In years 2016 through 2018, there were 1,044 conflict-related incidents reported in Borno state alone, with a total of 7,533 fatalities in all three years.
Reliable estimates of subnational vaccination coverage are critical to track progress towards global immunisation targets and ensure equitable health outcomes for all children. However, conflict can limit the reliability of coverage estimates from traditional household-based surveys due to an inability to sample in unsafe and insecure areas and increased uncertainty in underlying population estimates. In these situations, model-based geostatistical (MBG) approaches offer alternative coverage estimates for administrative units affected by conflict.
We estimated first- and third-dose diphtheria-tetanus-pertussis vaccine coverage in Borno state, Nigeria, using a spatiotemporal MBG modelling approach, then compared these to estimates from recent conflict-affected, household-based surveys. We compared sampling cluster locations from recent household-based surveys to geolocated data on conflict locations and modelled spatial coverage estimates, while also investigating the importance of reliable population estimates when assessing coverage in conflict settings.
These results demonstrate that geospatially-modelled coverage estimates can be a valuable additional tool to understand coverage in locations where conflict prevents representative sampling.
Sbarra AN, Rolfe S, Haeuser E, et al. Estimating vaccine coverage in conflict settings using geospatial methods: a case study in Borno state, Nigeria.Nature. 8 July 2023. doi: 10.1038/s41598-023-37947-8.
Han Wunrow, Rose Bender, Hmwe Hmwe Kyu, Mohsen Naghavi, Christopher J.L. Murray, Simon Hay, Avina Vongpradith, Sarah Sirota, Lucien Swetschinski, Amanda Novotney, Authia Gray, Kevin Ikuta, Eve Wool, Aleksandr Aravkin, Katrin Burkart, Xiaochen Dai, Lalit Dandona, Rakhi Dandona, Regina-Mae Dominguez, Mohammed Hassen, Stephen Lim, Tomislav Mestrovic, Ali Mokdad, Hasan Nassereldine, Bobby Reiner, Theo Vos, Dereje Yohannis Yada, Peng Zheng