Immunization is a crucial aspect of public health, because of its cost-effectiveness and efficiency in preventing vaccine-preventable mortality These preventable diseases accounted for 413% of deaths among children under the age of five in Nigeria in 2019 (Kurayi et al, 2022) An estimated 14% of unvaccinated children globally live in Nigeria Improving routine immunization coverage is a significant public health concern in Nigeria.   A 2013 survey revealed that Nigeria’s coverage of the Penta 3 vaccine was 38% compared to the global average of 86% (WHO), with a majority of states in northern Nigeria having less than 15% coverage, The poor-performing states in Nigeria were responsible for 30% of the overall number of unimmunized children in the world (STC 2022) The reasons for these results include poor coordination of routine immunization programs and a lack of technical, leadership, and management capacity among program officers.   To address these issues, the Bill & Melinda Gates Foundation and the Aliko Dangote Foundation partnered with the governments of six least-performing northern states to provide funding and technical assistance for routine immunization programs. The partnership was formalized through a multi-year Memorandum of Understanding (MoUs) and is supported by national-level reforms through the National Primary Health Care Development Agency (NPHCDA). This document aims to document the design, implementation and successes recorded from the capacity-building interventions of the Mou via a systems strengthening grant (NNRISP) implemented across the 6 northern states.   Read more