Abuja, Nigeria. September 27th, 2016– The recent outbreak of polio in Borno state (Gwoza and Jere local government areas to be specific) have presented a cause for reflection on the issue of immunization in Nigeria. This is a major setback for the government as Nigeria has been polio-free for two years and thecrippling disease resurfaced weeks after its second-year milestone and months before Nigeria was to clinch World Health Organization certification after three years without the virus.[1]
A poll conducted by NOIPolls in 2013, which sought the views of Nigerians on immunization, revealed that the largest proportion of Nigerians (91 percent) agreed that Immunization remained beneficial to the health and wellbeing of children. In addition, 8 in 10 Nigerians (83 percent) disagreed with the controversial view that the Polio vaccine is intended to kill or harm the reproductive health of children. Also, effective communication was suggested as the key to improve the success rate of immunization programs. These were some of the key findings from the Immunization Poll which was conducted in the week of March 4th 2013.
Brief background
According to the Nigerian Federal Ministry of Health definition, a child is considered fully vaccinated if he or she has received a BCG (Bacillus Calmette–Guérin) vaccination against tuberculosis; three doses of DPT to prevent diphtheria, pertussis (whooping cough), and tetanus; at least three doses of polio vaccine; and one dose of measles vaccine. All these vaccinations should be received during the first year of life, over the course of five visits, including the doses delivered at birth.[2]
The Expanded Program on Immunization (EPI), introduced in 1978 with the aim of providing routine immunization to children less than the age of two years, recorded initial but intermittent successes. The optimum level was recorded in 2015 when Nigeria was declared polio free by the World Health Organization (WHO) because no polio case was reported since 24th July 2014.[3] However, in recent times EPI recorded setbacks with the announcement that Nigeria is no longer polio free as the federal government has confirmed two new cases of polio in the North-East state of Borno and this has disqualified Nigeria from the polio-free certification which was initially scheduled for 24th July 2017.[4]
Some of the challenges limiting effective vaccination in Nigeria includes; inadequate health care service, over vaccination, cultural and traditional barriers, and finally distance and location. In the light of media reports on controversies surrounding immunization and vaccination programs and the recent outbreak of polio, NOI Polls sought the opinions of Nigerians concerning the issue of immunization and vaccination; expecting that findings will help beam the search light on citizen perception towards immunization programs and serve as background to encourage further discourse around how immunization processes can be improved.
Excerpts of Findings from the NOIPolls opinion survey on immunization in Nigeria
Firstly, we sought to ascertain theawareness level of Nigerians regarding the Government’s policy on Immunization. Findings showed that an overwhelming majority (92 percent) responded affirmatively, admitting that they are aware of the Federal Government’s policy which provides free immunization to the public. On the contrary, a meager 7 percent responded negatively, stating that they are not aware of the policy.
The survey gave insights on the extent to which Nigerians agreed or disagreed with the belief that Immunization/Vaccination is beneficial to the health and wellbeing of children, and the outcome showed that 91 percent of the respondents stated thatImmunization/Vaccination remained beneficial to the health and wellbeing of children, 3 percent remained neutral as they ‘neither agreed, nor disagreed’, while 7 percent disagreed with the assertion.
In addition, analysis of results across geo-political zone revealed that the South-West region accounted for the largest proportion of the respondents (95 percent) who agreed that Immunization was beneficial to the health and wellbeing of children, while the North-West (79 percent) accounted for lowest in this category. In addition, the result revealed that more female respondents (92 Percent) than male respondents (90 percent) agreed to this statement.
Subsequently, the analysis of results indicated that 83 percent of respondents ‘disagreed’ with the misconception that polio vaccines are administered with intent to kill or harm the reproductive health of children. Also, 4 percent of respondents were neutral, while 12 percent of the respondents claimed that the misconception is true.
Furthermore, analysis on geo-political zone revealed that almost all the Southern region typically disagreed that Polio vaccines were administered with the intent to destroy or harm the sexual health of children. However, the North-East has the highest ratio of respondents who agreed to this statement whereas, the North-West zone had more of its residents (15 percent) who remained neutral.
In February 2013, the media reported the killing of nine health workers by unknown gunmen in two separate shooting incidents as they were administering polio vaccines in Kano. Also, three medical doctors working at a government-run hospital in Yobe state were also killed in a separate attack. In this regard the survey ascertained the perception Nigerians regarding these of killings. The analysis of results revealed that the majority (59 percent) of respondents nationwide condemned the act and did described it saying that ‘it is very bad and shameful’; 31 percent also described the incidents as ‘sad & uncalled for’ and a meagre 2 percent were indifferent about the killings.
Lastly, analysis of survey results revealed a vast majority (44 percent) of respondents who suggested that better communication efforts were needed to educate the public on the benefits of Immunization and Vaccination. This was closely followed by 15 percent who were of the view that health workers required better training to be able to convey the benefits of their activities to the service users. Also, 13 percent suggested that religious and political leaders need to be fully involved in promoting immunization programs. Other suggestions include: logistics for vaccines and immunization materials have to be improved (12 percent); better coordination between the health ministry and local partners (9 percent); and the provision of security for health workers (3 percent).
In conclusion, this result affirms the previous findings by Gavi Alliance, which suggested a reappraisal of the national polio vaccination strategy. They further emphasized the need for all stakeholders to be involved in the polio eradication effort; with a focus on integrating polio vaccination into the general baby vaccination programme, and strengthening existing health systems. Vaccination services also need to be part of the healthcare intervention package within primary healthcare centers and taken to the children through outreach clinics.
In summary, results indicated that the majority of Nigerians were aware of the Government’s policy on Immunization; and about 9 in 10 Nigerians agreed that immunization is beneficial to the health and wellbeing of children. The results also pointed out that the most Nigerians did not agree with the controversial view that the polio vaccines have negative effects on the reproductive health of children neither did they support the killing of health workers. Also, the key suggestions given to improve the current immunization program were to have better & effective communication strategies to educate the public on the benefits of immunization and to gain the support of religious and political leaders to champion immunization schemes. Given the recent media report regarding the recent recorded confirmed cases of polio, there is urgent need for relevant stakeholders to re-strategize by improving on past success and creating new efficient system targeted at completely eradicating the polio virus from Nigeria. Such involvement in programs should help to create mass appeal and provide weight to correct the misconceptions and myths surrounding immunization programs, particularly the polio vaccine.
Survey Methods
The opinion poll was conducted on the week of 4th March, 2013. It involved telephone interviews of a random nationwide sample. 1,000 randomly selected phone-owning Nigerians aged 18 years and above, representing the six geopolitical zones in the country, were interviewed. With a sample of this size, we can say with 95% confidence that the results obtained are statistically precise – within a range of plus or minus 4%. NOI Polls Limited is Nigeria’s leading opinion polling and research organization. We conduct periodic opinion polls and studies on various socio-economic and political issues in Nigeria. More information is available at www.noi-polls.com
Disclaimer
This press release has been produced by NOIPolls Limited to provide information on all issues which form the subject matter of the document. Kindly note that while we are willing to share results from our polls with the general public, we only request that NOIPolls be acknowledged as author whenever and wherever our poll results are used, cited or published.
NOIPolls hereby certifies that all the views expressed in this document accurately reflect its views of respondents surveyed for the poll, and background information is based on information from various sources that it believes are reliable; however, no representation is made that it is accurate or complete. Whilst reasonable care has been taken in preparing this document, no responsibility or liability is accepted for errors or fact or for any views expressed herein by NOIPolls for actions taken as a result of information provided in this report. Any ratings, forecasts, estimates, opinions or views herein constitute a judgment as at the date of this document. If the date of this document is not current, the views and content may not reflect NOIPolls’ current findings and/or thinking.
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[1] http://www.dailytrust.com.ng/news/general/how-polio-returned-to-nigeria/158649.html
[2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4139536/
[3] www.who.int/mediacentre/news/releases/2015/nigeria-polio/en/
[4] www.premiumtimesng.com/…/208484-nigerias-polio-free-certification-suffers-setbac…
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