Leaving No Child Behind: AFENET’s Impact on Routine Immunization in Nigeria

Over the past decade, AFENET has played a pivotal role in strengthening Nigeria’s routine immunization (RI) system through the design and implementation of high-impact, evidence-based interventions. The interventions covered key components of immunization, including enhancing RI microplanning, integrated supportive supervision, and the delivery of targeted interventions to underserved, zero-dose, and under-immunized populations. In collaboration with government partners, AFENET led initiatives such as the 2019 demand generation project, which resulted in a 15% increase in immunization coverage; the first-ever district-level coverage survey in Nigeria in 2014, which provided critical insights into RI performance; and the Hepatitis B birth dose project, which increased timely birth dose coverage from under 10% to over 60% within a year. Other impactful strategies included the Identify, Enumerate, and Vaccinate (IEV) approach in consequential geographies, defaulter tracking and linkage, and immunization intensification through the Optimized Outreach Strategy (OOS) and community engagement using the Circle of Care approach. These efforts contributed to a sustained increase in RI coverage—specifically improving DTP3/Penta3 coverage from 33% in 2016 to 57% in 2021—and helped bridge immunity gaps among children under five.

A cornerstone of our work has been promoting resilience and accountability in RI service delivery through innovative, technology-driven solutions. One such initiative was the rollout of a real-time SMS reporting platform across 18 priority states, which institutionalized timely RI data reporting and use. This platform empowered local health authorities to make evidence-based decisions and led to national recognition by NPHCDA in 2021 for AFENET’s leadership in driving real-time immunization data use. Today, AFENET remains one of the most trusted and consistent partners in the RI space in Nigeria—both at national and subnational levels. Together with government and stakeholders, we continue to build a transparent, accountable system that works to achieve universal health coverage and ensure that no child is left behind.