Attaining quality immunization services in Nigeria through effective capacity development for health workers

Immunization has been proven to be one of the most successful and cost effective health intervention of modern day medicine. Over the years, Immunization has successfully prevented millions of deaths and disabilities globally especially amongst children. Effective vaccines stimulate the body’s immune system to produce anti-bodies (natural protecting substances) which prepares the body to fight off infectious agents that causes diseases. Due to advancement in medicine, effective vaccines against diseases like measles, pneumonia, hepatitis B, polio, tuberculosis, pertussis (whooping cough), yellow fever and Rota virus (diarrhea causing agent) have now become readily available. Following a global immunization campaign, small pox infection which is caused by a highly contagious virus was eradicated in 1979. Polio is also on the verge being eradicated as a result of availability of an effective vaccine and massive global effort to ‘kick it’ out. Also, vaccine against the deadly Ebola virus will soon become available following successful trials in some West African countries and there are lots of success stories coming out from the malaria vaccine trials as well.

Besides conferring individual protection against diseases, vaccines are also capable of conferring community protection through the concept of “herd immunity” if a significant number of individuals in the community are immunized against those diseases. This reduces the possibility of disease outbreaks and the incidence of such disease in the community.

Immunization also comes with a lot of economic benefits especially for developing countries like Nigeria and other countries with emerging economies like India and Brazil. When immunization coverage is scaled up, high costs of medical treatment, hospitalizations, and loss of productivity due to time spent taking care of sick children can be averted. With immunization, the population is healthier and children have a higher possibility of reaching their full potential and contribute to the nation’s economic growth.

In order to deliver immunization effectively, skilled health personnel are required to give the right quality and quantity of vaccines at the right time. Health workers also need to possess or acquire the skills required to manage the whole immunization process which includes, carrying out community outreaches to create demand, client education, recognizing and managing some of the adverse effects associated with immunization, disease surveillance and very importantly, immunization data management. Without skilled health workers to carry out immunization services, national immunization coverage will be low and the threat of disease outbreak will still loom even though these vaccines are available. Therefore, it’s imperative for health workers to receive the necessary training that will equip them with the knowledge and skills needed to carry out immunization confidently and manage the whole process.

As with other medical professionals, health workers in the field of immunization need to continuously update their skills and knowledge to meet current professional standards (after their initial pre-service training) by undergoing effective in-service training regularly.

By effective, I mean training that is conducted in a very conducive environment using the appropriate curriculum that is designed to achieve the objectives of the training exercise. Having the right blend of facilitators who are skilled in adult learning methodologies and have an understanding of the training curriculum will also make training effective. It doesn’t stop there, as effective training also entails some form of evaluation, regular supportive supervision and on the job mentoring to ensure that the training has led to a change in behavior geared towards increased performance and quality on the part of the health workers.

Following the introduction of some new vaccines into the routine immunization schedule in the last four years, a lot of funds have been invested into capacity development of health workers providing immunization services and as result, a lot of trainings have been conducted. It is estimated that about 20,000 health workers across the country would have been trained by government and partners after this exercise is completed. While this can be said to an achievement, it is also important for stakeholders to view this as an opportunity to effect a paradigm shift by addressing some of the inherent challenges associated with the way health workers are trained in order to ensure quality and effective trainings in the future.

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