Addressing immunization inequities in fragile settings through a digital and community based routine immunization model
1
1. Sydani Initiative for International Development, FCT Abuja, Nigeria 2. Sydani Institute for Research and Innovation, FCT Abuja, Nigeria, FCT Abuja, Nigeria
Popul. Med. 2026;8(Supplement Supplement 1):A948
ABSTRACT
INTRODUCTION:
Nigeria has one of the world’s highest burdens of zero-dose children, with Niger state particularly affected due to low immunization coverage, insecurity, seasonal flooding, and difficult terrain. To address these chronic inequities, the Strengthening Immunization in Consequential Areas of Niger State (STRICAN) project was implemented, to integrate digital innovations into community-based delivery. This approach represents the first precision immunization model applied in Niger state, aimed at reaching underserved populations and improving access to immunization services.
METHODS:
Implemented in 10 local government areas, STRICAN used an “identify-enumerate-vaccinate” strategy. House-to-house enumeration identified zero-dose children, while a GIS-enabled (Geographic Information System-enabled) Micro Coverage Tracking Tool (MCTT) geo-tagged households and visualized coverage gaps. Real-time dashboards guided microplanning, while Community Health Influencers, Promoters, and Services (CHIPS) agents conducted community sensitization and referrals. Service delivery combined mobile teams, outreach sessions, and strengthened fixed post facilities.
RESULTS:
The project enumerated 362309 households and 255626 under-five children, identifying 83675 zero-dose and 47821 under-immunized children. Despite security and geographic challenges, 34666 zero-dose and 72070 under-immunized children were vaccinated. Penta 1 uptake increased by up to 14% in some local government areas, and GIS-enabled micro plans were established for all routine immunization facilities.
CONCLUSIONS:
The STRICAN project epitomizes the potential of integrating technology into traditional immunization strategies to reduce zero-dose burdens in fragile contexts. The model scalability is highly feasible. However, long-term sustainability requires addressing systemic bottlenecks such as insecurity and weak infrastructure, offering a replicable framework for equitable immunization in hard-to-reach areas.
Nigeria has one of the world’s highest burdens of zero-dose children, with Niger state particularly affected due to low immunization coverage, insecurity, seasonal flooding, and difficult terrain. To address these chronic inequities, the Strengthening Immunization in Consequential Areas of Niger State (STRICAN) project was implemented, to integrate digital innovations into community-based delivery. This approach represents the first precision immunization model applied in Niger state, aimed at reaching underserved populations and improving access to immunization services.
METHODS:
Implemented in 10 local government areas, STRICAN used an “identify-enumerate-vaccinate” strategy. House-to-house enumeration identified zero-dose children, while a GIS-enabled (Geographic Information System-enabled) Micro Coverage Tracking Tool (MCTT) geo-tagged households and visualized coverage gaps. Real-time dashboards guided microplanning, while Community Health Influencers, Promoters, and Services (CHIPS) agents conducted community sensitization and referrals. Service delivery combined mobile teams, outreach sessions, and strengthened fixed post facilities.
RESULTS:
The project enumerated 362309 households and 255626 under-five children, identifying 83675 zero-dose and 47821 under-immunized children. Despite security and geographic challenges, 34666 zero-dose and 72070 under-immunized children were vaccinated. Penta 1 uptake increased by up to 14% in some local government areas, and GIS-enabled micro plans were established for all routine immunization facilities.
CONCLUSIONS:
The STRICAN project epitomizes the potential of integrating technology into traditional immunization strategies to reduce zero-dose burdens in fragile contexts. The model scalability is highly feasible. However, long-term sustainability requires addressing systemic bottlenecks such as insecurity and weak infrastructure, offering a replicable framework for equitable immunization in hard-to-reach areas.
| eISSN: | 2654-1459 |
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