title: Demand Creation for Polio Vaccine in Persistently Poor-Performing Communities of Northern Nigeria: 2013-2014.
abstract: BACKGROUND
  Poliomyelitis remains a global threat despite availability of oral polio vaccine (OPV), proven to reduce the burden of the paralyzing disease. In Nigeria, children continue to miss the opportunity to be fully vaccinated, owing to factors such as unmet health needs and low uptake in security-compromised and underserved communities. We describe the implementation and evaluation of several activities to create demand for polio vaccination in persistently poor-performing local government areas (LGAs).
  
  
  METHODS
  We assessed the impact of various polio-related interventions, to measure the contribution of demand creation activities in 77 LGAs at very high risk for polio, located across 10 states in northern Nigeria. Interventions included provision of commodities along with the polio vaccine.
  
  
  RESULTS
  There was an increasing trend in the number of children reached by different demand creation interventions. A total of 4 819 847 children were vaccinated at health camps alone. There was a reduction in the number of wards in which >10% of children were missed by supplementary immunization activities due to noncompliance with vaccination recommendations, a rise in the proportion of children who received ≥4 OPV doses, and a decrease in the proportion of children who were underimmunized or unimmunized.
  
  
  CONCLUSIONS
  Demand creation interventions increased the uptake of polio vaccines in persistently poor-performing high-risk communities in northern Nigeria during September 2013-November 2014.
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: Charity
authors.initials: C
authors.lastname: Warigon
authors.affiliation: World Health Organization, Regional Office for Africa, Brazzaville, Congo; and.
authors.forename: Pascal
authors.initials: P
authors.lastname: Mkanda
authors.affiliation: National Primary Health Care Development Agency, Abuja, Nigeria;
authors.forename: Ado
authors.initials: A
authors.lastname: Muhammed
authors.affiliation: National Primary Health Care Development Agency, Abuja, Nigeria;
authors.forename: Andrew
authors.initials: A
authors.lastname: Etsano
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: Charles
authors.initials: C
authors.lastname: Korir
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: Samuel
authors.initials: S
authors.lastname: Bawa
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Gali
authors.affiliation: Global Public Health Solutions, Atlanta, Georgia.
authors.forename: Peter
authors.initials: P
authors.lastname: Nsubuga
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: Tesfaya B
authors.initials: TB
authors.lastname: Erbeto
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: George
authors.initials: G
authors.lastname: Gerlong
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: Richard
authors.initials: R
authors.lastname: Banda
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: Yared G
authors.initials: YG
authors.lastname: Yehualashet
authors.affiliation: World Health Organization, Country Representative Office, and.
authors.forename: Rui G
authors.initials: RG
authors.lastname: Vaz
mesh_terms: D002675:Child, Preschool; D003153:Community Health Services; D006301:Health Services Needs and Demand; D049674:History, 21st Century; D006801:Humans; D017589:Immunization Programs; D007223:Infant; D007231:Infant, Newborn; D009111:Local Government; D009549:Nigeria / Q000453:epidemiology; D010349:Patient Compliance; D011051:Poliomyelitis / Q000453:epidemiology* / Q000266:history / Q000517:prevention & control*; D023321:Poliovirus Vaccines / Q000008:administration & dosage / Q000276:immunology*; D011159:Population Surveillance; D014611:Vaccination
chemical_list: D023321:Poliovirus Vaccines
keywords: Northern Nigeria; demand creation; noncompliance; persistently poor performing LGAs; persistently poor performing high risk communities; underserved communities; unmet health needs