Mahdi Garba (Lead Writer)
After contracting polio at age 6, Ibrahim Hussaini, now 41, was left physically disabled. But rather than let his condition define him, he chose to become an advocate, joining immunisation campaigns in his home state of Bauchi to ensure every child has access to life-changing vaccines.
“When we enter these communities together with the vaccinators, I tell parents that my disability is a result of polio. I will not be happy to see their kids disabled too. Since the disease and its vaccine have been identified, parents should present their children for vaccination,” Hussaini narrated. “That has tremendously helped immunisation efforts.”
According to the Nigeria Zero-Dose Situation Analysis published in 2023, about 2.3 million children in Nigeria have not received a single dose of any vaccine. These are referred to as zero-dose children. In Bauchi, the situation is concerning as the number of zero-dose children remains a major public health challenge.
Data from the National Demographic and Health Survey (NDHS) 2018 showed that only 33% of children aged 12–23 months in Bauchi were fully vaccinated, highlighting a large proportion of under-immunised or zero-dose children. The situation remained concerning in the 2021 Multiple Indicator Cluster Survey (MICS) which revealed that about 25% of children in the state had not received any vaccinations at all.
Hussaini, who works with the Heal Disability Initiative, voluntarily advocates through the Bauchi State Zero-Dose Learning Hub’s (ZDLH) Community of Practice (COP).
The Learning Hub was established by Gavi, the Vaccine Alliance, and is being implemented in Nigeria by the African Health Budget Network, a sub-partner to the Africa Field Epidemiology Network (AFENET). The initiative aims to address issues around immunisation equity.
Community of diverse voices
The Community of Practice (COP) is a multisectoral initiative that includes members from academia, civil society organisations, persons living with disabilities, faith-based groups, traditional institutions, local government immunisation officers, health educators, and the director of public health. Its primary objective is to monitor and track the immunisation budget within the state.
Led by Dr. Hassan Shuaibu, the COP tracks budget releases and monitors accountability and service delivery for immunisation efforts. The insights generated are used for advocacy, with goal of improving funding for essential healthcare services. The COP applies the Advanced Measurement Approach (AMA) framework to identify under-immunised children, facilitating targeted outreach and advocating for increased immunisation coverage in the community.
Image credit: ZDLH
It also publishes an immunisation scorecard annually, supporting supervisors from local non-governmental organisations (NGOs) to be part of the state-level immunisation team and supervise immunisation and other health services.
“We successfully got the ₦870 million projected immunisation financing to be captured in the 2025 budget. And, this alone is a success story. You all know the budgetary process, all the budget circulars are out, engagement of stakeholders and giving justification why figures should be maintained or otherwise. We were part of the process,” Dr Shuaib explained.
The state’s health budget was ₦30 billion in 2023, but it increased to ₦45 billion in 2025. For PHCs, it was ₦8.6 billion in 2023 but is currently at ₦11.5 billion. The state’s budget for immunisation was ₦774 million in 2023 but increased to ₦1.215 billion in 2024. Dr Shuaib attributed this success to their advocacy.
He added that to actualise this, the COP attended zonal engagements organised by the State Ministry of Budget and Economic Planning to sensitise on the significant disruption of progress to improved health outcomes in the absence of development partners.
Another success highlighted by the group was holding stakeholders accountable. They visited health facilities where routine immunisation services are rendered to inspect how sessions are planned and carried out, and how the budgeted amounts translate to the services that are provided.
“The Civil Society Organisation (CSO) members in the COP have been successful in helping us to ensure budget tracking and perhaps putting the government on its toes to ensure that budgeted money for immunisation is actually used for immunisation.”
The recent NDHS survey reveals a significant achievement in Bauchi State: the coverage rate has risen to 58% from 33%.
Learnings and addressing gaps
Dr Shuaib, however, noted that they faced difficulties bringing all stakeholders on board because it is the state’s first multi-sectoral initiative of its kind. He explained that stakeholders were reluctant to share finance data. It took a lot of advocacy, leveraging personal relationships to convince stakeholders.
The initiative, which is being implemented in Bauchi, Ganjuwa, Alkaleri, Darazo, Gamawa, Itas Gadau, Shira, Ningi, Katagum, Misau, Toro, and Zaki local government areas of the state, is yielding positive results. He expressed hope that other LGAs in the state would replicate the work they are doing. “It has all been learning and correcting the gaps, advocating for stakeholders to do the needful, and making others replicate the success we were able to achieve,” he said.
Bauchi State, determined to leave behind its status as a “Zero-Dose” state for under-five children, joined other states in the first phase of campaigns to increase demand for Polio, RI and other PHC services through CSO-led demand generation activities in response to the persistent refusals and vaccine hesitancy regarding polio vaccination and other PHC services. The statewide polio immunisation campaign, which commenced in April, represents a concerted effort by the state government to confront the threat of polio and secure the health and future of its youngest residents.