by Moshood Isah
Easy access to the land borders in north-east and north-west zones, particularly Borno, Yobe, Sokoto, Zamfara, Katsina states has remained a key source of criminality and violent crimes in these parts of the country. As at 2022, 137 out of about 261 borders in the north-east and north-west regions of the country were unguarded as revealed by former chief of Army Staff, Lucky Irabor.
Sokoto State which shares borders with the Niger Republic has battled varying degrees of insecurity relating to kidnapping, cattle rustling and banditry in recent years. Areas primarily affected include Isa, Sabon Birni, Gwadabawa, Illela, Tangaza, and Goronyo. They contribute to a total of 65 out of the 240 wards in the state. Beyond security challenges, hard to reach areas, unavailability of vaccines, unfavorable weather conditions and vaccine hesitancy due to religious beliefs largely contributed to low immunization coverage rates in Nigeria and most inequitable in the world according to United States Agency for International Development (USAID). As of 2018, vaccination rates in Sokoto state were among the lowest in Nigeria, with only 3% of children receiving pentavalent vaccine by their first birthday as revealed by National Bureau of Statistics and United Nations International Children Emergency Fund (UNICEF).
In 2016, eHealth Africa was engaged by the State Ministry of Health with support from Bill and Melinda Gates Foundation (BMGF) and Dangote group on the Vaccine Direct Delivery project to commence the delivery of vaccine and dry goods for immunization against vaccine preventable diseases in Kano, Bauchi, Zamfara and Sokoto State. The intervention most recently done in Collaboration with Sokoto State Primary HealthCare Development Agency (SSPHCDA) devised strategic ways to deliver Antigens and dry goods to cold chain-equipped health facilities at ward-level and LGA cold stores at appropriate temperatures (between +2 to +8 Degree Centigrade).
Using the Logistics Management Information System (LoMIS) ;a suite of offline-capable mobile and web applications developed by eHealth Africa, they address challenges with the supply/distribution of health commodities to last-mile health facilities. The LoMIS Suite applications have been instrumental in providing critical solutions that ensure availability of health commodities, effective vaccine management. It also enables broader health system policy decisions through the use of real data for insight and decision-making and execution at the community, LGA and state l level.
Stakeholders in Sokoto state agree that the Vaccine Direct Delivery interventions have contributed to reducing the challenge of zero stock for vaccines as a result of effective automated documentation of vaccines and its consumables while also limiting the use of papers to promote sustainability in both environment and the health sector. In the words of Murtala Bello, the Director, Pharmaceutical Services, and Logistics Officer, Primary Health Care Development Agency, Sokoto State, “the use of digital solutions has improved delivery, it has also improved availability of these vaccines.” This according to him has improved accessibility and increased immunization coverage in the State.
According to eHA project Manager, Mohammed Faosy, in the last 6 months (Jan-June), over 2 million vaccines have been delivered to average of 351 cold-chain equipped health facilities monthly, leading to the immunization of over 800,000 children against Vaccine preventable diseases in Sokoto State. This is an 18% increase in the number of children reported vaccinated in the state in the first half of 2022. He reiterated that, despite implementing the VDD project in a security-compromised location such as Sokoto state, the project’s performance in terms of delivery rate has been outstanding.
Reaffirming this, a Health Delivery Officer, Umar Muhammed remarked that due to insecurity, vaccines could not be delivered directly to about 5 health facilities in Sokoto state; Kiyara PHC, Damba PHC, Bauni PHC, Raka PHC, and Dangulbi PHC. He however revealed that the delivery team found a creative way to ensure these vaccines get to these high risk areas by liaising and collaborating with the Health facility in charge within those communities to get vaccines to their health facilities through close communications and stipend-based reward to ensure they have vaccines at their health facilities. He said, “we don’t just provide a stipend, we monitor and follow up until vaccines arrive at the facilities safely, deliveries were always 100% successful to the affected facilities”.
Also, bad road conditions escalated by the rainy season also made delivery of vaccines to Fadarawa Health Post, and Rugga Kijjo Health Post to be carried out using motorcycles from the LGA cold store. The Health Delivery Officer in the location Salihu Muhammed Hali said, the team monitors the process until vaccines arrive at the facilities safely within the required temperature, deliveries were always 100% successful to the affected facilities.
The team commended the effort of the Sokoto Ministry of Health and the Sokoto State Primary Healthcare Development Agency’s (SSPHCDA) commitment to reducing zero-dose children and ensuring that quality vaccines are available at ward-level cold-chain equipped health facilities in the 23 LGAs in Sokoto state.
