Tracking the Naira and the Needle: How Budget Accountability Is Shaping Immunization Outcomes in Northern Nigeria
By Ahmed Ahmed
In a region where preventable diseases still threaten the lives of thousands of children, the link between public finance and public health has never been more critical.
The 2025 Immunization Budget Accountability Scorecard released by the Africa Health Budget Network (AHBN), in collaboration with its Communities of Practice (CoP) across Bauchi, Sokoto, and Kano States, offers a revealing snapshot of how government commitments, funding releases, and implementation realities intersect to shape immunization outcomes in northern Nigeria.
The scorecard, contained in a press statement signed by the AHBN Coordinator, Dr. Aminu Magashi Garba, and made available to journalists in Bauchi, builds on years of evidence-based tracking and citizen-led accountability.
It assesses government performance across key indicators, including budget allocation, releases, and service delivery outcomes for routine immunization during the 2025 fiscal year.
Although the Zero Dose Learning Hub (ZDLH) initiative supported by GAVI with technical partnership from AFENET—formally concluded in December 2025, AHBN and its partners insist that accountability efforts must continue to ensure no child is left behind.
At the heart of the scorecard is a shared goal: expanding equitable access to life-saving vaccines, especially for zero-dose children—those who have not received a single routine vaccine.
The findings reveal a mixed picture of commendable progress, persistent gaps, and opportunities for reform across the three states reviewed.
Bauchi: Strong Funding, Weak Coverage
Bauchi State stands out for its fiscal commitment to immunization in 2025. The state government allocated and fully released ₦872 million into the Immunization Memorandum of Understanding (MoU) Basket Fund, achieving a rare 100 percent release.
This milestone, applauded by AHBN and the Community of Practice, reflects strong political will and continuity in supporting routine immunization financing.However, the scorecard reveals a troubling disconnect between financial inputs and health outcomes.
Despite the full release of funds, Penta 1 and Penta 3 vaccination coverage rates in Bauchi remain below 40 percent. These figures suggest that funding alone is not enough. Challenges related to implementation, community engagement, health worker deployment, and demand creation continue to limit vaccine uptake.
For AHBN, the lesson is clear: sustained investment must be matched with effective service delivery. Strengthening community outreach, addressing supply-chain bottlenecks, and tackling vaccine hesitancy are critical steps if Bauchi is to translate budgetary success into real protection for every child.
Sokoto: Advocacy Paying Off, Transparency Still Needed
In Sokoto State, the 2025 scorecard highlights a more incremental but significant gain. The state government released ₦365 million for immunization programmes, marking a positive step toward strengthening routine immunization financing.
This progress, AHBN notes, was largely driven by sustained advocacy and engagement by the Community of Practice.
The impact of this advocacy was publicly acknowledged by the Executive Secretary of the Sokoto State Primary Health Care Development Agency, Dr. Bilyaminu Balarabe Yari Sifawa, during the ZDLH End-of-Year Media Parley.
His recognition underscores the growing influence of civil society and citizen-led accountability in shaping public health priorities.Yet, the scorecard also points to areas requiring urgent attention.
Data transparency and accessibility remain weak, limiting shared understanding and evidence-based decision-making. AHBN and the CoP have therefore called on the Sokoto State Ministry of Budget and Planning to leverage existing platforms, including government websites, to publish timely and comprehensive quarterly budget performance reports.
Such openness, they argue, will strengthen trust, coordination, and results.
Kano: Investment Meets Impact
Kano State presents perhaps the most encouraging narrative in the 2025 scorecard. The state recorded a historic milestone with a total ₦1.4 billion allocated to immunization services—nearly triple the ₦528 million allocated in 2024.
This substantial increase signals a growing prioritization of immunization within Kano’s health agenda.More importantly, the increased funding appears to be delivering results. Penta 1 and Penta 3 vaccination coverage rates in the state both exceeded 65 percent, a marked improvement compared to previous years.
For AHBN, Kano demonstrates what is possible when political commitment, adequate financing, and effective implementation align.To sustain this momentum and further reduce the number of zero-dose children,
AHBN and the Community of Practice have urged the Kano State Primary Health Care Management Board to prioritize timely and adequate disbursement of the Basic Health Care Provision Fund (BHCPF) to primary healthcare facilities. Frontline facilities, they stress, are where budgets ultimately become vaccines in children’s arms.
Looking Beyond 2025
Across Bauchi, Sokoto, and Kano, the 2025 Immunization Budget Accountability Scorecard reinforces a central message: accountability is not an event, but a process.
As the ZDLH initiative ends, AHBN and its partners remain committed to sustaining citizen-led monitoring and advocacy into 2026 and beyond.
The stakes are high. Immunization is one of the most cost-effective public health interventions, yet
its success depends on more than allocations on paper. It requires transparency, timely releases, strong systems, and active communities
. As northern Nigeria continues its fight against preventable childhood diseases, the scorecard serves as both a mirror and a roadmap showing where progress has been made, and where urgent action is still needed
.