Nutrition, Retrospective mortality and Vaccination Coverage Survey based on the SMART methodology in Dange Shuni and Wamakko Local Government Area, Sokoto State, Nigeria.

Principal investigator

Nigeria flying epi

Location

Nigeria
Topics

Mortality, Nutrition, Vaccination
Methodology

Observational study
Reference

OCA026-13
Views

7
Downloaded

0

Purpose of study

Study status

Concept
Protocol & ERB
Implementation
Completion
Archived

Study timeline

Documents

No documents uploaded

Publications

No publications recorded

Previous study

Next study

Purpose of study

Recent evidence indicates that Dange Shuni and Wamakko LGAs face a high burden of acute malnutrition. Both LGAs were classified under the Integrated Food Security Phase Classification (IPC) for acute malnutrition as Phase 3 (Serious) during the 2025 analysis, with Dange Shuni projected to deteriorate to Phase 4 (Critical) during the 2026 lean season4. Furthermore, the 2025 Northwest Nigeria SMART Survey reported a combined Global Acute Malnutrition (cGAM) prevalence of 15.8% (95% CI: 12.8 -19.3) for the Central Sokoto domain5 (which includes Dange Shuni and Wamakko LGAs), while routine MSF programme data consistently identify these two LGAs among the leading contributors of severe acute malnutrition admissions to the MSF-supported Inpatient Therapeutic Feeding Centre in Sokoto (Table 1). These trends indicate a sustained burden of SAM requiring further population-level assessment. In addition, the 2025 Northwest Nigeria SMART survey showed crude mortality rate (CMR) of 0.26 deaths/10,000 persons/day and U5MR of 0.36 deaths/10,000 persons/day in Central Sokoto domain (comprising Bodinga, Dange-Shuni, Sokoto North, Sokoto South, Wamakko). Although the survey provides estimates for the Central Sokoto domain, it does not provide LGA-specific estimates to support operational decision-making in Dange Shuni and Wamakko LGAs. The selection of Wamakko and Dange Shuni LGAs for the nutrition survey was informed by IPC projections indicating higher levels of food insecurity, availability of OTP services, and favorable security conditions that allowed safe access to implement the survey (and possibly medical activities). Sokoto State continues to record one of the highest burdens of zero-dose and under-immunized children in Nigeria, with a large proportion of children either unvaccinated (zero-dose, having not received DTP1) or incompletely vaccinated (under-immunized, having not received DTP3), resulting in significant immunity gaps. The Nigeria Demographic and Health Survey (NDHS) 2023 - 20246 reported that only 39% of children aged 12 - 23 months received all basic antigens and 20% were fully vaccinated, with particularly low coverage in Sokoto state (8.4%; fully vaccinated 2.7%). In response to the diphtheria outbreak that began in late 2022, the Sokoto Vaccination Project (SokVax), implemented by MSF-OCA in collaboration with the Sokoto State Ministry of Health from April 2024 to June 2025. The intervention sought to improve vaccination coverage among children under five through combined multi-antigen mass vaccination campaigns in urban areas (including Dange Shuni and Wamakko LGAs) and strengthened routine immunization services in rural areas of Wamakko and Dange Shuni LGAs through implementation of the Reaching Every Ward (REW) strategy and support to primary healthcare facilities. As vaccination coverage survey data are available only for the urban mass vaccination campaign, vaccination coverage indicators (Pentavalent 1, Pentavalent 3, Measles-1, and Measles- 2) will be added to the nutrition survey to estimate coverage and gain a better understanding of routine immunization (RI) performance in the rural populations of Wamakko and Dange Shuni LGAs. The proposed survey will therefore provide representative estimates of acute malnutrition, among children aged 6-59 months and PBWG, mortality estimates and vaccination coverage (pentavalent vacci and MCV). The findings will guide programme planning, inform decisions on potential nutrition interventions, provide overall LGA-level estimate of vaccination coverage in both study locations and establish baseline indicators for monitoring and evaluation of future MSF-supported activities and advocacy.