In Nigeria, the state and institutional leaders, including the traditional title holders play pivotal roles in enhancing Universal Health Coverage (UHC) by encouraging the populace to embrace health services, especially vaccination.  

To further strengthen the collaboration, the World Health Organization (WHO) Country Representative (WR), Dr Walter Kazadi Mulombo, and his team, in accompany of the Executive Director of the National Primary Health Care Development Agency, Dr Faisal Shuaib, embarked on advocacy visit to three states in the northwest -  Zamfara, Sokoto and Kebbi states, - as a tactical effort to improve access to primary health care service delivery, especially vaccination to inaccessible security-compromised communities in the states. 

The six states in the Northwest region of the country - Kaduna, Niger, Zamfara, Kebbi, Katsina and Sokoto have been witnessing unprecedented security challenges, thus affecting the effective delivery of health services, including immunization, contributing to the high number of zero-dose children in Nigeria.

Zero-dose children are those that have not received any routine vaccine.  

Both Sokoto and Zamfara states are suffering from the outbreak of Circulating Variant Poliovirus Type-2 (cVPV2), having the first and second high burden in the country. Interrupting cVPV2 and catching up with all missed children is a big goal for the country to achieve Sustainable Development Goal 3. 

Institutional collaboration

To this effect, Drs Mulombo and Shuaib at a strategic meeting with northern traditional leaders from inaccessible security-compromised communities in the six states emphasized the importance of accessing children at the inaccessible settlement with life-saving vaccines. 

The strategic meeting recently held in Sokoto State aimed to find an amenable solution to getting access to the communities. 

Dr Mulombo, delivering the opening speech, stressed the importance of the primary Health Care (PHC) approach in achieving Universal Health Coverage globally. 
Patting the traditional leaders on the back for their leadership and historic role played in the eradication of wild poliovirus in the country, he urged them not to rest their oars until Nigeria sees an end to the transmission of the Circulating Variant Poliovirus in the country and ensure all children irrespective of where they live access immunization.

“NTLC should collaborate with other stakeholders and map out strategies for reaching all children at inaccessible locations with life-saving vaccines and health care services," he said. 
Likewise, Dr Shuaib implored the traditional leaders to consistently advocate for immunization and other PHC services by utilizing their influential and revered position in society to propagate the importance of regular immunisation and other PHC services to parents and caregivers.

In his remark, the Emir of Arugungu, who is also the Chairman of the NTLC on polio eradication, said it is unagreeable that the region accounts for the highest burden of unvaccinated children in the country.
The Emir lamented that Zamfara bears the highest burden of unvaccinated children due to insecurity, followed by Sokoto, Kaduna, Katsina & Niger States. 

Representing the Sultan of Sokoto, he mentioned that the strategic meeting with the district heads and stakeholders is meant to address how to reach inaccessible settlements in both States.
Given the level of influence of traditional and political leaders within the communities, WHO  has been strategically engaging with them to achieve the 2023 Triple Billion Targets ‒ that is, 1 billion more people benefitting from universal health coverage; 1 billion more people better protected from health emergencies; and 1 billion more people enjoying better health and well-being.

Call for collaborative agenda

As part of the mission, the train made advocacy visits to the governors of Sokoto, Kebbi and Zamfara states, where Dr Mulombo entreated the state governors to create and adopt policies and strategies to intensify and improve Routine Immunization, diseases surveillance and other primary health care intervention, as well an outbreak response towards achieving Universal Health Coverage. 

In his remark during the separate interactive meetings with the governors, Dr Mulombo re-affirmed continuing technical support of WHO to the states

In Zamfara, the WR used his first-time visit to the state to highlight the historic role the State is expected to play by tackling circulating Variant Poliovirus type-2 (cVPV2) transmission, especially in security-compromised areas, and harnessing innovative strategies to reach zero dose children.

He also entreated the governor to use his vast experience as a banker to support health financing in the state. 

While at Kebbi the WR had the opportunity to congratulate the Kebbi State team for the courageous steps taken in reaching over 190,000 children in security-challenged settlements during the recently concluded polio outbreak response in the State. 

“The support given to the teams and the innovative strategies employed in reaching these security-challenged areas that are fast becoming a haven for the outbreak of circulating variant Polio viruses in this country are commendable”, he said. 

It is worth noting that Zamfara State is of peculiar concern as a result of its health indices. Meanwhile, Zamfara and Sokoto states are part of two states in the country currently battling with active transmission of cVPV2, with the highest-burden  21 and 17 cases, respectively. 

During the visit to the three states, the delegates were received by the Deputy Governor of Sokoto, Engineer Idris Muhammad Gobir on behalf of the state governor,  the Deputy Governor of Kebbi State, Umar Abubakar as well as the Governor of Zamfara, Dauda Lawal Dare.

Support for Polio eradication in Nigeria through WHO is made possible by funding from the Bill and  Melinda Gates Foundation, Gavi, Vaccine Alliance and the GPEI partners.