Acceptability and feasibility of measles vaccination, small-quantity lipid-based nutrient supplementation, and their co-delivery among children aged 6-23 months in northern Nigeria: a qualitative study
- 1University of Bordeaux, INSERM UMR 1219, IRD EMR 271, Bordeaux Population Health Centre, Bordeaux, France
Abstract
Background. Undernutrition and infectious diseases form a vicious cycle that endangers child survival in low-resource settings, including in Northern Nigeria. The NutriVax-Measles trial was designed to evaluate a strategy combining preventive small-quantity lipid-based nutrient supplements (SQ-LNS) distributions with community mobilization and routine immunization services for children aged 6-23 months to improve measles vaccination uptake. To inform future programs co-delivering nutrition supplementation and immunization services at scale, we aimed to assess the feasibility and acceptability of measles vaccination, SQ-LNS distribution, and the NutriVax strategy. Methods. A qualitative study was conducted at the end of the trial using in-depth interviews (n=53) and focus group discussions (n=8) with key stakeholders: caregivers, health care workers, community health workers, and community representatives. Thematic analysis was guided by multiple conceptual frameworks. Results. The majority of the participants expressed satisfaction with measles vaccines in both arms, and with SQ-LNS in the NutriVax arm, as they perceived the benefits for their children health. In both arms, community awareness sessions and previous experience of outbreaks were key to motivating caregivers to bring their children to healthcare centres. Although distance to health facilities was identified as one of the main barriers to accessing care, SQ-LNS was perceived as an important source of motivation to bring their child to the clinic where they subsequently received vaccination. All stakeholder groups emphasized the importance of community leaders support and targeted male sensitization to address the prevailing sociocultural norms. Additionally, improved service organization to reduce waiting time was considered crucial to enhance caregivers acceptability of the intervention. Conclusion. Both measles vaccination and SQ-LNS provision were acceptable and feasible, supporting the NutriVax strategy within primary healthcare settings in fragile health systems. Successful implementation depends on sustained community sensitization, continued engagement of fathers and community leaders, and service delivery decentralized as close as possible to beneficiaries.
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BibTeX
@misc{ahmad2026acceptability,
title = {{Acceptability and feasibility of measles vaccination, small-quantity lipid-based nutrient supplementation, and their co-delivery among children aged 6-23 months in northern Nigeria: a qualitative study}},
author = {S. I. Ahmad and J. Nabunje and S. K. Adamu and A. M. Sheriff and A. G. Gwayo and A. Goje and I. Atanga and A. M. Akinyi and E. C. Ugonna and S. Bahonon and U. Chiroma and H. M. Adam and R. Becquet and N. S. Muhammad and B. W. Goni and C. Cazes and K. P. Q. Phelan and M. Plazy},
howpublished = {medRxiv},
year = {2026},
month = nov,
doi = {10.64898/2026.11.06.26367420},
url = {https://www.medrxiv.org/content/10.64898/2026.11.06.26367420v1},
note = {CC BY-NC},
}
RIS
TY - UNPB
TI - Acceptability and feasibility of measles vaccination, small-quantity lipid-based nutrient supplementation, and their co-delivery among children aged 6-23 months in northern Nigeria: a qualitative study
AU - S. I. Ahmad
AU - J. Nabunje
AU - S. K. Adamu
AU - A. M. Sheriff
AU - A. G. Gwayo
AU - A. Goje
AU - I. Atanga
AU - A. M. Akinyi
AU - E. C. Ugonna
AU - S. Bahonon
AU - U. Chiroma
AU - H. M. Adam
AU - R. Becquet
AU - N. S. Muhammad
AU - B. W. Goni
AU - C. Cazes
AU - K. P. Q. Phelan
AU - M. Plazy
PY - 2026
DA - 2026/11/06
PB - medRxiv
DO - 10.64898/2026.11.06.26367420
UR - https://www.medrxiv.org/content/10.64898/2026.11.06.26367420v1
AB - Background. Undernutrition and infectious diseases form a vicious cycle that endangers child survival in low-resource settings, including in Northern Nigeria. The NutriVax-Measles trial was designed to evaluate a strategy combining preventive small-quantity lipid-based nutrient supplements (SQ-LNS) distributions with community mobilization and routine immunization services for children aged 6-23 months to improve measles vaccination uptake. To inform future programs co-delivering nutrition supplementation and immunization services at scale, we aimed to assess the feasibility and acceptability of measles vaccination, SQ-LNS distribution, and the NutriVax strategy. Methods. A qualitative study was conducted at the end of the trial using in-depth interviews (n=53) and focus group discussions (n=8) with key stakeholders: caregivers, health care workers, community health workers, and community representatives. Thematic analysis was guided by multiple conceptual frameworks. Results. The majority of the participants expressed satisfaction with measles vaccines in both arms, and with SQ-LNS in the NutriVax arm, as they perceived the benefits for their children health. In both arms, community awareness sessions and previous experience of outbreaks were key to motivating caregivers to bring their children to healthcare centres. Although distance to health facilities was identified as one of the main barriers to accessing care, SQ-LNS was perceived as an important source of motivation to bring their child to the clinic where they subsequently received vaccination. All stakeholder groups emphasized the importance of community leaders support and targeted male sensitization to address the prevailing sociocultural norms. Additionally, improved service organization to reduce waiting time was considered crucial to enhance caregivers acceptability of the intervention. Conclusion. Both measles vaccination and SQ-LNS provision were acceptable and feasible, supporting the NutriVax strategy within primary healthcare settings in fragile health systems. Successful implementation depends on sustained community sensitization, continued engagement of fathers and community leaders, and service delivery decentralized as close as possible to beneficiaries.
ER -