An LGA Cold Chain Officer in Nasarawa State opens Nigeria’s Last Mile Vaccine Stock Visibility (LMVSV) dashboard. Across the health facilities in their LGA, green marks adequate vaccine stock, red signals a stockout and other colors show facilities approaching reorder levels or carrying less stock than they need. Behind every color is a person. At each participating health facility, a designated focal person, often an M&E officer or officer-in-charge, enters stock information into a DHIS2-based reporting tool. That information becomes visible to the LGA Cold Chain Officer, who can investigate shortages, identify where stock is available and help inform decisions about resupply or redistribution.
A stock count made inside one clinic has become a signal that can travel through the health system.
That matters enormously in Nigeria. The country’s routine immunization program serves a birth cohort of roughly eight million children each year across 11 vaccines, yet 2022 WHO and UNICEF estimates placed the number of zero-dose children at 2.3 million, the second-highest total in the world. Half live in just 16 percent of Nigeria’s districts. Vaccine availability explains only part of that inequity, but health teams need to know whether doses are available where children go to receive them. A healthy stock position at national or LGA level can still conceal a shortage at an individual clinic, even when another facility nearby has doses available; aggregate data can mask very different realities on the ground.
Nigeria has already demonstrated the value of supply chain visibility upstream. OpenLMIS covers all 835 vaccine cold stores, giving managers information on stocks, batches and expiration dates. Coordinated use of those data helped prevent more than 850,000 vaccine doses from expiring during 2024 and 2025.
Until recently, however, Nigeria’s digital line of sight largely ended at the LGA. Around 20,000 primary health facilities continued to rely on paper stock records. That left a critical gap between the vaccine supply visible to national and subnational managers and what was actually available when a child arrived for immunization.
Extending Nigeria’s line of sight
The National Primary Health Care Development Agency (NPHCDA) is now leading the nationwide rollout of the LMVSV system, with technical assistance from VillageReach and Development Delivery Partners (DDP).
The work began with an existing DHIS2 tool that had previously been piloted but had usability gaps. Working with NPHCDA and the developers, VillageReach and DDP helped refine the reporting tool and analytics dashboard, develop the national implementation plan and training materials, establish governance processes and prepare the system for national rollout.
The team also adapted the technology around the people expected to use it, refining the digital reporting form to mirror familiar paper tools, while offline functionality and other improvements were introduced through user feedback. National trainers were prepared to support deployment across the country, while VillageReach and DDP provided deeper implementation support in Bayelsa, Jigawa, Ogun and Nasarawa, directly training health facility focal persons and state and LGA officers and placing consultants in-state to help troubleshoot reporting and implementation challenges.
By July 2026, 13,634 health facilities across all 36 states and the Federal Capital Territory had been enrolled. More than 29,000 facility focal persons and 1,900 state and LGA officers had been trained. The dashboard was hosted on an NPHCDA server, placing ownership and oversight firmly within government.
Nigeria is building a national chain from a stock balance entered at a health facility to information that can support a supply decision.
Between June 21 and July 26, the number of facilities that had reported at least once grew from 3,680 to 4,855. Their reports are already exposing supply risks that could previously remain inside paper registers. During one July reporting week, more than 1,000 facilities reported at least one antigen below minimum stock levels, while hundreds recorded a stockout. Each report now gives immunization teams somewhere specific to look.
Keeping the picture current
The next challenge is making that national picture consistently reliable. Weekly reporting reached 1,756 facilities before server disruption contributed to a fall to 582. Once the issue was resolved and follow-up intensified, reporting recovered to 1,614 facilities.
The four deep-engagement states offer an instructive early signal. Although Bayelsa, Jigawa, Ogun and Nasarawa represent about 7.5 percent of facilities with reporting credentials, they generated nearly 22 percent of all facility reports during the referenced week. Their experience illustrates what happens around the technology after training. In-state consultants work with government teams to identify reporting gaps, resolve problems and bring performance into routine review meetings. Across the wider program, states with stronger supportive supervision, accountability and regular review have shown faster improvements in reporting.
At the Africa Primary Health Care Forum, Dr. Muknaan David Nshe of the Christian Health Association of Nigeria urged digital health programs to design systems “around the workflow of the health worker.” LMVSV is putting that principle into practice: reporting must fit into days already filled with immunization, patient care and commodity management; users need responsive technical support and to see that the information they submit leads somewhere.
A planned operations center will further strengthen that feedback loop, helping identify persistent non-reporting while giving facilities a direct route to report system problems and receive support.
Connecting stock, storage and distribution
The next phase will deepen what those facility reports can tell Nigeria’s immunization system.
Integration with OpenLMIS will connect the facility-level picture with data from higher levels of the vaccine supply chain. Planned interoperability with real-time monitoring devices and the Cold Chain Data Exchange (CCDX) will add information about temperature and equipment performance. A manager could then see more of the conditions surrounding a vaccine: how much is available, how quickly it is being consumed and whether the cold-chain equipment protecting it is functioning properly.
As reporting becomes more consistent, that history can also support predictive analytics. Patterns in consumption and recurring shortages could help teams identify emerging risks earlier and guide vaccines toward facilities before services are interrupted.
Omofome Ikogho of DDP captured the discipline required for that future: “You cannot automate a broken system.” Nigeria’s experience shows what building the system beneath the analytics actually entails: usable tools, dependable reporting, government governance, interoperability and sustained implementation support.
On the dashboard, a color becomes useful when a facility focal person has entered reliable information, the system has carried it forward and someone with the authority to act can see what it means.
Green, red and everything between them are the visible end of that chain. The promise behind the colors of last-mile visibility is that Nigeria can increasingly see each facility clearly enough to respond before a shortage reaches the child waiting for a vaccine.