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Sustaining the Push: Essentials for Attaining a Polio-free Nigeria

Children at a school in Kogi State receive the Oral Polio Vaccine during an Immunization Plus Days (IPD) activity

Children at a school in Kogi State receive the Oral Polio Vaccine during an Immunization Plus Days (IPD) activity

Today, June 19, 2020, the World Health Organization (WHO) declared Nigeria, polio-free.

The first requirement for attaining the polio-free certification—no wild poliovirus transmission for three consecutive years—was attained on August 21, 2019  1.

The Africa Regional Certification Committee’s visit to Borno State in March 2020 as part of the process for certifying Nigeria polio-free

The Africa Regional Certification Committee’s visit to Borno State in March 2020 as part of the process for certifying Nigeria polio-free

This success is the result of several sustained efforts, including domestic and international financing, the commitment of thousands of health workers and the switch to electronic, technology-driven data collection and management systems which have given decision-makers and polio eradication partners the accurate data needed to develop plans and strategies for reaching every eligible child, even in hard-to-reach and security-challenged areas 2.

Having achieved the milestones of primary requirements, the ARCC will first review the complete documentation report of the interruption of wild poliovirus type 1 and then proceed to conduct field verification visits to select states in the south of Nigeria. If the ARCC is satisfied with the national documentation and field verification after both visits in December 2019 and March 2020, the WHO African Region could be certified to have eradicated polio by mid-2020.
— Dr. Fiona Braka, WHO Nigeria Team Lead, Expanded Programme on Immunization (EPI)

eHealth Africa supported these efforts by providing Geographic Information Systems-based solutions and services including the Vaccination Tracking System (VTS). Here is how states benefited :

  • eHA supported states to develop a comprehensive, up-to-date list of settlements. 

In 2014 and 2015, eHA mapped the eleven northern states under the Global Polio Eradication Initiative (GPEI). The data proved so useful to decision-makers that eHA received funding from the Bill and Melinda Gates Foundation (BMGF) teamed up with the National Primary Health Care Development Agency (NPHCDA), the UK Department for International Development (DFID), Flowminder, the United Nations Population Fund (UNFPA) and the Center for International Earth Science Information Network (CIESIN) to map the rest of Nigeria during the Geo-Referenced Infrastructure and Demographic Data for Development (GRID3) project which lasted from 2017 to 2019. We also frequently execute data collection and campaign activities across the country during which we gather spatial and non-spatial data relating to several points of interest including settlements and health facilities. These data are housed in what we call the eHA Geodatabase (GDB). 

Using the datasets in the GDB, we have helped states in Nigeria to identify previously unknown settlements and update their master list of settlements. eHA developed and provided the states updated LGA and ward level maps. The maps include the geocoordinates, names, and delineated boundaries of known and newly identified settlements. These updated master list of settlements and the new maps allow health planners to develop accurate, comprehensive micro plans for Routine and Supplementary Immunization Activities and reach eligible children in the remotest communities.

The Vaccinator Tracking System dashboard

  • eHA built the capacity of health teams at the state and local government levels to visualize and analyze vaccination coverage data for decision making during campaigns.

Through the VTS dashboard decision-makers, partners, and other stakeholders can access near real-time information about ongoing and concluded immunization campaigns such as the immunization coverage and missed settlements. eHA trained health teams at the state and LGA levels to easily access, visualize and analyze the data on the dashboard, and use it to promptly identify and address challenges that may affect the immunization coverage levels in the state. 

The milestones recorded by Nigeria’s Polio Eradication program prove without a doubt, the positive outcomes that are possible when decision-makers use quality data as the basis for planning and implementing projects. eHealth Africa is proud to be a part of Nigeria’s Polio success story. We thank and congratulate our partner organizations and governments at the national and sub-national levels, who were all instrumental in this achievement.

Going forward, we know that a strong immunization program is essential to sustain this success so, we continue to support immunization programs at the state and national levels through projects such as Vaccine Direct Delivery, LoMIS Stock, and Kano Connect.

Supporting Vaccine Logistics and Maintaining the Cold Chain in Northern Nigeria

By Sadiq Haruna Hassan

A child in Kano State getting vaccinated

A child in Kano State getting vaccinated

Every year, Nigeria spends millions of dollars to procure vaccines. The amount has grown from over US$ 302 million in 2015 to an estimated US$ 426.3 million in 2020. 1 Once the vaccines have been procured, a major challenge is maintaining the cold chain in transit to and on-site at last-mile health facilities. The cold chain is the system of storing and transporting vaccines at recommended temperatures—ideally between 2°C and 8°C—from the point of manufacture to the health facilities where they are used.2 If the cold chain is broken at any point between manufacture and usage, it could result in:3

  • Loss of vaccine potency

  • High vaccine wastage rates

  • Loss of funds spent on procuring vaccines

  • Need for re-immunization

To maintain the cold chain, health facility workers, and cold chain officers at local government and state levels in Nigeria must monitor and track the performance of cold chain equipment (CCE) regularly. Health workers record data on daily temperatures of CCE and the functionality of the equipment at health facilities across the country ( i.e. whether the equipment is working or not) using paper-based charts and forms, and cold chain officers visit health facilities routinely to collect this data.

A vaccinator in Kogi State shows us the vaccine to be used in her House-to-House Immunization Plus Days visit

A vaccinator in Kogi State shows us the vaccine to be used in her House-to-House Immunization Plus Days visit

As a result of insecurity, the location of the health facilities, and now, the COVID-19 pandemic, conducting this process in Northern Nigeria has been challenging. 

Vaccine Direct Delivery is a third-party logistics (3PL) service offered by eHealth Africa to the Sokoto and Zamfara State Primary Health Care Management Boards. Through this service, eHA picks up the required amount of vaccines from the state cold stores, transports them at the appropriate temperatures, and delivers directly to health facilities that are equipped with functional CCEs, ensuring that the cold chain is maintained and that the vaccines remain potent even in transit. In addition, using the VARO application, eHA helps decision-makers and key stakeholders to remotely monitor the performance of CCEs at 393 apex health facilities in both states.

A Health Delivery Officer in Zamfara State downloads the temperature records of Cold Chain Equipment

A Health Delivery Officer in Zamfara State downloads the temperature records of Cold Chain Equipment

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In Kano state where VDD is not operational, the apex health facilities, LG, zonal, and state cold stores keep track of CCE performance using LoMIS Stock, a solution developed by eHealth Africa. The solution allows health workers to send reports about vaccine stock data including vaccine utilization, wastage, and cold chain equipment functionality, using their mobile phones. These reports can be accessed in near-real-time by cold chain officers and decision-makers so that the faulty cold chain equipment can be fixed and back-up protocol for maintaining the cold chain can be followed.

Vaccines save lives. At eHA, our goal is to provide our partners with accurate data and technological tools so that they can better reach underserved populations with potent life-saving vaccines.