Barriers and Enablers to Childhood Immunization in High Zero-Dose Burden Communities in Kano and Lagos states, Nigeria

Save the Children Nigeria, in collaboration with the RESONATE team, conducted a study to understand why many children in Kano and Lagos miss routine vaccines. The team used qualitative methods and held 40 focus group discussions with caregivers in urban, peri‑urban, and rural communities. Key findings showed strong awareness of the benefits of vaccination among caregivers, yet uptake remained low. Fathers held significant decision‑making power, limiting women’s ability to act. Rumours and fears about vaccine safety persisted across households. Economic pressures pushed families to prioritize daily needs over clinic visits. Several caregivers described negative treatment at health facilities, which discouraged them from returning. The study also identified strong motivators. Religious and traditional leaders shaped community decisions. Respectful health workers increased trust. House‑to‑house outreach made services easier to reach. Incentives like diapers or mosquito nets encouraged attendance. These insights will guide BOOST project team in designing targeted solutions to reach zero‑dose children and improve vaccination uptake.