Compelling, credible, recent, direct impact data
Time to read
1 minute
Read so far

The EPI in Borno State, Nigeria: impact on routine disease notifications and hospital admissions

0 comments

Bondi, F. S. and M. A. Alháji (1992). "The EPI in Borno State, Nigeria: impact on routine disease notifications and hospital admissions." Journal of Tropical Medicine and Hygiene 95(6): 373-381.

Abstract: This report attempts to determine the effectiveness of the EPI (Expanded Programme on Immunization) in Borno State, Nigeria. Specifically, it reviews vaccine utilization and coverage, and the impact of the programme on target disease morbidity and mortality over the period 1983-91. Trends in routine notifications for the main diseases: diphtheria, pertussis, tetanus, tuberculosis, measles and pneumonia were included for analysis and a before and after comparison in terms of the intensifications of EPI by age-specific strata was performed. Borno State is one of the 21 states of Nigeria, with a population of almost 3 million, of whom around 75% live in the rural areas. The results of the study show an apparent reduction in morbidity from disease, particularly following intense vaccinations between 1988-91. This reduction occurred despite the prevailing adverse socioeconomic conditions and the absence of a specific control strategy for pneumonia. On the whole therefore, EPI was seen to have a positive impact in Borno State, as shown by a decline in hospital admissions. Based on the results of the study it is concluded nevertheless that there is a need to develop new strategies to improve immunization services in Nigeria. These include encouraging vaccine compliance and addressing the mechanisms that facilitate disease transmission such as poor maternal hygiene and education. There is a need to intensify other intervention measures alongside EPI activities.ADDITIONAL ABSTRACT:Borno State had a population of almost 3 million in 1963, when the last accurate census in Nigeria was taken. About 75% of these people live in rural areas. In the present study on the Expanded Programme on Immunization (EPI), disease was diagnosed clinically-by paediatricians in hospital, and by nurses and trained community workers in the remote health facilities. Routine vaccination has been complemented by a series of mass campaigns; reported vaccination coverage increased steadily from 10% in 1985 to 86% in 1991. However, the rates for measles were lower than those with BCG; and vaccinations with oral polio and diphtheria-pertussis-tetanus (DPT) vaccines were substantially less than 3 times those rates, indicating that many children received fewer than the required 3 doses. Nevertheless, there has been a sustained decline in reported cases of EPI diseases from the entire State, except for tuberculosis. Moreover, whereas the total admissions to hospital for the periods 1983-87 and 1988-91 were similar, there was a 40% decline in admissions for EPI diseases between these periods. Whilst welcoming this evidence of a positive impact of EPI, the authors note an absence of laboratory confirmation of the diagnoses, and the need for improvement of the immunization services. N.W. Preston

Add new comment

Your Priorities, Opportunities and Challenges? Complete the SURVEY

Why the focus on direct impact data?

A common challenge from policy makers, funders, community members, people directly experiencing development issues, and governments is: Demonstrate your Impact. Prove that what you are doing works. The high quality, highly credible data presented on the cards below is designed to help you answer that question for your social change, behaviour change, community engagement, communication and media for development, strategy formulation, policy engagement and funding initiatives. At this link filter the research data to your specific interests and priorities

Why a playing cards design?

There is a physical pack of cards with this data (to get a copy please request through the comment form for any card). The card approach allows for easy identification and selection of relevant direct impact data in any context. For example if talking with a donor and you need to identify proof of impact say "take a look at the 7 of Hearts". Quick access can be provided to high-quality data for many areas of your work – funding, planning, policy, advocacy, community dialogue, training, partner engagement, and more. A card deck is also engaging, easy to use and share, a conversation starter, and a resource - and they are fun and different. So we kept that design for the online images as it can serve similar purposes. 

What are the criteria for inclusion?

The impact data presented meets the following high standard for inclusion criteria:

  • Positive change or trend in a priority development issue;
  • Social change or behaviour change strategy or process;
  • Randomized Control Trial or Systematic Review methodology;
  • High quality peer review journal published;
  • Numeric impact data point
  • Published since 2010.