One Child Health Project

Improving and expanding access to routine childhood vaccines in underserved communities

The COVID-19 pandemic stalled the progress and increased the challenge of routine childhood immunization by straining the health system in Nigeria. Most children, particularly those under the age of five living in underserved and disadvantaged areas, were unable to receive basic vaccine doses during the pandemic. Currently, the rates at which routine childhood vaccines, such as the pentavalent vaccine, are being given have remained very low. As a result, there has been a resurgence of vaccine-preventable diseases such as measles and pneumonia. Under-five mortality and morbidity rates are not declining as well. 

Even though routine immunization is an essential health tool for improving child survival and health outcomes worldwide, Nigeria still has one of the lowest and most inequitable immunization coverage rates in the world. From data on vaccine coverage, only 31% of children receive all the routine vaccinations as recommended by the national EPI schedule. In fact, seven out of ten children are not fully vaccinated by age five with some receiving as low as just one vaccine.  

Apart from the pandemic, a couple of major issues still affect childhood immunization rates in Nigeria. One is poor education and awareness about the needed vaccines. Another issue is limited access to vaccines including distant health care facilities. Also, there is a lack of support among new parents and caregivers that further exacerbates their being overwhelmed due to inexperience and vaccine appointments. 

For parents and caregivers in rural communities, the solution uses text SMS to create offline awareness and provide basic education about routine childhood vaccines. It is also used to debunk common myths and misconceptions about vaccinations. Additionally, the text SMS platform is used to send personalized reminders about scheduled vaccine appointments. 

For parents and caregivers with Internet and hardware access, One Child Health Project leverages a WhatsApp and text-based chatbot to push personalized reminders about vaccine appointments. This assists parents and caregivers who are busy and might forget to take their children for immunization. It also uses a notification feature to follow up on those who have missed one or more vaccine appointments. 

To give users an opportunity to plan ahead, the entire national EPI schedule, including dates and doses, is an integral part of the chatbot. Parents and caregivers are connected to the closest health facility around them to address distance-related challenges. Users can also join online support groups, that encourage human connections, inorder to get practical and helpful information regarding how to start and complete their children's vaccination schedules. 

Our main target population is children under the age of five living in underserved communities across Ibadan. One of their biggest challenges is their limited access to vaccines due to external factors. Furthermore, those children can only be reached if their parents and caregivers are reached. 

Female parents and caregivers find it challenging to bring their children for routine immunization, particularly those who don't get the opportunity to attend antenatal clinics and listen to health talks about vaccination. Consequently, their children are always at risk of vaccine-preventable diseases or worse still, childhood mortality. Inorder to include them, and their children, in this project, we go to their communities and register them on our database. By doing so, no child under the age of five within our reach is left unvaccinated. 

Our project aims to improve and expand access to life-saving vaccines for under-five children by engaging with and providing support to their parents and caregivers. As a result, the incidence of diseases like measles would significantly reduce as more children are vaccinated. 

As a clinical student at the University College Hospital, I have met several children in pediatric clinics who were either not immunized or partially immunized against diseases. After closely interacting with their parents and caregivers, I learned about the personal reasons they had for not starting or completing their children's vaccination according to the national EPI schedule.

Furthermore, I served as a volunteer with a medical group that organized free outreaches to underserved communities. During this time, I saw first-hand how children in such areas were disadvantaged with regards to receiving routine childhood immunization.  

In addition, One Child Health Project is led by clinical students who understand the importance of vaccines and the challenges of vaccine delivery in underserved communities. It is on this basis that we are committed to this project. By using a tech-based solution, working among healthcare providers and interacting with parents and caregivers, my team is at a vantage point to solve this problem. 

During the research phase, we were able to identify potential users and carry out the following activities: 

1. Interview of 50 parents and caregivers in 3 different health facilities to understand if and how our solution would benefit them.

2. Visit 5 underserved communities in Ibadan to find out their challenges regarding accessing routine childhood vaccines.

3. Survey of 10 immunization clinics in Ibadan to check their vaccine supplies and collaborate with the health workers on this project. 

These activities helped us to better understand the extent of the problem inorder to create an innovative and community-centred solution. 

In addition to sending reminders about vaccine appointments, our solution also provides education, connects facilities and enhances support. Thus, it brings a wholistic approach to the problem of low childhood immunization coverage rates.

Our plan and vision by next year is to reach over 300 children in underserved communities across Ibadan through this project. We intend to do so by educating parents and caregivers about childhood vaccines, sending personalized reminders about appointments and connecting households with the nearest healthcare facilities. 

We hope to significantly increase vaccination coverage rates and at the same time, reduce the incidence of vaccine-preventable diseases among children under the age of five. 

Technology is an integral part of our solution to reach as many parents and caregivers as possible. Our major digital platforms are SMS texts and a WhatsApp and text-based chatbot. These platforms are easily and widely accessible by parents, caregivers and even health workers across Ibadan. In addition, they are very reliable, fast and simple to use. 

Current number of people we are serving: 50 children in 5 communities.

Number of people we'll be serving in one year: 250 more children in 15 communities.

Our solution currently needs to raise more funds to run vaccination campaigns and adequately train volunteers.

Establishing strong partnerships with rural communities and healthcare facilities might also be challenging.  

We are working with government healthcare facilities in Ibadan to support our project through partnership and to also update parents and caregivers about available vaccines. 

We will need volunteers, funding and access to health facilities to run this project. To provide an online and mobile based service to improve and expand access to childhood vaccines, we will need to involve parents, caregivers and healthcare workers. An increase in the immunization coverage rates in specific communities will be a measure of our impact. 

We will raise funds during public events and also apply for grants to continue to fund this project.