Evaluating the Impact of a Technical Assistance Approach for COVID-19 Vaccination Coordination and Coverage in Nigerian States: A Most Significant Change Evaluation Study

Abstract Introduction In 2023, Nigeria was still faced with the challenge of achieving COVID-19 vaccination targets, especially at the subnational levels. The Technical Assistance for COVID-19 Vaccine Deployment Project (TA CVDP), was implemented in 18 states to strengthen coordination, data use and institutional capacity. Methodology A Most Significant Change Evaluation study was conducted to identify outcomes attributed to the TA intervention. Six states were purposively selected, 1 per geo-political zone. Fifty-five stakeholders participated and 32 significant change stories were randomly selected and analyzed across the domains of assessment, planning and coordination, data use and institutional strengthening, using a thematic content analysis approach. Results The study found that there were significant changes across the domains. The stories showed improvement in COVID-19 Technical Working Group planning, coordination and functionality, and there was a noticeable increase in the utilization of data for planning, resource allocation, and targeting. Additionally, institutional strengthening was evident in increased government ownership, enhanced supervision, and improvement in state actors’ capacity to lead data management and logistics. Respondents consistently attributed these positive changes to the substantial support from the TA interventions such as the capacity building on data use, deployment of action plan tracker, and the establishment of the data control room. Conclusion The evaluation emphasizes the targeted role Technical Assistant Intervention can play in improving health systems in resource-constrained settings. Importantly, these changes were aligned with what respondents considered crucial, and there was a strong consensus that the project significantly addressed gaps in response to the anticipated results.