……Experts Highlight Deep-Rooted Barriers
By Fatima Saka
In commemoration of World Immunization Week, the Solina Centre for International Development and Research has called for sustained, data-driven and community-focused interventions to address persistent immunisation gaps in Nigeria, warning that millions of children remain vulnerable to vaccine-preventable diseases despite decades of global progress.
The call was made during a virtual interactive session with journalists on Wednesday to mark the global campaign, where SCIDaR’s Associate Principal, Amina Abdulkarim, outlined the organisation’s efforts to strengthen vaccine uptake and health systems. The initiative, led by the World Health Organization, promotes the life-saving benefits of vaccines.
Observed annually from April 24 to 30, this year’s campaign, themed “For every generation, vaccines work,” highlights the enduring impact of immunisation, which has saved more than 150 million lives globally since 1974 and continues to protect against over 30 infectious diseases.
Immunisation: A Life-Saving Yet Underutilised Tool
Abdulkarim emphasised that vaccines remain one of the most powerful and cost-effective public health interventions, preventing diseases such as measles, polio, pneumonia and other life-threatening infections.
However, she noted a paradox: the very success of vaccines has contributed to declining urgency in some communities.
“Because vaccines work so well, many of these diseases are no longer visible, and that ironically reduces the urgency among caregivers,” she said.
She stressed that immunisation is preventive rather than reactive, making it less prioritised compared to treatments for visible illnesses such as malaria or diarrhoea.
“This is where the gap begins—when prevention is misunderstood or undervalued,” she added.
A System-Wide Approach Beyond Vaccine Availability
Abdulkarim underscored that improving immunisation outcomes requires a system-wide response rather than isolated interventions, noting that SCIDaR’s strategy is anchored on three interconnected pillars.
On demand generation and trust building, she explained that low awareness and weak risk perception remain major barriers to vaccine uptake, as many caregivers do not fully understand why healthy children should be vaccinated.
In addressing this critical issue, Abdulkarim said SCIDaR conducts behavioural research, develops culturally sensitive messaging in local languages and engages trusted figures such as religious and traditional leaders.
“The organisation also co-creates communication strategies with communities to build trust and ownership, a process that enhances acceptance and drives action”.She added.
Abdulkarimn emphasized that in addressing misinformation requires sustained engagement rather than one-off campaigns.
On supply chain strengthening, the principal Associate noted that although vaccines may be available at the national level, last-mile delivery remains a major challenge. She identified frequent stockouts, weak tracking systems, inadequate cold chain infrastructure and reliance on manual record-keeping as key issues.
She explained that SCIDaR supports real-time tracking of vaccine stocks, strengthens logistics and distribution systems, improves inventory management and enhances cold chain monitoring to maintain vaccine quality. According to her, the challenge is not always supply at the top but distribution efficiency at the grassroots level.
On governance and data utilisation, Abdulkarim described weak use of data as a critical bottleneck in Nigeria’s immunisation system. While data exists, she said, the real issue lies in how effectively it is interpreted and used for decision-making.
To address this, she said that SCIDaR is embedded with technical teams within state and local government structures to support real-time data analysis, guide planning and prioritisation, strengthen coordination among stakeholders and build institutional capacity. “This approach enables targeted strategies such as identifying zero-dose children, deploying intensification campaigns in underserved communities and allocating resources more efficiently”, the Associate Principal highlighted.
She further emphasised that the organisation’s role is to strengthen existing systems from within rather than replace them.
Deep-Rooted Barriers to Immunisation
Abdulkarim further identified multiple and overlapping barriers responsible for low vaccination coverage in Nigeria. She explained that demand-side challenges include limited understanding of vaccines as preventive tools, fear of injections and side effects, cultural beliefs, misinformation and low prioritisation of preventive healthcare.
She added that access barriers arise from remote and hard-to-reach communities, difficult terrain, nomadic populations, insecurity and displacement, all of which complicate service delivery.
She also highlighted data and planning gaps, including the lack of accurate, real-time population data and the difficulty in tracking children and caregivers across locations. In addition,
The Associate Principal pointed to human resource constraints, such as the shortage of skilled health workers driven partly by migration, as well as limited workforce capacity to cover large populations. She stressed that these challenges are interconnected and often reinforce one another.
Targeted Interventions to Reach the Unreached
In response, Abdulkarim said SCIDaR deploys highly targeted and context-specific interventions, including micro-planning to map underserved settlements and identify zero-dose children by name and location, allowing for tailored outreach strategies for each community.
She also highlighted the organisation’s investment in community health workforce development, where local individuals are trained to deliver basic immunisation services, track defaulters and engage caregivers. According to her, this approach enhances trust and effectiveness, as community members understand local languages and cultural dynamics.
In addition, she pointed to ongoing enumeration efforts described as a “mini-census” approach, involving the registration of children under five, tracking of pregnant women and continuous monitoring of immunisation status. She said this enables a shift from assumptions to precision by identifying exactly who needs services and where.
Northern Nigeria Remains a Priority
Abdulkarim noted that SCIDaR’s focus on northern Nigeria is driven by significant disparities in immunisation coverage. While many southern states record coverage above 70 percent, several northern states, particularly in the northwest, remain between 30 and 40 percent. She stressed that this gap represents millions of children at risk.
She attributed the disparity to lower awareness levels, a higher prevalence of hard-to-reach communities, security challenges and socio-cultural factors influencing health-seeking behaviour. However, Associate Principal cautioned against complacency in the south, noting that even higher-performing regions must aim for optimal coverage levels of 80 to 90 percent.
Real-Life Consequences and the Way Forward
To underscore the urgency, Abdulkarim referenced real-life cases of individuals suffering long-term complications from vaccine-preventable diseases, describing them as preventable tragedies and emphasising that behind every statistic is a human story.
She called for stronger government leadership, improved use of data and technology, increased community engagement, sustained investment in health workers and infrastructure, and continuous adaptation of strategies to local realities.
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“Vaccines work. The challenge is ensuring they reach everyone, everywhere,” she said.
Scaling Impact Across Africa
Speaking on scaling impact across Africa, Abdulkarim noted that since its establishment in 2017, SCIDaR has expanded beyond Nigeria into more than 13 African countries, implementing over 15 large-scale programmes spanning routine immunisation strengthening, maternal and child health, nutrition, primary healthcare reform and gender and social development.
She added that the organisation continues to collaborate with governments and partners to align its interventions with national priorities, reinforcing the message that ending immunisation inequities is achievable through deliberate, coordinated and sustained action.
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