By Peter Emmanuel |
Through targeted data use, community engagement, and integrated primary healthcare services, Bauchi State is expanding vaccination access to zero-dose children in hard-to-reach communities, reducing long-standing immunisation gaps.
In Tumfafi Ward of Shira Local Government Area in Bauchi State, Jamila Muhammad approaches a vaccination post at a moment that reflects a quiet but significant shift in how communities once hesitant about immunisation are now engaging with health services.
Her decision is part of a broader change unfolding across the state, where data-driven planning and community-led outreach are helping health workers reach children who have never received any routine vaccines, commonly referred to as zero-dose children.
What was once marked by distance, distrust, and limited access is gradually being replaced by closer services, repeated engagement, and improved trust in primary healthcare delivery.
Closing Immunisation Gaps Through Coordinated Action
The urgency of strengthening immunisation efforts became more evident in early 2026 when measles cases reported in Wuro Bugga examined the persistent gaps in vaccine coverage across parts of Bauchi State. Despite earlier campaigns, several children had still missed routine immunisation due to caregiver hesitancy, misinformation, and difficulties accessing health facilities.
In response, the Bauchi State Government, through the State Primary Health Care Development Agency, intensified integrated outreach activities in collaboration with the National Primary Health Care Development Agency. The initiative also received technical and operational support from partners including the World Health Organization (WHO) and Gavi, the Vaccine Alliance.
The approach aligns with Nigeria’s National Strategy for Immunisation and Primary Health Care System Strengthening (NSIPSS), which prioritises reaching zero-dose children, improving equitable coverage, and strengthening primary healthcare systems in line with the Immunisation Agenda 2030.
“Our priority is to ensure that every child, regardless of location, has access to life-saving vaccines,” said the Bauchi State Commissioner for Health, Dr Sani Mohammed Dambam. “This approach expands access, rebuilds trust, and closes long-standing immunity gaps.”
How Routine Health Data Is Driving More Targeted Immunisation Efforts in Remote Communities
Routine immunisation data in Bauchi State continues to show uneven coverage across local government areas. At least 13 LGAs—including Toro, Kirfi, Alkaleri, Ganjuwa, Shira, and Ningi—record high numbers of zero-dose children and low uptake of the pentavalent vaccine, which protects against five major childhood diseases.
While overall immunisation coverage in the state is estimated at about 79 percent, nearly 45 percent of LGAs remain below the 80 percent threshold. Health officials warn that these disparities leave many communities vulnerable to outbreaks of vaccine-preventable diseases.
To address this, the state adopted a microplanning approach that uses localised data to identify missed settlements and prioritise hard-to-reach populations, including nomadic and riverine communities. This has allowed health teams to focus efforts more precisely on areas where children are most likely to be missed.
Building Trust to Improve Vaccine Acceptance in Rural Communities
In many of these communities, vaccine hesitancy is shaped by a mix of misinformation, limited exposure to accurate health information, and low confidence in formal healthcare systems.
To respond, health workers and community mobilisers have adopted sustained engagement strategies rather than one-off vaccination campaigns. These include repeated household visits, community dialogues, and engagement with religious and traditional leaders, often conducted in local languages.
The emphasis has shifted toward consistency and trust-building.
“They didn’t rush us. They kept coming back and explaining,” Jamila said. “That is what made me change my mind.”
Mallam Musa Adamu, a community leader in Tumfafi Ward, said the approach has gradually changed perceptions.
“At first, many families refused. Some believed vaccines were not safe, while others felt their children were healthy and did not need them,” he said. “But after continuous engagement in mosques and community meetings, more parents started bringing their children.”
Expanding Vaccination Access by Bringing Health Services Closer to Rural Families
To reduce barriers such as distance, transport costs, and limited access to health facilities, the Bauchi State Government introduced an integrated service delivery model combining routine immunisation for children aged 0–23 months, the rollout of the malaria vaccine, and the “Big Catch-Up” campaign targeting children aged 24–59 months who missed earlier doses.
As part of the strategy, vaccination posts were established closer to communities, including hard-to-reach settlements, making services more accessible to caregivers and reducing the need for long travel distances to health facilities.
During a four-day malaria vaccination intensification campaign held from 24 to 28 March 2026, 1,292 health workers were deployed across 323 wards in all 20 local government areas of the state. The campaign reached 5,139 children with routine vaccines and delivered the first dose of the malaria vaccine to 105,451 children aged 5–21 months.
Health officials also said 737 zero-dose children—those who had never received any routine immunisation—were identified and vaccinated during the exercise. In addition, 10,929 children aged 24–59 months received pentavalent vaccine doses under the catch-up campaign, while 2,411 girls aged nine years were vaccinated with the human papillomavirus (HPV) vaccine.
According to health authorities, integrating multiple services into a single outreach helped reduce missed opportunities and allowed caregivers to complete several vaccinations during one visit, improving both efficiency and uptake across communities.
Gradual Shift in Caregiver Perceptions and Acceptance of Immunisation Services
For many caregivers, personal experiences have played a key role in changing perceptions.
In Zango settlement, Safiya Yakubu said her decision was influenced by her own experience with illness.
“I once had severe malaria and almost collapsed,” she said. “When I heard about the vaccine, I went straight to the health facility. I did not want my child to go through what I experienced.”
Frontline health worker Aisha Sani said community response has changed significantly over time.
“Before, we saw fear and resistance. Now caregivers are asking questions and are ready to vaccinate their children,” she said. “When people understand, they accept.”
Within minutes of arriving at the vaccination post, Jamila’s child received life-saving vaccines.
“Before, I was afraid of vaccines,” she said. “Now I am more afraid of the diseases.”
Bauchi’s Progress Amid Nigeria’s Wider Immunisation Challenge
Despite improvements, Bauchi State still faces challenges with reaching all zero-dose children, particularly in underserved and remote communities.
This reflects a broader national and global concern. Nigeria remains one of the countries with the highest number of zero-dose children globally, with more than 2.1 million children who have not received any routine vaccinations.
Globally, an estimated 14.3 million children remain unvaccinated each year, contributing to recurring outbreaks of vaccine-preventable diseases.
Health experts say reaching these children is critical to achieving Universal Health Coverage and strengthening primary healthcare systems, as unvaccinated children remain the most vulnerable and continue to drive disease transmission.
How Data and Partnerships Are Sustaining Immunisation Gains
The World Health Organization continues to support Bauchi State through technical assistance, microplanning, training of health workers, and strengthened data systems used to identify and track zero-dose children.
Officials say the experience in Bauchi shows that when data is used effectively, services are integrated, and communities are actively engaged, immunisation coverage improves significantly.
However, sustaining and scaling these gains across all local government areas remains essential to ensuring that every child is reached with life-saving vaccines and no community is left behind.
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