Demand creation for polio vaccine in persistently poor performing communities of northern Nigeria: 2013–2014

Introduction. Poliomyelitis remains a global threat despite availability of oral polio vaccine (OPV), proven to reduce the

burden of the paralyzing disease. In Nigeria, children continue to miss the opportunity to be fully vaccinated, owing to factors

such as unmet health needs and low uptake in security-compromised and underserved communities. We describe the implementation

and evaluation of several activities to create demand for polio vaccination in persistently poor-performing local government

areas (LGAs).

Methods. We assessed the impact of various polio-related interventions, to measure the contribution of demand creation

activities in 77 LGAs at very high risk for polio, located across 10 states in northern Nigeria. Interventions included provision of

commodities along with the polio vaccine.

Results. There was an increasing trend in the number of children reached by different demand creation interventions. A total of

4 819 847 children were vaccinated at health camps alone. There was a reduction in the number of wards in which >10% of children

were missed by supplementary immunization activities due to noncompliance with vaccination recommendations, a rise in the

proportion of children who received ≥4 OPV doses, and a decrease in the proportion of children who were underimmunized or

unimmunized.

Conclusions. Demand creation interventions increased the uptake of polio vaccines in persistently poor-performing high-risk

communities in northern Nigeria during September 2013–November 2014