for their women and children.

The vision of the project is to achieve 100% immunization coverage and demand uptake by mothers.

To achieve the 4 specific objectives we embarked on the following activities – Advocacy meetings with National/State & Community stakeholders to get their positive attitude towards immunization as a key component of primary health care which is to be made accessible to all despite the location, gender, creed, age and other factors.

We carried out an in depth advocacy in the 4 target communities aimed at the making immunization a community policy by meeting with Traditional Rulers, Town Union Leaders, Women Leaders & Youth Leaders. We are happy to report that we achieved behavioural change towards immunization demand by the communities who now perceive immunization as an ally and key to child development.

EXECUTIVE SUMMARY

The choice of Umueze1, Umueze 2, Agbajah & Dioka Nzerem for Vaccine Demand uptake in the present WAVA sponsored Immunization Project is predicated in the geographical record that Ehime Mbano communities are not in the mainstream of community development domain in Imo State. There are few socio-economic facilities in the area with particular reference to Agbajah, Dioka Nzerem, Nzerem Ikpem and other closed communities in the LGA. The LGA is at the extreme end of Imo State. During rainy seasons, the communities are completely cut off and inaccessible by other communities. Community members are locked up. The undulating nature of topography is intimidating to visitors. Civil Servants posted there go on protest and accept the offer as retirement decision.

This is why this project is focused on these areas. Areas of great needs produce opportunities for great impacts. BECOLIN/OLPHI had carried out community mobilisation on Breast Feeding Programme in Ehime Mbano LGA and we discovered that the situational problems in the area impede immunisation coverage and other environmental services. We also discovered during the implementation of this project that open defecation is prevalent in these communities which we tried to mainstream during the community engagement.

Community / Public Awareness: Community by community Awareness was also carried out at the grassroot with immunization messages that Immunization is Safe, critical for child development, cost effective and an investment into national development. Some slogans were employed – Vaccine Good oh; Vaccine Save Life; Vaccine Saves Money; Money invested in Immunisation is an investment well spent.

Immunization is a sustainable and futuristic program because the child today is the leader of tomorrow. Every program on children and women are sustainable because they are the planks for National Development. There was a wide reach of awareness information to over 4000 persons or 16,000 in the 4 target communities.

• We conducted 2 day trainings for capacity building in the four communities

• Location: Communities provided venues for the trainings as part of their contribution for the project


• Training Objective – to train immunization agents and ambassadors who will cascade training and knowledge acquired to their peers in the remote corners of their communities leaving no one behind in the campaign. This is in sync with the vision of Sustainable Development Goals and the Voice Nigeria Campaign which is aimed at involving ALL in democratic and developmental processes at the community levels.


• Training Timeframe: The trainings were conducted between November 1 – 30th.


• Participants – in each community 9 persons were trained – 5 women and 4 men for gender sensitivity. These were trained as immunization agents (8 agents and 1 ambassador). These are the sustainable structures we established for continuous immunization awareness, education, sensitization and conscientisation.


• Training Curriculum: the curriculum with subject on immunization, maternal & child health and child development. Each participant had a copy of the curriculum as their own daily guide. The method was interactive and language employed was English & native dialect to drive home the message of immunization.


• Training Outcome: a. 8 immunisation agents &1 ambassador were trained in each community or 32 agents in the 4 communities and 4 ambassadors in the 4 communities each was equipped with a curriculum and a register to capture the demographic data of new born, their parents & their immunization schedule. This is another structure established in these communities as a sustainable reference for immunization data analysis.


• Community Impact Assessment on the Project: there was one day impact assessment forum in each community where we shared ideas & information on the project, lessons learnt, level of peoples change towards immunization and the way forward.


• & Manifestations of Impact

• Child immunization has become a household word in the 4 target communities. Women, now, know the value of immunization and immunization schedules and where to access them.


• Each community raised a community song in their own dialect depicting their acceptance and knowledge that immunization is indispensable to child development. A dvd copy of the song will be forwarded to WAVA for your information.


• The curriculum is now a permanent community resource on immunization knowledge and the register containing demographic data of the child and immunization schedule is also community resource as reference points for future immunization records and development programs.


• Immunization Handbills are everywhere in the communities speaking the language and message of child immunization.

Handover of the Project: During the Community Impact Assessment forum, we officially handed over the project to the community traditional leaders, women leaders and the trained community Immunisation agents and committees as part of our sustainability strategy.

Looking Forward: BECOLIN / OLPHI will continue with quarterly monitoring and evaluation exercises in the communities to ensure that the sustainability strategies are in place and functioning.

Media Roundtable: The project was rounded up with a media roundtable for review of the project on the 15th December to officially end the program. The participants were representatives from BECOLIN & OLPHI, Journalist from 2 newspapers, Radio Nigeria Heartland FM and representatives from the 4 target communities male & female and WAVA member CSOs – DIG Ebonyi & FENRAD Abia. Radio Nigeria Heartland FM achieved a wider coverage on Imo State level in its program “Issues of the Moment” which was aired publicly on Monday 18th December 2017. Copies of the media tools will be sent to you for your information.

Challenges:

• During our advocacy engagements with the ministries necessitating continuous re-scheduling of our meetings with their attendant increased expenditures.


• The rumour peddled in the country that immunization was dangerous also affected our program. We had to repeat advocacy meetings with community leaders to dissuade them from that rumour and accept the traditional truth that immunization is key to mother and child health.


• The geographical terrains of the communities during the rains impeded our movement. The roads were almost impassable with undulating features and sloopy formations that scared away motorcyclists. The roads are not motorable. All the above had hard delaying impacts on our campaign.

In development work, areas of greatest need have opportunities of greatest impacts. Despite the challenges mentioned we were able to change behaviours of the people at the grass root which will indicate, from now on, increased immunization uptake to correct the poor records before our campaign.

The advocacy meetings held at the National and State levels especially the ministries of Budget and National Planning produced high level awareness of increased immunization budget.

Activities

Advocacy Visits/Meetings:

Activity

Community Impact Assessment Forum in the 4 target communities of Ehime Mbano LGA – Umueze1 & 2, Agbajah & Dioka Nzerem

Output

Interactive Sessions on immunization behavioural change, free speeches during the meetings in their dialects and good attendance.

Results

Immunization is good for mother and child. Communities passed resolutions to affirm immunization as a community policy which every parent must adhere to.

Lessons Learned:

1. That protocols are permanent features in governance at all levels. We contended with so many protocols in the National and State Ministries and the Community Traditional Rulers.


2. Alliance building is important for program success as indicated in Becolin/Olphi collaboration in this project.


3. The greater the challenge the greater the outcomes & impacts.


4. For any behaviour change to occur there must be repeated intensive and extensive advocacies. These were our experience in this program


5. Next Steps:


6. Quarterly Monitoring & Evaluation to ensure that the strategies are in place and in application.


7. We intend to replicate this program to other disadvantaged communities in Imo State on Immunization demand uptake.