Routine immunization: We have seen improvements but overall coverage remains low --- Mrs Kemi Oshodi, State Immunization Officer, Lagos

By Sola Ogundipe 

Concerns have been raised over declining routine immunisation coverage across several Local Government Areas in Lagos State as revelations show that 63,597 children were unvaccinated in the state between January and September 2025.

Speaking at stakeholders dialogue of key players in the Lagos State health sector organised by Save the Children International under the GSK supported Better Opportunities for Optimised Targeted Intervention (BOOST) project for Zero-Dose and Unimmunised Children in Nigeria,  the State Immunisation Officer, Lagos, Mrs. Kemi Oshodi, decried uneven progress of routine immunisation across the LGAs, noting that some councils failed to meet even minimum coverage targets. 

In a review of the 2025 Quarter 3 Routine Immunisation report for Lagos State, Oshodi stated: “We have seen some improvements, but our overall coverage remains below expectation. For a megacity like Lagos, 78 per cent coverage is not where we should be. From the state’s data, Lagos operates 874 primary health facilities, of which 334 offer routine immunisation services. 

“Out of five tertiary health institutions, four currently administer vaccines. The state uses two population benchmarks, the Lagos Bureau of Statistics estimate of 30.9 million residents and the national projection of 15.1 million,  both based on the 2006 census with a 3.2 per cent annual growth rate,“ Oshodi said.

According to the state’s data, Lagos operates 874 primary health facilities, of which 334  offer routine immunisation, while four out of five tertiary health institutions currently offer routine immunisation services, nevertheless, the State fell short of its vaccination targets across all antigens.

“For instance, coverage for penta 1 stood at 78 percent by Quarter 3, below the expected 90 per cent threshold, while measles 2 coverage dropped to as low as 21 per cent in some LGAs.”

Further, she said rotavirus vaccine coverage was affected by recurrent national stockouts, and lamented poor uptake of the measles 2 vaccine largely because caregivers fail to return when children reach 15 months.

Oshodi explained that the state uses two population benchmarks, the Lagos Bureau of Statistics estimate of 30.9 million residents and the national projection of 15.1 million  both based on the 2006 census.

It was gathered that Surulere and Kosofe LGAs were flagged for particularly poor performance, even as Alimosho LGA, which has the state’s largest child population, recorded encouraging numbers in absolute figures, although still showed large gaps in overall coverage and a high number of unvaccinated children.

“Surulere has consistently underperformed despite full data entry. We’ve had several engagement meetings with them and hope to see progress by the last quarter. Alimosho alone accounts for more than 14,000 unimmunised children, and by year’s end, we may be looking at up to 20,000 unvaccinated children,” Oshodi warned.

Citing multiple factors for the lagging numbers, including vaccine stockouts, human resource shortages, and vaccine hesitancy in certain communities, the SIO called for more public awareness and enlightenment.

“Many parents believe that once their child turns one, vaccination ends. Others are simply unaware that they need to return for the second measles dose.”

Among others, she pointed at community distrust of government health initiatives. For instance in parts of Surulere such as Itire, Coker, and Aguda, officials reported vaccine hesitancy linked to political tensions and misinformation.

Oshodi cited a development from the Mile 12 area of Kosofe, where immunisation turnout dropped drastically after a beloved male health worker was temporarily transferred. “He’s very friendly with the community. When he was moved, coverage at that facility fell sharply,” she recounted.

According to the Lagos Bureau of Statistics, Lagos has a population of N30.9 million. Children unvaccinated (Jan–Sept 2025) totalled 63,597; LGAs with highest number of unimmunized children are Alimosho, Kosofe, Surulere,been as measles 2 coverage dropped as low as 21 per cent in some LGAs, while HPV vaccination coverage exceeded targets in five  pilot LGAs

The review showed that across all antigens, Lagos fell short of its vaccination targets. For instance, coverage for Penta 1 stood at 78 percent by the third quarter, below the expected 90 percent threshold, while measles 2 coverage dropped to as low as 21 percent in some local government areas. 

Multiple factors cited for the lagging numbers, include vaccine stockouts, human resource shortages, and vaccine hesitancy in certain communities. According to Oshodi, logistical barriers such as lack of weekend vaccination options and limited community awareness campaigns, especially in hard-to-reach and highly mobile areas like Ibeju-Lekki and Ikosi-Isheri played a role.

On a brighter note, Lagos recorded strong performance in the HPV vaccination campaign, particularly in school-based programmes targeting girls aged nine years. Oshodi said the school-based strategy has proven most effective, noting that consent is easier to obtain in schools, while it remains a challenge in communities.

Community distrust of government health initiatives also emerged as a recurring barrier. In parts of Surulere such as Itire, Coker, and Aguda, officials reported vaccine hesitancy linked to political tensions and misinformation. 

The state has categorized LGAs by performance, marking Kosofe and Surulere as high-risk councils requiring urgent intervention. Monthly data reviews are ongoing, with a comprehensive Quarter 4 assessment scheduled for January 2026. 

Despite current setbacks, Oshodi expressed optimism. “We’ve engaged underperforming LGAs and shared strategies for reaching children in densely populated areas. With continued partner support, we expect significant improvement by the end of the year,” she said.

All hands must be on deck to ensure every child receives life-saving vaccines — Dr. Itunu Dave-Agboola, Policy & Advocacy Coordinator, GSK- BOOST Project

By Sola Charles

At a dialogue in commemoration of World Polio Day 2025, key players in the Lagos State health sector converged with a unified resolve to strengthen routine immunisation and end the scourge of vaccine-preventable diseases among children.

The stakeholder meeting  organised by Save the Children International under the GSK Better Opportunities for Optimised Targeted Intervention (BOOST) project for Zero-Dose and Unimmunised Children in Nigeria, brought together representatives from government, professional health associations, academia, media and development partners among others 

Speaking at the forum, the Policy and Advocacy Coordinator for the BOOST Project, Dr. Itunu Dave-Agboola, explained that the gathering was one of several activities designed to mark the 2025 World Polio Day, an initiative originally championed by Rotary International. She said the meeting aimed to identify the enablers and barriers to routine immunisation in Lagos and across Nigeria, noting that despite progress made, significant challenges remain.

“Some of the barriers identified include inadequate funding, shortage of skilled manpower in hard-to-reach areas, and attitude, both from caregivers and health workers. We focus largely on attitude because attitude can be an issue on the part of both the health worker and the caregiver. 

“When the caregiver misses appointments or comes late, it could be an issue, and then that's why health workers in not showing empathy or not being kind to the caregiver or long waiting times could be things that would put off parents and caregivers from bringing their children for immunisation. Our expectation going forward is that all hands will be on deck from both public and private sectors to improve service delivery and ensure that every child receives life-saving vaccines,” she asserted.

The interactive session culminated in a communique outlining practical steps to overcome these barriers. Recommendations included improved service delivery, health worker training, enhanced caregiver education, and regular feedback meetings to evaluate progress and share best practices.

Dave-Agboola noted that all associations present pledged to cascade the resolutions to their members and play an active role in ensuring optimal immunisation coverage. She commended Save the Children International and GSK for funding the initiative under the BOOST project, describing the collaboration as a critical driver of Nigeria’s fight against zero-dose and under-immunised children.

“Part of our activities include sensitisation, creation of awareness, and we've had television and radio programmes to create awareness about the benefits of routine immunisation, and why prevention is better than cure, especially in the face of prevalence, childhood killer diseases, that are prevalent in our environment.

She said the activity was largely to call stakeholders together from both the public and private sector to identify the enablers and barriers to routine immunization. Among barriers identified include inadequate funding, inadequate manpower, especially in reaching rural and hard-to-reach areas, and then attitude.

We expect all hands will be on deck from both the public and private sector to ensure optimal routine immunisation by improving service delivery, improving the attitude of caregivers and health workers. 

“Caregivers will be certified through health education. They will be educated when they bring their children for immunisation, and health workers will be trained. Their capacity will be built on how to relate better, build rapport with parents and caregivers who bring their children for immunisation."

Among participants were representatives of various health workers associations, including the Association of General Medical and Private Medical Practitioners of Nigeria (AGPMPN), Nursery and Midwifery Council of Nigeria, Nursery Council, Pediatric Association of Nigeria, Pharmacist Council of Nigeria (PCN).

Others were the Lagos State Ministry of Health (LSMOH) and Lagos State Primary Health Care Board (LSPHCB). the Provost of the College of Nursing, Lagos University Teaching Hospital (LUTH).

Stakeholders unite under GSK-BOOST project to strengthen routine immunisation in Lagos State

By Sola Charles

Key stakeholders in the Lagos State health sector have consented to a strengthened commitment and partnership on routine immunisation towards combating vaccine-preventable diseases among children in the State.

The participants who included representatives of the Lagos State government, professional health associations, the academia, the media, and development partners among others  resolved to collaborate to fight against zero-dose and under-immunised children.

At the event put together by Save the Children International under the GSK-supported Better Opportunities for Optimised Targeted Intervention (BOOST) project for Zero-Dose and Unimmunised Children in Nigeria, among barriers identified were inadequate funding, shortage of skilled manpower in hard-to-reach areas, and the attitude from caregivers and health workers.

The Policy and Advocacy Coordinator for the BOOST Project, Dr Itunu Dave-Agboola, said that despite remarkable progress on immunization, challenges still prevail particularly as a result of health worker and caregiver attitude.

"The BOOST activities include sensitization, creation of awareness  about the benefits of routine immunization and why prevention is better than cure, especially in the face of prevalence, childhood killer diseases that are prevalent in the environment.

"When the caregiver misses appointments or comes late, it could be an issue, and then that's why health workers in not showing empathy or not being kind to the caregiver or long waiting times could be things that would put off parents and caregivers from bringing their children for immunisation.

“We expect all hands will be on deck from both the public and private sector in ensuring optimal routine immunization through improving service delivery, improving the attitude of caregivers and health workers,” Dave-Agboola said.

Highest number of zero dose children

On his part, the State Immunisation Programme Coordinator, Dr. Adetola Akinpelu, lamented what he called the dwindling fortunes of routine immunisation in Lagos, attributing the decline to exponential population growth and limited resources.

Akinpelu, who represented the Permanent Secretary of the Lagos State Primary Health Care Board (LSPHCB), decried the development, noting, “When you compare Lagos to other states, it appears we’re doing very well, but when you dig deeper, you realise that the state also has the highest absolute number of zero-dose children. For every child vaccinated here, it’s like vaccinating five children in another state.”

Painting  a grim picture of the struggles faced by frontline health workers  from riverine communities involving the hiring of boats up to ₦200,000, he said overstretched vaccinators attend to 60–70 children a day, far above the recommended 15.

“Excellence brings its own problem. People migrate to Lagos in search of better opportunities, and the population keeps growing. The system is simply overstretched. Some of these communities are inaccessible for weeks. To reach them, you need not just resources, but commitment. That’s what BOOST is trying to address, finding sustainable solutions that go beyond quick fixes.”

Over 63,000 children unvaccinated Jan -Sept 2025

In a related development there were concerns about the falling routine immunisation coverage across several Local Government Areas in Lagos State as revelations show that over 63,000 children were unvaccinated in the state between January and September 2025.

The State Immunisation Officer, Lagos, Mrs. Kemi Oshodi, decried uneven progress of routine immunisation across the LGAs, saying some councils failed to meet even minimum coverage targets. In a review of the 2025 Quarter 3 Routine Immunisation report for Lagos State, Oshodi reassured that there was, however, hope on the horizon.

"We have seen some improvements, but overall, our coverage remains below expectation. For a megacity like Lagos, 78 percent Penta 1 coverage is not where we should be; the expected threshold is 90 percent, while measles 2 coverage dropped as low as 21 percent in some local government areas.

“Surulere has consistently underperformed despite full data entry. We’ve had several engagement meetings with them and hope to see progress by the last quarter. Alimosho alone accounts for more than 14,000 unimmunized children, and by year’s end, we may be looking at up to 20,000 unvaccinated children,” Oshodi warned.

On a brighter note, Lagos recorded strong performance in the HPV vaccination campaign, particularly in the school-based programmes targeting girls aged nine years as consent is easier to get in schools, while it is still a challenge in communities.

"We have engaged the underperforming LGAs and shared approaches for reaching children in high-density areas, so we expect to see significant improvement towards the end of the year," she stated.

Lagos bridging the gaps

Also speaking, the Director of Nursing Services, Lagos State Ministry of Health, Mrs. Olusola Aketi, assured that the State was more committed than ever to strengthening immunisation systems and community health engagement.

Aketi said that Lagos is making conscious efforts to bridge the immunization gaps by strengthening monitoring systems, improving community engagement, and ensuring that every child has access to life-saving vaccines.

 “We need to show the international community that we are serious about our health systems. When the partners lift their hands, our transparency and commitment should be apparent. Lagos State has now prioritized initiatives that strengthen the immunization value chain-from vaccine logistics to public trust.

“Post-COVID, many believed that we could not sustain essential health services  but we proved otherwise. Lagos State health workers have demonstrated capacity, professionalism, and courage. The moment trust is eroded, it takes years to rebuild. That’s why communication and attitude among health workers are crucial. 

"Our nurses, midwives, and vaccinators must see themselves as ambassadors of care. Our CSOs play a great role; they are the bridge between the health system and the community. They help us identify dark spots and reach the unreached.

" Lagos State is ready; it is leading by example in achieving Nigeria's immunisation goals. We have done a lot, but there's still more to do.," Aketi maintained, calling for stronger collaboration with the media and implementing partners to promote accurate information and sustain public confidence. 

In her remarks, the Provost of the College of Nursing, Lagos University Teaching Hospital (LUTH), Dr. Olubukola Adebimpe Olawuyi, urged renewed advocacy and better partnerships in overcoming the lingering vaccine hesitancy among parents, notably mothers within markets, schools, and religious settings.

She emphasized that effective community sensitization had to be taken away from the clinics and hospitals into people's immediate environments.

“It's almost 2026, and let me assure you that we are ever ready to partner with you anytime. We need to plan early, collaborate, and ensure that all - from health workers to community members - are prepared to play their role.

“Sometimes, people refuse to present their children for immunisation not because they don’t believe in it, but because of how they perceive the people delivering the service.

"If we can teach children from an early age what immunisation means and why it's important, they will grow up understanding that it's part of their wellbeing. Advocacy must start from the classroom," Olawuyi noted.

The activity was largely to call stakeholders together from both the public and private sector to identify the enablers and barriers to routine immunization. 

Recommendations comprised practical steps in overcoming these barriers through improved service delivery, training for the health workers, enhanced care giver education, and feedback meetings to provide an opportunity for review of progress or sharing of best practices.

Also present were representatives from the Association of General and Private Medical Practitioners of Nigeria (AGPMPN), Pharmacy Council of Nigeria (PCN), Nursing and Midwifery Council of Nigeria, Pediatric Association of Nigeria, Pharmacist Council of Nigeria, were among other associations.

LASAM CSO coalition, partners rally under CCSI banner to champion Lagos RMNCAH+N policy overhaul

By Sola Charles

Partners at a one-day policy dialogue held in Lagos have called for stronger collaboration among civil society organisations through a unified coalition platform coordinated by the Centre for Communication and Social Impact (CCSI), towards ensuring that advocacy for gender, PHC, and family planning speaks with a common voice.

 At the forum organised by the Centre for Communication and Social Impact (CCSI), in collaboration with the Lagos State Accountability Mechanism CSO Coalition and partners,  there was a resolution to push for a comprehensive review of existing state health policies to better integrate gender and inclusion principles and to ensure that such policies align with realities at the community level.

 The CCSI-led meeting, themed “Setting Policy Agenda for Gender, Social Inclusion, PHC Improvement, Family Planning (FP), and RMNCAH+N in Lagos State”, called for more transparent budgeting, with clear lines for RMNCAH+N and family planning, timely fund releases, and stronger mechanisms for tracking expenditure and outcomes.

 In the view of the Lagos State Advocacy Coordinator, CCSI, Mr Abiodun Ajayi, the forum was specifically designed to provide a platform for government, CSOs, and partners to jointly review progress, identify challenges, and chart action points that will strengthen policy implementation and accountability in the health sector.

 Participants reaffirmed the importance of improving PHC infrastructure and the health workforce. They urged the government to invest in staffing, training, and essential commodities, noting that PHCs are the first point of contact for women, children, and adolescents.

 The role of community and faith-based leaders was also emphasised, particularly in driving social and behavioural change around gender norms and family planning. The forum concluded that sustainable health progress will depend on engaging these community actors to promote acceptance, trust, and accountability.

 The meeting was a response to the urgent need to review and realign Lagos State’s health policies on the challenges around gender equity, social inclusion, and primary health care. The challenges of inconsistent implementation, gaps in funding, coordination, and accountability and underscored the need for better data and evidence use were highlighted.

 Further, recommendations were highlighted for creation of scorecards and dashboards to monitor service delivery indicators such as family planning uptake, adolescent health access, and PHC functionality. The aim is to provide a basis for evidence-based decision-making and to allow stakeholders  track the impact of policy reforms.

The dialogue around gender, inclusion, and health-system improvement was primarily to enable the partners to shift from fragmented interventions toward a more coordinated and accountable framework.

 The meeting positioned for a shared policy direction that addresses health equity, inclusion, and access to quality care across communities. It was a response to the urgent need to review and realign Lagos State’s health policies on the challenges around gender equity, social inclusion, and primary health care.

 Participants observed that Lagos has well-intentioned policies on family planning, reproductive and maternal health, and primary care, but implementation remains inconsistent, with gaps in funding, coordination, and accountability.

 Stakeholders highlighted that many primary health centres (PHCs) in the state remain under-resourced, lacking adequate staff, essential drugs, and equipment, even as they called for pooling of resources to sustain gains. The absence of a robust accountability and budget-tracking system was also identified as a key reason why policies often fail to translate into real improvements in people’s lives.

 The dialogue marks a defining step toward a more inclusive and accountable health system in Lagos State. By uniting government, civil society, and community actors under a shared vision for gender-responsive, equitable, and accessible care, the forum set the tone for a new era of collaboration and reform.