First 1000 days of life and routine immunisation in Nigeria

World Breastfeeding Week is observed between August 1 and 7 annually. While global conversations on breastfeeding led by the World Health Organisation (WHO) and public health leaders recommend this practice to “improve the health of babies around the world,” breastfeeding also has links to broader health practices, especially immunisation.

This is especially in the first 1000 days (equivalent to conception, 0 – 2 years) of life. Health research has long established the importance of the first 1000 days of a child’s life where the foundation of the child’s health and wellbeing in life is predicated by factors such as feeding practices as well as vaccinations.

Indeed the United Nations Children’s Fund (UNICEF), in recognition of this states: “The time spanning roughly between conception and one’s second birthday – is a unique period of opportunity when the foundations of optimum health, growth, and neurodevelopment across the lifespan are established.”

Vaccines are growing day by day in efficacy against our known diseases, including the most challenging of the diseases. As Africa begins its countdown to being polio-free, in Nigeria the world is losing sight of the poor performance in Routine Immunisation. Gains in immunisation have not had a knock-on effect on routine immunisation.

Routine Immunisations (the process of receiving a vaccine and subsequent immunity to a disease) and vaccines are quite possibly the greatest contribution to global health to date, given the high rate of infectious diseases affecting under-fives in the global South. In recent times, extremely deadly diseases, such as smallpox and measles, have become rare and even eradicated, improving health indices of many countries.

In Nigeria, routine immunisations are particularly important as the under-five mortality rate has consistently been high in the country. The 2013 Demographic Health Survey (DHS) indicated an under-five mortality rate in Nigeria of 128 deaths per 1000 live births. While Acute Respiratory Infections (ARIs), diarrhoea, malaria, malnutrition, are the major culprits and drivers of these mortality rates, childhood killer diseases such as tuberculosis, yellow fever, whooping cough, diphtheria, measles and polio are also to blame.

However, research shows that 1 in 4 of the deaths that occur in children under-five can be prevented with the aid of vaccines. It is estimated that 2 to 3 million lives a year are saved globally from routine immunisation of vaccine-preventable diseases.

READ ALSO : Nigeria still has a long way to go on immunisation — EU

Nigeria offers vaccines through routine immunisation for childhood killer diseases. The immunisations offered specifically target the following infectious diseases: tuberculosis, polio, hepatitis B, meningitis, diphtheria, whooping cough, tetanus, influenza, measles and yellow fever.

The National Programme on Immunization recognises the following for the routine immunisation of Children in Nigeria: BCG (Bacili Calmette Guerin), a vaccine against tuberculosis; OPV (Oral Polio Vaccine), a vaccine against poliomyelitis; DPT combination vaccine against diphtheria, pertussis, tetanus; Hepatitis vaccine for hepatitis A and B; Measles vaccine; Yellow fever vaccine and supplemental vitamin A. According to the Federal Ministry of Health, a child is only considered fully vaccinated when they have received the following on their appropriate schedule.

In spite of these existing immunisation programmes, the number of children that are not immunised in Nigeria continues to remain high in the country for a variety of demographic factors. The 2016/17 Multiple Indicator Cluster Survey (MICS) identified that 3 in 4 children in Nigeria do not receive all of their necessary vaccines. This means that there are millions of children in the country who are put at risk of contracting diseases that are life-threatening or cause disability and suffering. And this number grows; as children turn into adults. This, experts assert, explains the poor health status of children in Nigeria as seen with under-five mortality rates.

How to get vaccinated in your local area

In Nigeria, vaccines are generally available at designated primary healthcare centres, general hospitals, and tertiary hospitals such as the Federal Medical Centres and the teaching hospitals. In addition, designated centres known as state immunization units, found at the state capitals, also give vaccinations. Private primary healthcare centres and hospitals also stock and deliver vaccinations, but since this is not in every case because of the logistics of handling vaccines, one would need to find out if his/her facility has this service.

Vaccines are stored and transferred in a cold chain system (i.e each type of vaccine is kept at a particular temperature until it reaches the health centre where it will be used). For this reason, facilities have immunisation days for all or each type of vaccine. This ensures that opened vaccine bottles do not go to waste by use for only two or three children. For mothers attending antenatal clinics, each health facility would inform you of their vaccination days within that period or after delivery. Health centres would refer you to other near-by centres if they do not provide this service. Always ask.

If you live in a state capital, you can also inquire from the immunisation unit of their vaccination schedule days. Most also provide some vaccinations that are not in the National Immunization schedule like the HPV vaccination for girls from age 9, to prevent future cervical cancer.

In addition to the routine route of getting vaccinated, the Ministry of Health also carries out supplemental immunisation days. These are not specified days but would usually be announced in advance to create awareness before being carried out. Supplemental immunisation days are targeted at diseases that are set for elimination or have a high burden, in areas where there is a perceived shortfall in vaccination activities, or for a suspected outbreak or one that is ongoing. So be on the lookout for announcements made in your area, or ask further questions if you hear news about such. Also, note that immunisations days are far apart. It is important that you keep to the dates given.