In Kuraken Sanni, a settlement in Kumbotso, a local government area of Kano State, getting a child vaccinated is not always straightforward.
For many mothers, the challenge goes beyond proximity to a health facility. Social norms, gender roles, and household decision-making often determine whether and when a child is vaccinated
Sadiya was a 12-month-old girl who had not received any vaccines since birth. Her mother had been counselled on the importance of immunisation. Still, like many married women in her community, she lives under kulle (purdah), a tradition that limits women’s movements outside the home without their husbands’ permission or presence.
When the zero-dose targeted response team arrived in her community, Sadiya’s mother was at home, but she could not bring her out for vaccination. Still determined to protect her child, she took a small but powerful step within the limits she faced. She entrusted her sister, along with a volunteer community mobiliser (VCM), to take her for vaccination.
However, her brother intervened just as the child was getting ready for her shot. He objected, insisting that the child shouldn’t be immunised since his father was not around. This moment of tension is familiar in settings where family dynamics and layered authority influence decisions around health.
Nearby stood another mother, Aisha, with her 17-month-old zero-dose twins. She understood the situation all too well.
Like Sadiya’s mother, she lives within the same reality, where decisions depend heavily on her husband’s approval. Her twins had not received any vaccines because her husband did not consider them necessary and was concerned about adverse events following immunisation (AEFI). When she heard that the vaccination team was in the community, she seized the opportunity and brought her children out for vaccination while her husband was away.
Seeing Sadiya’s situation unfold before her, she did not hesitate. She stepped forward, stood by Sadiya’s sister, and gently held the child to support the health worker in vaccinating the child, despite the resistance.
In that shared moment of quiet resilience and collective support, Sadiya received her first vaccine, her first step toward a healthier future.
The Zero-Dose Targeted Response in Kano State
Kano State carries one of the highest burdens of zero-dose (ZD) children in Nigeria, children who have not received even a single routine vaccine. These children are often concentrated in hard-to-reach and underserved communities, where access is shaped not only by service availability but also by social norms, mobility constraints, and household decision-making dynamics.
Through the zero-dose targeted response, SCIDaR, alongside CHAI and Chigari, is supporting the Kano State government in identifying and reaching zero-dose children in these hotspot communities.
A combination of targeted interventions is in place to ensure success:
- Community engagement and advocacy: Structured dialogues with community and traditional leaders are conducted to build trust, address concerns, and create an enabling environment for immunisation uptake
- Demand generation through VCMs: Volunteer Community Mobilizers conducted household-level sensitisation, addressing misconceptions and supporting caregivers to access services
- Localised awareness strategies: Town announcers were engaged to provide timely information on vaccination activities, ensuring caregivers were aware of when and where services were available
- Flexible service delivery: Outreach and mobile sessions were strategically deployed to bring services closer to households, particularly for caregivers with restricted mobility
These approaches collaborate to establish crucial access points, allowing us to reach children like Sadia, even in limited environments.
Sadiya, alongside thousands of children reached during the first round of the intervention, is no longer a zero-dose child. This reflects the impact of targeted strategies to identify and address barriers to immunisation at the household, community, and service delivery levels.
Subsequent rounds of the intervention will build on lessons learned from the first round to expand coverage and reach more children.
