Impact of the COVID-19 Pandemic on Routine Immunization Programs in Northern Nigeria

This study aimed to evaluate the impact of the COVID-19 pandemic on routine immunization (RI) programs in six northern Nigerian states: Bauchi, Borno, Kaduna, Kano, Sokoto, and Yobe. This was a cross-sectional analytical study that compared programmatic data from 2019 and 2020, as well as survey data collected during the pandemic. RI program variables included service delivery, leadership and governance, monitoring and evaluation/supportive supervision, community engagement, vaccine supply chains, and health finance and management. Data were analyzed using SPSS (version 23, IBM), Student’s t-test, and structural equation modelling.  
The results showed that RI programs were affected by the pandemic in terms of reduced meetings and low completion rates for action points in certain states. However, routine immunization support services increased owing to improved monitoring techniques and consistent vaccine deliveries, with fewer reports of stockouts. The most significant impact of the pandemic was observed on activities coordinated at the healthcare facility level, whereas those at the state level were less impacted. The major challenges encountered during the pandemic included insufficient supplies and consumables, movement restrictions, shortages of human resources, and fear of infection. In building a more resilient health system, governments and non-state actors will need to invest in strengthening delivery mechanisms at the core implementation level with a focus on facilities and communities.
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