Challenges of Immunization Coverage among a Semi-Nomadic Population in Kano State, North West Nigeria

Nigeria has been reported to be off track in achieving the 4 th Millennium Development Goal (Reducing Child Mortality) due to poor health indicators such as  Under five Mortality (U5MR) and Infant Mortality  (IMR) which stand at 94 and 61 per 1000 live births respectively . The burden of these childhood vaccine preventable diseases vary across the zone of the country with North West and North East worst affected due to multiple problems including low immunization coverage. Kano State has consistently reported low immunization coverage with about 70% of polio cases in the country in as at the third quarter of 2014. The challenges for the immunization coverage especially among rural semi-nomadic communities have not been studied; this may pose serious programmatic and services challenges. Thus the motivation behind conducting the study to establish specific challenges related to mobile Fulani communities, the findings which is expected to inform stake holders for policy and programming of immunization activities. The study was part of a large scale cross-sectional descriptive study carried out in Tofa village, Rano Local Government Area of Kano State, Nigeria. The village is inhabited by semi-nomadic Fulani families. All the inhabitants of the village and its surrounding hamlets were invited to participate in the study. A total of 245 mothers and care givers of under five children were studied, among whom 136 (55.51%) of the under five were females while the remaining 109 (44.49%) were males. The mean age of the under-five was 33.6 + 14.4 months, and majority of them (107; 43.67%) were below the age of 24 months.  Similar majority of the under-five have received at least one dose of immunization (172; 70.20%). However, the immunization coverage which was assessed using immunization cards shows that only 6.5% were fully immunized for age.  The care givers’ level of education was the only independent predictor of immunization after controlling for confounding factors with P< 0.0001  OR of 0.27 and 95% CI 0.14 – 0.51. The study has shown that the immunization coverage was low among the semi-nomadic communities due to many factors such as lack of awareness of the importance of immunization as well as physical barriers. This has implication on the spread of child hood vaccine preventable diseases because of the role of these nomadic communities as bridge populations. It also indicated that level of education of mothers and care givers is a very strong positive predictor of childhood immunization. Although immunization has been demonstrated to be the most cost effective public health intervention that reduces burden of infectious diseases for many years, childhood vaccine preventable diseases are still the major cause of morbidity and mortality in sub-Saharan Africa including Nigeria.