NPHCDA Zonal Office in Kano gets an Upgrade

An often neglected aspect of executing health projects or interventions is the availability of functional infrastructure. A comfortable working environment and the availability of work tools such as internet and communication systems have a positive impact on employee performance and increase work productivity.

eHealth Africa collaborates with partners to design, build, restore and maintain diverse sites and facilities. With funding from the Bill and Melinda Gates Foundation (BMGF) and in partnership with the National Primary Health Care Development Agency (NPHCDA), we renovated the administrative block of three NPHCDA zonal offices in Kano, Minna and Bauchi states in 2018.

The renovated NPHCDA zonal office in Kano

The focus of this renovation was on alleviating the perennial problem of insufficient workspaces and power outages which have hindered staff from delivering on tasks. The administrative offices were fitted with new work tables, chairs and office equipment. The reception area and the conveniences were also refurbished. eHealth Africa renovated a thirty-seater conference room and fitted it with audio and video conferencing technologies like microphones and a projector system.

30- seater conference room

eHA also upgraded the IT facility in these facilities, installing a state of the art data/ server system.  In addition, an off-grid hybrid (Solar and wind) power system was installed to provide 24-hour electricity. Solar panels are a cost- effective electricity source that will not be financially burdensome on the agency in the long- run.  

On the 18th of December, 2018, the staff of the Kano Zonal NPHCDA office moved into the newly renovated office. eHealth Africa also conducted a technical know-how/ product knowledge training for relevant staff at the Kano zonal office to enable them configure, use and properly use the IT facilities.

NPHCDA zonal staff and eHA renovation team at the renovated Kano zonal office in Naibawa

Are you interested in our infrastructure services? Click here to read more.

Three things I learned at the 2018 ASLM Conference

By Tolulope Oginni

At eHealth Africa, we aspire to operate effective laboratories that use state-of-the-art tools and technologies to collect, analyze and disseminate usable, reliable data that can help governments, stakeholders and the health system in general, to mount appropriate responses to public health threats.

The 4th conference of the African Society for Laboratory Medicine (ASLM) was held in Abuja, Nigeria from 10-13 December 2018. This year, the focus was on “Preventing and Controlling the Next Pandemic”. The event provided a platform for stakeholders in the international laboratory medicine community to address issues, share best practices and develop innovative approaches to combat current and emerging health threats.

Conferences are an exciting, interactive way to learn new things in any field. I was excited to attend the 2018 ASLM conference with a colleague from our Sokoto Meningitis Lab. Here are three new things I learned.

1. The need for labs to adopt External Quality Assurance (EQA) to improve their laboratory processes and performance

External quality assurance is a system for objectively checking a lab’s performance and processes by comparing it against an external agency or facility. EQA helps to identify systematic problems associated with kits and operations so that corrective action can be taken immediately. By participating in external quality assurance, training needs and capability gaps among lab staff can be identified and solved so that the lab can produce more accurate and reliable results. This is especially important for labs in Africa which are the backbones of disease surveillance and response.

2. Increasing efficiency in lab diagnosis and testing

One of the resounding themes at the 2018 conference was the need for labs across Africa to learn and adopt modern testing techniques such as Multiplexing and microfluidic assays in their operations. Multiplexing and microfluidic assays allow various investigative procedures to be simultaneously conducted on two or more analytes—chemical components of interest—using the same biological sample. By reducing the time spent preparing samples and conducting multiple tests, it boosts efficiency and reduces wastage.

3. Collaboration in public health research

At eHealth Africa, we design and partner in public health laboratory research in order to contribute to the body of knowledge and increase access to quality information in the field of laboratory and diagnostics in Africa. We are currently collaborating with the International Foundation Against Infectious Disease in Nigeria (IFAIN) and University of Nebraska Medical Center (UNMC) on an investigative device that can increase access to sickle cell diagnostic services to low resource settings. In addition, we are collaborating with Sokoto state government to provide round-the-year laboratory-based meningitis surveillance in Sokoto, Kebbi and Zamfara state.

However, public health research in Africa is a field that is still largely untapped and one which requires a lot of strengthening. I was very pleased when the conference devoted an entire pre-workshop conference to Manuscript writing and research conceptualization. In addition, it gave me the opportunity to meet Professor Iruka Okeke, a professor of Microbiology whose work I have followed since my days as an undergraduate. One of the plenary sessions focused on synergizing partnerships which I believe is important for growth in this field. As one of the speakers said, “...the problem with public health research in Africa is not a lack of partners but lack of coordination of the many activities conducted by various partners.”

With friends at the conference

It is imperative that labs in Africa position themselves properly to support epidemiological surveillance systems. In West Africa especially, labs must do more to meet the standards set by their counterparts in Southern and Eastern Africa international accreditation such as ISO 15189. A large number of accredited labs in Nigeria are government-owned research labs. Work still needs to be done by privately- owned labs to attain this accreditation. In the face of emerging public health issues, now more than ever, efforts must be made to strengthen public-private partnerships and participation in laboratory medicine.

Partnering to Address Sickle Cell Disease in Northern Nigeria

By Muhammed Hassan

According to the U.S. Centers for Disease Control and Prevention (CDC), Nigeria alone accounts for more than 100,000 new sickle cell births every year1. Statistics from African region of the World Health Organization (WHO) puts the prevalence of the Sickle cell trait in Nigeria at 20% to 30%2. In sub-Saharan Africa, very few control programs exist and those that do exist, lack national coverage or the facilities to manage patients. Proactive, routine screening for sickle cell disease is not common practice so diagnosis is usually made when a severe complication occurs.

At eHealth Africa, we aim to improve the quality and availability of healthcare for underserved populations and to increase access to timely and quality diagnostic services. We partnered with Sickle Cell Well Africa Foundation (SCWAF), Pro-Health International and the Presidential Committee on the North- East Initiative (PCNI) to hold a two-week outreach in Bajoga LGA, Gombe state, and Toro LGA in Bauchi State from the 2nd-16th December 2018.

The team hosted community and school outreaches in both LGAs. Beneficiaries of the outreaches in both LGAs were educated about Sickle Cell Disease (SCD), inheritance, signs and symptoms, and the importance of genotype testing for SCD and prevention. Free genotype tests were conducted using the Sickle Scan Rapid Test Kit.

Patients who tested positive for SCD and those who presented with severe complications were given routine medication, advised on first-level crisis management and referred to tertiary hospitals. eHealth Africa captured, stored and analyzed the results of the tests. The analyses provided insight into the geographic distribution of patient and the average age distribution of patients who tested positive for SCD and the categories of complications presented at the outreach.

eHealth Africa, Pro-Health and SCWAF presented these results at stakeholder meetings in both states and provided evidence-based recommendations to enable the states to tackle Sickle Cell Disease. Going forward, eHA intends to work with Pro-Health to develop a comprehensive data collection tool which will support tracking and follow up of SCD patients in Prohealth Sickle Cell Clinics.

The Impact:

Practical Solutions to Challenges in Reporting: LoMIS Stock and eIDSR

By Abdullahi Halilu Katuka and Emerald Awa- Agwu

LoMIS Stock is an electronic stock management tool, developed by eHealth Africa as a part of a suite of mobile and web applications that address supply chain and logistics challenges in health systems, especially in Northern Nigeria. LoMIS Stock helps health workers report and keep track of vaccine stock usage and availability at the health facility level. Using these reports, their supervisors can prevent stock-outs at their health facilities by ensuring that vaccines and other commodities are always available. The information from LoMIS Stock also gives governments the real-time data that is needed to plan programs and interventions and to resolve issues.

The LoMIS Stock solution was introduced to Kano State in 2014 and is currently the official logistics management tool for Kano State Primary Health Care Management Board (KSPHCMB). Currently, the State cold store, all 44 Local Government cold stores, and 484 apex health facilities in Kano send weekly reports using the LoMIS Stock application.

Although health facilities reporting times have dropped by over 50% and reporting rates have tripled since the introduction of LoMIS Stock, certain facilities in hard to reach areas were consistently unable to send reports due to mobile data network challenges. Gleaning from lessons learned from a similar challenge encountered with our electronic Integrated Disease Surveillance and Response System (eIDSR) solution in Sierra Leone, eHealth Africa added an SMS compression feature to the LoMIS Stock application.

In Sierra Leone, we have recorded a significant improvement in the number of facilities that send timely reports using the eIDSR application. Health facility workers in Sierra Leone use eIDSR to collect data offline on epidemiologically important diseases and send surveillance reports. Initially, in areas with poor connectivity, the application would store the reports and submit automatically as soon as an internet or mobile connection became available. However, this meant that such facilities didn’t always meet the targets for timely reporting.

Introducing the SMS compression feature enabled health workers in the defaulting facilities to send their weekly reports using a USSD short code if an internet connection or mobile data was unavailable. Thanks to this feature,  all the districts in Sierra Leone consistently exceed the World Health Organization (WHO) African region and national report completeness and timeliness targets.

The USSD feature for LoMIS Stock has been piloted with the pharmaceutical department of KSPHCMB to monitor incoming and outgoing stocks and the results have promising. In the first month, the stock count report at the pilot health facilities shows 100% stock sufficiency reporting and 0% wastage. After the pilot period, the feature will be rolled out to all departments of KSPHCMB to allow better reporting and increased efficiency across health facilities in Kano state.

Innovative problem solving is one of our values at eHealth Africa and this is an example of how eHA develops context-specific solutions to problems in healthcare delivery.

Meet the Team - Sonia Khalil

Meet Sonia Khalil, the Procurement Supervisor in our Sierra Leone office!

Sonia joined eHealth Africa (eHA) over  4 years ago. Her role supports all programs and projects. She is responsible for procurement activities, including managing supplier contracts & relationships, managing efficient distribution of supplies in the supply chain cycle, and providing training internally to ensure good internal control systems. Sonia serves as the lead in the Operations team to ensure procurement processes and procedures are followed.

Sonia’s work with eHA  has made her develop a strong international field experience in supply chain. This role has  further made her diplomatic, cultural and gender sensitive. When Ebola broke out in Sierra Leone, Sonia had the opportunity of taking part in the Ebola Response Management System right from the beginning of the outbreak, where she served as the focal person for all logistical support for the organization.

During the U.S. Centers for Disease Control (CDC) Vaccine trial in 2015, Sonia also supervised the logistics, fleet and procurement staff in preparation and implementation of the project work plan to monitor supplies throughout the clinical trial at the time.

Sonia’s contribution to her team has been remarkable. She has established a good internal control system, provided training and coaching on best procurement practices, established proper procurement policy and templates, practiced with the team fair and transparent procurement structures.

Her greatest achievements have been: managing the initial set-up of the offices and providing a system for the rapid distribution of supplies and logistical support to the various emergency response centers in the districts during initial emergency stage in 2014; participating in program and emergency response strategy planning, participating in the development and deployment of policies for best practices.

Sonia won an award for Outstanding Non-Profit Professional Staff of The Year 2018. The award was presented by the Sierra Leone CEO council at the Golden Tulip Hotel, Aberdeen, Freetown, Sierra Leone.

We are happy and proud to have Sonia as part of our eHealth Africa team.

Would you like to be a part of our team? Click here to find out more.

eHA supports skill building of Sierra Leone’s Community Health Officers

By Sibongile Chikombore and Uche Ajene

The Ebola Virus Disease (EVD) exposed the need for increasing human resource capacity in  Sierra Leone’s fragile health system. Prior to the launch of the Community Health Officers Management and Leadership Training Program (CHO-MLTP) in 2016, there was no formal training of that nature for health professionals in the country. The U.S. Centers for Disease Control and Prevention (CDC) collaborated with the Ministry of Health and Sanitation (MOHS), Njala University, Emory University, ICAP of Columbia University, and eHealth Africa (eHA) to develop a novel training program to address this need and ultimately improve health service delivery and health outcomes in Sierra Leone. CHOs working at Community Health Centers (CHCs) were targeted to be the first cadre to receive this public health management and leadership training, given their key role as first-line health service providers and chiefdom leaders.

The aim of the MLTP is to emphasize public health systems thinking and basic management principles needed to run effective health facilities and outreach services. The emphasis of the project is also to strengthen interpersonal communication and engagement with community leaders in order to develop practical and sustainable solutions to longstanding public health challenges.

In Sierra Leone, the Peripheral Health Units (PHU) comprise of  Community Health Centres (CHCs), Community Health Posts (CHPs) and Maternal and Child Health Post (MCHPs). CHCs are headed by a Community Health Officer (CHO). The CHC is usually located at chiefdom headquarter level and provides services to a population ranging from 5,000-10,000 people. The CHP and MCHP are both usually located at smaller villages serving about 5000 or fewer people. They are manned by Community Health Assistants (CHAs) or Dispensers and Maternal and Child Health Aides (MCH-Aides) respectively.

CHO functions at the health center largely include administrative and clinical duties. The clinical responsibilities include treatment and appropriate referrals of medical, surgical and obstetric emergencies. They also supervise the activities of other PHUs in the chiefdom and report to the District Health Management Team (DHMT).

A total of ninety-nine (99) out of one hundred and seventy (170) CHOs across eight (8) districts (Bo, Kambia, Koinadugu, Bombali, Kenema, Kailahun, Western Area Urban and Rural) have been trained so far out of 12 targeted districts nationwide. The CHOs are trained in cohorts, comprised of CHOs from two districts.

As part of the effort towards sustainability and smooth transitioning of the CHO MLTP, selected staff from MOHS and Njala University are being trained as Trainers. Saidu Mansaray, CHO at Kroobay Community Health Center, is one of 99 CHOs who has been trained by eHA through the CHO-MLTP and was subsequently nominated to be part of the key individuals to form the Ministry of Health and Sanitation (MoHS), Training of Trainers (TOT) team. eHA conducted three TOT sessions for MOHS and Njala University staff who are the key MLTP implementing partners in Sierra Leone.

“I was part of the third cohort studies for the Sierra Leone CHO-MLTP. I was fortunate to be announced as one of the outstanding candidates in the CHO-MLTP Program.’”

— Saidu Mansaray

The CHO MLTP has eleven (11) modules covered over a six-month period, with one of the key modules on Quality Improvement (QI). Before a CHO is eligible to graduate, he/she is expected to implement a QI project on either Improving Human Immunodeficiency Virus (HIV) or Hypertension Screening at their respective health facilities over a three month (minimum) period. The QI aims to address gaps or challenges in health service delivery at facility level on HIV or Hypertension during the MLTP, but the knowledge gained can be later used to apply the QI principles on other health challenges at the facility.

Through implementation of the QI, the CHO and PHU staff are able to work together as a team to brainstorm root causes of the health challenge being faced at the  facility, come up with interventions, and prioritize interventions (based on ease of implementation and how important they are on a scale of one to five). From the prioritization matrix, the QI team from each facility then implements the interventions (also known as “change ideas”) within their own capacity, using the limited resources available.

Saidu implemented an HIV screening QI project at his health facility, where HIV testing rates were low. Prior to the implementation of the QI project, only 26% of eligible persons over 15 years old were tested for HIV. Saidu recognized that increased HIV testing would be necessary to ensure that members of his community know their HIV status and could receive appropriate care. Since the implementation of the QI project at his health facility, the HIV testing rate of eligible persons over 15 years has increased to 81%, and patients found to be positive have also started receiving HIV management care.

“This training has further helped me to manage both logistics and human resources at the facility. I am now able to use the little resources I have in my facility to produce the best of results.”

— Saidu Mansaray

Saidu was also nominated to be a TOT participant after showcasing good leadership skills during his MLTP training in cohort three, has attended 3 TOT sessions organized by eHA. In December 2018, Saidu and other CHOs participated in the 3rd ToT session and was captured actively participating during the TOT workshop facilitating and presenting group work assignments to colleagues - see pictures attached below. After the TOT, Saidu and other TOT participants are expected to mentor other CHOs undergoing the MLTP nationwide.

“I am also currently being trained to pass on the skills learned from the CHO-MLTP Program to others.”

— Saidu Mansaray

Meet the Team - Charles Otaigbe

Meet Charles Otaigbe, a groundskeeper at our Kano campus!

Charles joined eHealth Africa four years ago and was one of the staff who made our move to our present facility on Independence Road smoother. He keeps our grounds looking clean and beautiful by taking care of our lawns, flowers and outdoor pest control.

At eHealth Africa, every team member is valued for what they bring to the table. This, in particular, is what Charles loves best about eHealth Africa. He believes that the work environment contributes greatly to staff productivity.

“Even though I am not a core project or programs staff, I know that I have contributed to the success of eHealth Africa by doing my work diligently and this makes me proud.”

— Charles Otaigbe

We are proud to have Charles on our team.

Are you interested in joining our team? Click here to find the perfect spot.