Equipping Laboratories for Stronger health systems

By Emmanuel Uko

The journey of supporting and augmenting laboratories in Africa has only started, and evidently, the gap is huge. At the WHO Polio lab in Maiduguri, Borno State, eHA identified cases of damaged, obsolete and inadequate equipment and swung in to supply the needs with support from the World Health Organization (WHO).

As we walked into the office of Professor Marycelin Baba, the Director of the Laboratory, Professor of Medical Virology and lecturer with the University of Maiduguri, we could tell how busy the facility had become on a daily basis. Samples from patients were brought in  on a queue for processing. “Our work here is becoming satisfying”, Prof told us expressively, “especially with partnership from the World Health Organization (WHO) and eHealth Africa (eHA). They have provided various major equipment that enable the center to remain functional”, she said, her passion unwavering for 32 years in the profession.

The lab in Maiduguri, was set up by  Global Polio Laboratory Network (GPLN), to distinguish poliovirus as a cause of acute flaccid paralysis (AFP) from AFP caused by other diseases. It serves the northern part of Nigeria while the one earlier established in Ibadan, Oyo State, serves the southern part of the country. 

Prof. Marycelin Mandu Baba, Director, WHO Polio Laboratory in Maiduguri, is happy to have participated in the polio eradication process in Nigeria.

Photo Credit: eHA

The WHO Polio Laboratory in Maiduguri, like many other labs in developing countries, often  grapples with acute shortage of equipment, reagents, machines, power supply and human resource, which affect its productivity. Research has shown that the number of optimally functional laboratories accredited to international standards were 380, as of 2014; 91% of these were in South Africa. This means that 12 out of 49 countries in the region had one or more laboratories accredited to international quality standards; 37 had none. However, the Global Polio Laboratory Network consists of 146 WHO-accredited polio laboratories, in 92 countries, across the six WHO regions of the world.

Nigeria has 2 of those 146 WHO-accredited polio laboratories. eHA currently provides support to 7 laboratories: 2 in Nigeria, one each in Uganda, Kenya, Ethiopia, Egypt and the Democratic Republic of Congo. The organization is strategizing to commence support to laboratories in Cameroon, Côte d'Ivoire, Ghana, South Africa, Senegal and Central African Republic. This support will improve laboratory and diagnostic services for Africa’s teeming population. “We continue to carry out needs audits and take steps to offer solutions where we identify gaps,”  said eHealth Africa’s Project Manager, Tolulope Oginni. eHA has supported the lab with digitized biosafety cabinets for tissue culture, a Polymerase Chain Reaction (PCR) Workstation, a PCR thermomixer, multi-channel and single-channel pipettes of varied volumes for serology.

Dr Muhammad Talle of the WHO Polio Laboratory in Maiduguri showcases how the new PCR thermomixer donated by eHA works.

Photo Credit: eHA

Dr. Muhammad Talle remains hopeful that the lab will continue to deliver appropriate services according to approved standards.

Photo Credit: eHA

“eHA has brought us relief”, said the Assistant Director for Lab Technical Operations, Dr Bamidele Oderinde, who came in later to the conversation. “The new machines help to reduce technical problems and the functionality complaints we have. We have upgraded our operations, research capabilities and training standards for our students”.

Professor Baba remains keen on contributing her quota towards the eradication of viral diseases, through differential diagnosis of acute flaccid paralysis. According to her, the newly equipped lab benefits people beyond Borno State and extends to other parts of Nigeria. Supporting this lab and other laboratories is part of eHA’s service areas, to build and operate effective laboratories in-country across the globe, and develop the tools and technology needed for effective dissemination and use of public health-related information.

The Director, Prof. Marycelin Baba (3rd right), with eHA delegates and other staff of the laboratory, during eHA’s visit to the lab.

Photo Credit: eHA

Geolocation Intelligence and Clean Data for Mini-grid Setups

By Favour Oriaku

Sustainable Development Goal 7 is one of 17 Sustainable Development Goals established by the United Nations General Assembly in 2015

Overview:

Energy access is essential for proper healthcare service delivery. Healthcare facilities in Nigeria require electricity for lighting, emergency procedures, and storage of vaccines and drugs. Unfortunately, Nigeria’s grid electricity supply has stalled at around 4GW on average and covers only about 57 percent of the population. According to the World Bank, of the 16,900 public healthcare (PHC) facilities in Nigeria, 81 percent lack a reliable power supply. A recent study conducted in the Federal Capital Territory (FCT) shows that power supply to PHCs is intermittent, with an average of 4 hours or less daily. It is worse for facilities not connected to the grid as they rely solely on expensive fossil fuel generators to provide electricity. These generators contribute to both ambient noise and air pollution and are unsuitable for healthcare environments.

Globally, there is a growing interest in alternative power sources, including mini-grids and off-grid solar, which can be highly effective in helping to achieve Sustainable Development Goal 7 (SDG7) by 2030.

The government of Nigeria, other major corporate industry players, and the private sector have worked for years toward realizing the SDG 7. The aim is not just to achieve it but also because lack of or epileptic power supply in public healthcare centers can be life-threatening. Despite the large strides already made, the mini-grid market is yet to reach a tipping point at which it can expand without support. To achieve this, funding is required, but also, getting the right geolocation solution and clean data for informed decision-making remains a challenge. 

The Challenge:

Despite the great strides and enormous support made by the government and other stakeholders to ensure that renewable energy is an established, cost-effective alternative source of power in Africa, implementation is still lagging. For example, identifying the right site for a mini-grid may not be easy in Africa because not every region is mapped and assigned a geolocation coordinate. Demography data on residents within some remote and/or security-challenged regions are difficult to find.

A report by the African Development Bank on Green Mini-Grids in Sub-Saharan Africa has  identified the lack of up-to-date and reliable data as a  barrier to the growth of mini-grids in Africa. As businesses become more reliant on data, the importance of data quality has increased. Data analytics are used to help drive business decisions, therefore, it is important that data must be accurate, complete, reliable, relevant, and timely for it to be trusted. Getting a data set that meets these criteria requires an innovative approach that includes diligence, dedication, and quality assurance throughout the collection process.

The Solution:

Geospatial intelligence is achieved by visualizing and analyzing geographical data. Organizations can use intelligence tools to identify where an event has taken place, why it is happening, and what caused it by adding layers of geographical information, such as demographics, traffic, and weather data, to smart maps and dashboards. “It’s one of the hottest technologies out there,” said Professor Sunil Bhaskaran, founding director of the Geospatial Center of the CUNY CREST Institute (BGCCCI) at Bronx Community College.

A geospatial platform created by eHealth Africa is The Data Portal. A result of several years of geospatial data collection across Nigeria and some parts of Africa. It contains up-to-date data on points of interest, including schools, settlements, health facilities, and roads, including their population estimates. 

The goal of the data portal is to make existing geospatial data accessible and reusable. This will allow organizations to focus resources on programmatic data rather than base geospatial data for their planning and monitoring across Nigeria. A GIS expert with eHealth Africa, Fashoto Oluwatosin Busayo, spoke on the effectiveness of the data portal, “geospatial intelligence is proving to be a more effective way of allocating energy resources than traditional methods. Using this method, it is possible to identify areas that lack access to energy or are underserved. eHealth Africa has provided training on map production and micro-planning with geospatial data freely available on its data portal to various stakeholders” he said.

eHealth Africa’s recent project on Remote Assessment of Energy Gaps in Selected Health Facilities, used the remote survey method of data collection to get accurate, reliable data from 291 health facilities in Kano and Osun states, and 300 health facilities in Nasarawa State. “We deployed this method because it is reliable in security-challenged environments like Nigeria. It is also less expensive. Trained helpdesk agents conducted the remote surveys at eHealth Africa.” said the project manager Mohammed Bello.

eHealth Africa is committed to the design and implementation of innovative data-driven solutions for public health interventions across Africa.

In Nigeria, eHealth Africa uses GIS Tracking to Prevent Seasonal Malaria

By Mohammed Bello, Victoria Onyilokwu and Zakariyau Aliyu

In March 2012, the World Health Organization (WHO) issued a policy recommendation on Seasonal Malaria Chemoprevention (SMC), a new intervention against plasmodium falciparum malaria. This intervention has proved efficient, cost-effective, safe, and workable for prevention of malaria among children under 5 years of age in highly susceptible areas with intense seasonal malaria transmission.

The malaria parasite is still the leading cause of morbidity and mortality, causing an estimated 228 million cases of clinical malaria and at least 602,000 deaths in Africa, as of 2021 according to WHO. About 80% of these cases and deaths occur in children under five years old.

In Northeast Nigeria, malaria is endemic, with perennial transmission: the marked seasonal peak runs from July to November each year. This coincides with the onset of the rainy season (June through October) which limits humanitarian relief access and exacerbates the shelter, food, and health situation with direct risks related to sanitation, nutrition, and malaria.

SMC is designed to protect children by clearing existing infections and preventing malaria during the season of greatest risk. This is achieved through the monthly administration of antimalarial medicines, usually sulfadoxine-pyrimethamine plus amodiaquine (SP+AQ), for as long as the rainy season lasts. WHO recommends the SMC as a highly effective, community-based intervention among vulnerable populations.

Following the successful implementation of the pilot cycle of the SMC GIS Tracking Support in October 2021, eHealth Africa (eHA) worked with support from WHO in July 2022, for a state-wide administration of SMC. This time, the exercise covered all 21 Local Government Areas (LGAs) of Adamawa State, and 4 selected LGAs of Yobe State. During the campaign, eHA sought to improve the monitoring of the campaign using GIS Tracking of Community Drugs Distributors (CDD). In addition, they worked to improve accountability during commodity distribution and utilization across the campaign locations.

Training of field staff on the use of the MISTA Tool in Yola, Adamawa state.

Photo Credit: eHA

How did we do this?

eHA has in-depth knowledge of the Nigerian terrain, strong partnerships and extensive experience in collaboratively implementing projects across the country including in security-compromised locations. They use this experience in field operations, data management, project logistics, and project management to conduct GIS micro-planning activities, geospatial data analysis and visualization.

To access the hard-to-reach settlements and effectively monitor the campaign and coverage of commodities distributed and utilized, they deployed GIS Tracking throughout the SMC campaign in both states to aid effective and timely monitoring of the movement of over 2,000 teams of Community Drugs Distributors. This enabled real-time information on coverage of households and settlements. The tracking system identified omitted households and provided insight into the areas eligible for mop-up. This also enhanced accountability and transparency during the implementation.

The tracker analyzed and produced daily settlement visitation status and settlement coverage (visited/not visited). In addition, a dashboard was created for both Adamawa and Yobe to monitor drug distribution and utilization during the campaign. 

GIS Tracking proved effective in monitoring SMC campaign activities. It helped to improve accountability during commodity distribution/utilization. eHA remains committed to harnessing technology-driven approaches to eradicate the burden of malaria and other diseases.

CDD Team supervisor, Buhari Bello marks a house after administering SMC in Kofar Arewa Yusufari LGA, Yobe state.

Photo Credit: eHA

eHA Field Officer, Aisha Hussaini (right), retrieving trackers from Ward Focal Persons after SMC field activities in Yola North, Adamawa State.

Photo Credit: eHA

The Program Partners