Few countries represent such a challenge when it comes to the scale up of immunizations than Nigeria. Consistently immunization rates have trailed behind neighboring countries. It is where we hear stories of whole communities rejecting immunization due to a misunderstanding about the purpose of these programs and mistaken belief about those running the programs.

At the same time, few countries stand to benefit as much from rapid scale up of these programs than Nigeria: child mortality rates are abysmal – on the order of twice as high as nearby neighboring countries such as Ghana. Barriers to immunization adoption have also stymied efforts to eradicate polio: it is one of the three countries in the world where the virus remains endemic. Even India – another vaccine basket case by historical standards – has managed to go polio free.

So I was not terribly surprised to hear that “Vaccine Summit” has been organized this week in Nigeria to bring together national and international leaders and experts to put increased emphasis on immunization in this country. This is what national and international leaders and experts do when things don’t seem to be working well.

What I was surprised to learn about, however, is new project that the Gates Foundation has launched in this country to help incentivize uptake of immunization. Called the Governor’s Immunization Challenge, the new program will reward a cash prize to the Governor that demonstrates the greatest leadership in improving both routine and polio immunization by the end of the year. This is not what the Foundation, which admits that it has a bias towards technological solutions to global health challenges, does. It seems like a departure from their regular business model of focusing on technical and operational barriers and an admission that things like leadership of health officials might matter a lot.

I wonder if this represents a new new direction for the Foundation in general? I sure hope so, as I believe it could be a very fruitful avenue to explore.

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15 Responses to “The biggest technical barriers to immunization adoption in Nigeria….leadership?”

  1. Karen Grepin says:

    Leadership and immunizations in Nigeria:… http://t.co/9G5XwvZ4

  2. Alison Root says:

    Thanks for the blog! RT @KarenGrepin: Leadership and immunizations in Nigeria:… http://t.co/hjpu0Qav

  3. Interesting Observation By fellow #PublicHealthFreak :P RT @KarenGrepin Leadership and immunizations in Nigeria:… http://t.co/6b75jaLB

  4. Brett Keller says:

    RT @KarenGrepin Leadership and immunizations in Nigeria:… . http://t.co/gqkQZAga

  5. Mala Persaud says:

    Interesting Observation By fellow #PublicHealthFreak :P RT @KarenGrepin Leadership and immunizations in Nigeria:… http://t.co/6b75jaLB

  6. Mala Persaud says:

    #vaccines and leadership in #nigeria by @KarenGrepin http://t.co/XmhgS6t1 #Africa #globalhealth

  7. incentivizing political will in health intervention: the Gates Foundation & immunizations in Nigeria http://t.co/xixd9GY2 by @karengrepin

  8. David Steven says:

    incentivizing political will in health intervention: the Gates Foundation & immunizations in Nigeria http://t.co/xixd9GY2 by @karengrepin

  9. Leadership and immunizations in Nigeria:… http://t.co/9G5XwvZ4

  10. Heather says:

    Thanks for a good find & interesting post, Karen – it is indeed interesting. And, perhaps a very interesting way of promoting not just political will but, ahem, political skill.

    Do you know anything else about the (11) indicators on which the programs will be judged? It will be quite interesting, especially since it appears that participating states have been selected to reflect a range of current coverage realities (http://nigeriavaccinesummit.org/news/first-steps-toward-the-last-mile-in-nigeria/).

    It will be particularly interesting to see how the other five ‘first steps in the last mile’ – mostly systematic changes (financing, transport, cold chain, health-worker incentives, & demand-generation) – are incentivized in the ways the state’s efforts are judged & rewarded. For example, it seems like infrastructure (road & electricity improvements) would make a big difference in vaccine coverage and other aspects of development but it’s not clear whether the reward would reflect such broad changes or would focus mostly health-specific, *possibly* shorter-term, narrower gains.

  11. PSI says:

    The biggest technical barriers to immunization adoption in Nigeria….leadership? @karengrepin on the vaccine summit http://t.co/vLdoIm6e

  12. NYU Wagner says:

    Here's "The biggest technical barriers to immunization adoption in Nigeria….leadership?" from Prof. @KarenGrepin's blog http://t.co/iRgTn2Fj

  13. [...] the table to get state governments in Nigeria more involved in vaccination and MDG efforts (h/t @KarenGrepin). this effort recognizes the key role of governmental leadership in the implementation of [...]

  14. Mark Daku says:

    Leadership getting attention: 'The biggest technical barriers to immunization adoption in Nigeria….leadership?' http://t.co/gLxRgqpF

  15. Juliana says:

    The Gates Foundation is becoming quite interesting. It is focused on vaccines and immunizations, and it seems to have a lot of impact in non-traditional ways, just like in the article, targeting different levels of government, issues that seem to be forgotten by decision-makers etc., even though some of its funding draws from controversial sources.

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