Development of a Pandemic-Resilient Framework to Optimise Childhood Routine Immunisation and Maternal Health Services Post-COVID-19 Pandemic in Sokoto State, Nigeria: A Mixed Method Study Protocol

The COVID-19 pandemic reduced access to childhood immunisation and maternal health services in Nigeria, which already reports some of the highest maternal and child mortality rates globally. This study seeks to develop a pandemic-resilient framework to optimise these services post-pandemic. An explanatory sequential mixed method study design will be used, consisting of three distinct but interconnected phases. In phase 1, an analytical retrospective cohort study using administrative data from Sokoto State from 2015 to 2023 will be analysed to inform the qualitative study design. Microsoft Excel 2013 worksheets will be used to collect and export secondary data into R Statistical Software (version 4.1.2) for analysis using descriptive statistics and dynamic time-series regression. In phase 2, qualitative data collection tools will be developed based on the socio-ecological model and the Health Belief Model and refined based on the outcome of the quantitative analysis. The data will be collected using key informant interviews and focus group discussions with purposively selected participants. Thematic analysis involving deductive coding will be employed. In the final phase, the pandemic-resilient framework will be developed using Strength, Weakness, Opportunity, and Threat (SWOT) analysis; the Threat, Opportunity, Weakness, and Strength (TOWS) model; and the Build, Overcome, Explore, and Minimise (BOEM) model. The resulting framework will be validated using the Delphi technique and used to inform policy on building resilience of childhood immunisation and maternal health services during public health emergencies, which is critical for future pandemic preparedness.