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Bull World Health Organ. 2019 Jan 1;97(1):24-32. doi: 10.2471/BLT.18.211565. Epub 2018 Nov 6.

Using the polio programme to deliver primary health care in Nigeria: implementation research.

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World Health Organization, Nigeria Country Office, UN House, 617/618 Diplomatic Drive, Central Area District, Abuja. 900001, Nigeria.
Independent Public Health Consultant, Toronto, Canada.
United Nations Children's Fund, Nigeria Country Office, Abuja, Nigeria.
Bill & Melinda Gates Foundation, Seattle, United States of America.
Centre for Health Economics, University of York, York, England.
United Nations Children's Fund, Islamabad, Pakistan.
World Health Organization, Regional Office for Africa, Brazzaville, Congo.
United Nations Children's Fund, Kabul, Afghanistan.
World Health Organization, Kano Office, Kano, Nigeria.
World Health Organization, Borno Office, Maiduguri, Nigeria.
World Health Organization, Bauchi Office, Bauchi, Nigeria.
World Health Organization, Yobe Office, Damaturu, Nigeria.
National Primary Health Care Development Agency, Ministry of Health, Abuja, Nigeria.


in English, Arabic, Chinese, French, Russian, Spanish


To evaluate a project that integrated essential primary health-care services into the oral polio vaccine programme in hard-to-reach, underserved communities in northern Nigeria.


In 2013, Nigeria's polio emergency operation centre adopted a new approach to rapidly raise polio immunity and reduce newborn, child and maternal morbidity and mortality. We identified, trained and equipped eighty-four mobile health teams to provide free vaccination and primary-care services in 3176 hard-to-reach settlements. We conducted cross-sectional surveys of women of childbearing age in households with children younger than 5 years, in 317 randomly selected settlements, pre- and post-intervention (March 2014 and November 2015, respectively).


From June 2014 to September 2015 mobile health teams delivered 2 979 408 doses of oral polio vaccine and dewormed 1 562 640 children younger than 5 years old; performed 676 678 antenatal consultations and treated 1 682 671 illnesses in women and children, including pneumonia, diarrhoea and malaria. The baseline survey found that 758 (19.6%) of 3872 children younger than 5 years had routine immunization cards and 690/3872 (17.8%) were fully immunized for their age. The endline survey found 1757/3575 children (49.1%) with routine immunization cards and 1750 (49.0%) fully immunized. Children vaccinated with 3 or more doses of oral polio vaccine increased from 2133 (55.1%) to 2666 (74.6%). Households' use of mobile health services in the previous 6 months increased from 509/1472 (34.6%) to 2060/2426(84.9%).


Integrating routine primary-care services into polio eradication activities in Nigeria resulted in increased coverage for supplemental oral polio vaccine doses and essential maternal, newborn and child health interventions.

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