The Immunization Plus and Malaria Progress by Accelerating Coverage and Transforming Services, widely known as the IMPACT Project, was conceived as a strategic response to one of Nigeria’s most urgent public health challenges: the high burden of preventable illness and death among children under five. The project was designed against the backdrop of poor child survival outcomes, with Nigeria carrying a significant share of under-five deaths globally. Its first-phase Project Development Objective is clear and focused: to improve the utilization and quality of immunisation plus and malaria services in selected states, with immunisation plus covering immunization, maternal, child, and neonatal services. The project also aligns with the broader national vision of ensuring healthy lives and promoting wellbeing for Nigerians at all ages.
In Kano state, the implementation of the IMPACT Project is showing how a well-structured health intervention can move beyond policy into visible, measurable improvements in service delivery. At its core, the project is targeted at women and children under five, but its benefits extend across the wider population by strengthening systems, improving facility readiness, and making health services more reliable and responsive. This is especially important in a state like Kano, where scale, population pressure, and access gaps make health system efficiency a constant priority.
A major strength of the IMPACT Project is its use of Decentralized Facility Financing, DFF. Under this system, funds are provided directly to primary health care facilities to improve the quality of services. The financing approach supports immunization, care for children under five, reproductive and maternal health services, skilled delivery, postnatal care, WASH implementation, and minor/major rehabilitation of existing infrastructure, under the PHC revitalization program. Kano has translated this financing system into direct improvements at facility and local government levels. Through DFF and related performance-based support, essential drugs and other commodities were procured for 484 health facilities, helping reduce stockouts and improve the regular availability of critical supplies for service delivery.
The project has also significantly strengthened routine immunization services across the state. Outreach sessions were expanded and supported across 38 rural LGAs, while additional fixed sessions were funded in 8 metropolitan LGAs to ensure that missed settlements and hard-to-reach communities were reached for at least six months. This is not just an operational improvement; it is a direct investment in equity. It means more children in underserved areas now have a better chance of receiving life-saving vaccines, and more communities are being deliberately included in the state’s immunization architecture.
To make these outreach efforts more effective, the project provided 44 Boxer motorcycles to Routine Immunisation officers across the state. This intervention has strengthened supervision, improved mentoring, and made it easier to verify and track outreach services, particularly in hard-to-reach areas where transportation barriers often weaken health service delivery. By supporting mobility at the LGA level, the project has helped bridge the distance between policy intention and community-level impact.
Cold chain improvement is another area where the IMPACT Project has made a notable difference in Kano. Part of the LGHA performance fund was used to procure two large refrigerators per LGA, alongside solar power accessories to ensure uninterrupted cold chain operations. Beyond this, all LGA cold stores were comprehensively renovated to meet climate-resilient standards and equipped with two functional refrigerators and complete solarisation packages. The impact of this investment has already become visible in immunisation operations: a strong indication that cold chain performance and vaccine preservation have improved significantly across the state.
Another critical area of progress is supportive supervision and oversight. The project funded supportive supervision across all 44 LGAs, including the printing of supervision checklists for use in facilities, immediate resolution of identified issues where possible, and escalation of unresolved matters to higher levels. Monthly LGHA meetings were also supported, creating regular platforms where facility in-charges present data, discuss progress, identify challenges, and agree on the way forward. This kind of routine review structure strengthens accountability and creates a culture where performance is tracked, discussed, and acted upon rather than ignored.
The IMPACT Project also recognizes that health outcomes improve when decisions are informed by quality data. In line with its knowledge-for-change component and emphasis on monitoring and evaluation, Kano’s implementation has invested in digital and reporting capacity. Laptop computers were provided to Monitoring and Evaluation Officers in all 44 LGAs to support timely data entry into District Health Information System 2, DHIS2, analysis, reporting, and evidence-based decision-making. In addition, Wi-Fi routers with annual subscriptions were provided to 484 apex health facilities to enable real-time data entry across primary health care services. These investments are helping shift the system from delayed, paper-heavy reporting to a more responsive and accountable data culture.
Administrative and institutional strengthening has equally received attention. The offices of primary healthcare coordinators across the 44 LGAs were renovated, furnished, and equipped with needed office materials and solar power solutions. Archiving and documentation systems were improved through the provision of archive shelves and standardized files, making record keeping, retrieval, and institutional memory much stronger than before. A health system cannot function efficiently when its coordination offices are weak, poorly equipped, or unable to preserve records for planning and follow-up. Taken together, these achievements reflect the logic behind the IMPACT Project itself.
