Increasing Childhood Vaccination Rates: The Success of Mobile Clinics in Nigeria

Mother holding her child

Childhood immunization is a critical public health strategy to decrease vaccine-preventable diseases and ensure the health and wellbeing of children. However, in many low- and middle-income countries, including Nigeria, vaccination coverage remains alarmingly low. According to the most recent WUENIC estimates, Nigeria’s DTP3 (Diphtheria, Tetanus toxoid, and Pertussis) vaccination coverage is only 62%, indicating significant gaps in immunization efforts. Furthermore, Nigeria has one of the highest proportions of zero-dose children globally, highlighting the urgency of addressing these gaps. This issue particularly affects teenage and young mothers who face unique sociocultural and economic barriers. These barriers include limited access to healthcare facilities, lack of awareness about the importance of immunization, societal stigma, and economic challenges that prevent them from immunizing their children. A recent study, published in PLOS Global Public Health and presented at the VARN2023 conference provides valuable insights into these challenges and proposes innovative solutions to address them.

Challenges in Childhood Immunization

The study, led by Dr. Mofeyisara O. Omobowale and colleagues from the Institute of Child Health at the University of Ibadan, employed an exploratory cross-sectional action research design to better understand the impact of the SheVaccs intervention. This mobile immunization service targets working mothers in the markets of Ibadan and was implemented to address vaccine hesitancy and non-compliance among teenage and young mothers. The research aimed not only to assess how the intervention is functioning but also to identify ways it could be improved to better serve mothers.

The findings revealed that many young mothers avoid conventional immunization centers due to perceived stigmatization and subtle hostility from healthcare workers and older mothers. The social stigma discourages them from returning for subsequent vaccinations. Economic barriers, such as the inability to afford transportation to health facilities and the cost of registration fees, further impedes their access to immunization services. Additionally, the study found that many young mothers are often misinformed and lack a strong support system, which heightens their hesitancy towards immunization. The research also noted that these challenges are compounded by the social and economic inequalities faced by adolescent and young mothers, who often drop out of school early and lack formal education, which limits their access to reliable health information.

The SheVaccs Intervention

The SheVaccs intervention addressed these barriers by providing friendly, non-judgmental, and mobile immunization services directly in the markets where these mothers work. The mobile clinics were set up in three different markets in Ibadan and operated once a week for twelve months. Meeting these mothers where they were by providing immunization services at their workplace not only eliminated transportation costs but also created a welcoming environment that respected the mothers’ dignity and time constraints. At the clinics, mothers were offered counseling services and information about vaccination schedules, which further supported them in making informed decisions.

The success of this intervention in Ibadan suggests the importance of innovative, community-centered approaches to vaccination delivery. The mobile clinics helped overcome obstacles such as stigma, economic hardship, and lack of information, leading to improved vaccination coverage among children of adolescent and young mothers. Additionally, the research highlights the need for health care workers in immunization clinics to acquire non-hostile communication strategies and create a more accommodating environment for these mothers, as this is crucial for reducing vaccine hesitance and non-compliance.

Furthermore, the study emphasized the importance of maternal education in achieving improved childhood immunization rates. Limited access to education and the resulting socioeconomic challenges contribute to vaccine hesitancy. Therefore, efforts to keep children and adolescents in school and reduce dropout rates can have a positive impact on immunization coverage, delaying early childbearing and promoting informed health decisions.

The success of the SheVaccs intervention in Ibadan can serve as a model for similar initiatives in other regions facing comparable challenges. Interventions such as this one that address the unique needs of a particular cadre of mothers can significantly improve child immunization rates, reduce the incidence of vaccine-preventable diseases, and contribute to achieving global health goals like the Sustainable Development Goals (SDGs) and the Immunization Agenda 2030. Addressing non-health factors, including social, economic, and cultural determinants, is key to reducing the rate of immunization hesitance and non-compliance among young mothers.