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

eHealth Africa: getting ahead of Breast Cancer through awareness

By Favour Oriaku

Kano, Nigeria

Staff who attended the training physically at the eHealth Africa's HQ office in Kano State.

18 years ago, Hauwa Garba, witnessed a family friend go through breast cancer and eventually lost her. She had never heard of cancer. It was a painful experience that stuck with her. It left her terrified.

Over the years, Hauwa has lost others - colleagues and friends to several forms of cancer. “It is never an easy experience to see a loved one dying gradually. Awareness of breast cancer and other cancers is very important. It is consoling to know that early detection can help save lives.” She said.

According to the World Health Organization (WHO), 2.3 million women were diagnosed with breast cancer in 2020. 685,000 deaths were recorded globally, and significant differences in breast cancer mortality rates have been evidenced among countries. As expected, low- and middle-income countries had increasing mortality rates. A study has revealed that a lack of awareness and early detection programs in developing countries is the reason for escalating mortality.

To commemorate Breast Cancer Day, eHealth Africa partnered with EHA Clinics to host a training session for the entire eHA workforce including Hauwa who is a procurement manager at the organization. The training addressed misconceptions about breast cancer, including those Hauwa had held for so long. It also reminded participants of the importance of early detection in fighting the disease. The session was anchored by Dr. Mujidat Babah, who has a verifiable track record of applying medical knowledge to the diagnosis, prevention, and management of diseases in both clinical and public health settings. She gave information on how mammogram works, new discoveries in treating breast cancer, as well as adopting the right lifestyle as a preventive measure for not contracting the disease.

Hauwa Abdulmutalib-Garba, Manager, Procurement and Asset, eHealth Africa

“I used to believe that mammograms were dangerous because of the radiation, but during the training, I learned that the radiation level used for a mammogram is insignificant.”

— Hauwa Abdulmutalib-Garba

Asked what other lessons she'd take away from this session for other women who share similar misconceptions about breast cancer, Hauwa committed to encouraging women to examine their breasts regularly for lumps and squeeze the nipple to see if any liquid comes out. She would also advise them to go for a medical examination if anything felt strange. 

The training brought together all staff of eHA Africa and staff of the eHA clinics in Kano, including their family and friends. Another Participant Aisha Bello, also commented “the training was an eye-opener for me. It was also quite revealing to me to learn that men could also get breast cancer. I always thought it was entirely a women’s issue"

eHealth Africa is intentional about staff health and well-being and continues to prioritize it at all times through insightful trainings and sebinars to optimize their performance and general well-being.

eHealth Africa: Making Mental Health a Priority

By Emmanuel Uko

Discussions about mental health are becoming popular. However, the gap between reliable information and positive action remains to be bridged. One of those who experienced this information gap is Farid Suleiman, an intern at eHealth Africa. He believed that mental health interventions could only take place in psychiatric units. For Farid, this is now changing.

“My perspective has improved. I now know that being overworked  and stressed, and the quality of my social interaction directly correlate to the state of our mental health”, he said.

All staff at eHealth Africa participated in the campaign, either virtually or physically.

For the 2022 World Mental Health Day, eHealth Africa created a forum where Farid and the rest of the eHealth workforce would learn, following the theme: “Make Mental Health and Wellbeing for All a Global Priority”. The learning session was anchored by a mental health expert and public speaker, Chidi Chukwudi-Madu. The session opened with a clarification that there is no physical health without mental health. It explored the relationship between pressure, stress and mental health. The learning forum presented facts, causes and red flags associated with the topic of the day and how they relate to the workplace.

Mental health issues are prevalent amongst young people especially in low income countries. According to WHO, one in four adults experience mental health issues annually and nearly 1 billion people live with a mental health disorder. More so, one out of ten young people experiences a mental health problem; three out of four of these have their onset by the age of twenty, and about 50% of mental health disorders start by the age of fourteen. 11% of 18 – 34-year-olds report having attempted suicide and 16% report self-harm at some stage in their lives. 

It is estimated that by the year 2032, depression will put more burden on countries than any other disease. There is, therefore, a need for more interventions around mental health management, especially in the workplace, which potentially has multiple stressors.

Anchoring the learning event on mental health, Ms Chukwudi-Madu emphasized three key points on prioritizing mental health at work:

Farid Suleiman’s perspective on mental health topics has changed.

1. At the workplace, three out of ten employees develop mild mental health issues annually, for varied reasons. Individuals must therefore, ensure work-life balance, talk with friends, keep active creatively and learn new productivity skills.

2. Red flags to watch out for include social withdrawal, decline in work performance, deteriorating physical appearance, frequent headaches, poor judgments and indecision. Other red flags include unexplained changes in eating and sleeping patterns, self-harming behaviors, emotional numbness, frequent tearfulness and poor memory.

3. Managers should hold regular check-ins with employees, enable people to connect, review workloads, encourage discussions and promote learning at the workplace.

Mohammed Bello, a Project Manager at eHealth described the session as, “An eye-opener and a wake-up call to be deliberate about mental health, especially in the workplace where employees spend most of their time”.

Adama Shallangwa, an Intern with eHealth Africa, added, “This session has opened me up to the responsibility of mutual support towards remaining mentally healthy and productive at work and at home, understanding that it is okay not to be okay.”

Asked what he would do differently after the campaign, Farid expressed, “Now that I know better, I will be deliberate about my state of mind, think positively, rest adequately, avoid stress and most importantly, treat people well and add value to the wellbeing of others.”

eHealth Africa, one of Nigeria’s #BestPlacesToWork, continues to use innovative ways to enable its workforce access relevant information that add value to their personal and professional productivity.

In Tanzania, eHealth Africa hands over state-of-the-art Polio Emergency Operations Center (PEOC) to support the fight against polio

By Juliana Okoro

On Thursday, 13th October 2022, the Ministry of Health Tanzania commissioned the polio emergency operations center (PEOC) set up by eHealth Africa in Dodoma, Tanzania.

With support from Bill and Melinda Gates Foundation (BMGF) and the Global Polio Eradication Initiative (GPEI), the PEOC supports the Ministry to facilitate collaboration and coordination of public health stakeholders within the country in the fight against the Vaccine-Derived Poliovirus 2 (cVDPV2) and vaccine-preventable diseases.

Over the years, Tanzania has made magnificent progress in eradicating polio, but with polio rising in neighboring countries, the need for further efforts to prevent cross-border epidemics has increased. The effect of the covid-19 pandemic has negatively affected the country’s vaccination program, including the coverage for polio vaccines. With the establishment of the Polio emergency operation centers, equipped with modern technology, coordination will be easier. The PEOC will serve as a central location for coordinating operations and providing tools and resources for the strategic management of public health emergencies. 

To ensure sustainability, e-health Africa handed over the center to the Ministry of Health, Tanzania to support their effort in the fight against polio and other vaccine-preventable diseases. The center will provide health data that will give the government information on any threats within their borders and those coming up in their neighboring borders. “The goal of the polio emergency operations center (PEOC) is to ensure you have the resources you need to fight and respond to outbreaks all in one place. Joint efforts of the government and partners will help to improve the quality of any response in Tanzania. It will function at this national level during emergencies and ensure proper response to other outbreaks beyond polio.” said Dr Delayo Zomahoun, GPEI Coordinator for Tanzania.

The growing cases of the Vaccine-Derived Poliovirus 2 (cVDPV2) in many African countries require focused efforts to establish Emergency Operating Centers to improve the coordination and coverage of vaccination efforts to tackle the spread of type 2 circulating vaccine-derived poliovirus (cVDPV2). eHealth Africa’s project manager Sodipe Oluwaseun said “In March, we came to Tanzania to support the setup of the EOC and outbreak response. 7 months later, we facilitated the setup of the polio EOC. We hope this EOC provides the platform to ensure no child is left behind in the fight against polio and other vaccine-preventable diseases. We thank the government of Tanzania for an enabling environment.”

Here are some pictures from the handover event in Dodoma, Tanzania. 

Abel Makubi, representing the Ministry of Health in Tanzania, opens the PEOC in the presence of partners

All stakeholders in the conference room, discussing with virtual participants

Permanent Secretary, Tanzanian Ministry of Health, Abel Makubi, giving a speech at the handover ceremony.

WHO Country Representative for Tanzania, Dr Zabulon Yoti giving a speech at the handover ceremony

eHealth Africa’s project manager, Oluwaseun sodipe presenting the worktools to the permanent secretary.

Presentation of worktools - 5 lenovo laptops and 4 smartphones.

Permanent Secretary, Tanzanian Ministry of Health, Abel Makubi (middle) and other dignitaries after the PEOC handover ceremony

BMGF Focal person for Tanzania, giving a speech at the handover ceremony

eHealth Africa’s project manager, Oluwaseun Sodipe giving his remark at the handover ceremony.

Renewable Energy for Improved Healthcare Delivery in Nigeria

By Juliana Okoro

Access to energy is a prerequisite for quality health care and it is fundamental to the achievement of universal health care coverage and the Sustainable Development Goals. Yet, about one in four health facilities in Sub-Saharan Africa lack access to electricity, and three in four facilities lack reliable power. The lack of sufficient and reliable power is jeopardizing the well-being of hundreds of millions of people, especially women and children, who often bear the brunt of inadequate primary healthcare services. According to Dr Julie Yemi-Jonathan. O, Country Manager, We Care Solar, “without a reliable source of electricity, nighttime deliveries are most of the time, attended in near darkness, cancelled or conducted by flashlight, and the outcomes are often tragic.”

Off-grid renewable energy solutions present a key opportunity to provide clean, reliable and cost-effective electricity to rural health centers, which can dramatically transform the quality of healthcare services provided to rural communities.

Harnessing the enormous potential of renewable energy to improve energy access for primary healthcare facilities requires combined action from the health and energy sectors. To this end, the Nigeria Energy Conference, which took place between 20 - 22 September 2022, brought together key energy and health sector stakeholders, including policy-makers, practitioners, financial institutions, development partners, and NGOs that can play a role in enhancing electricity access for primary healthcare facilities.

During a panel session at the conference, eHealth Africa facilitated a discussion about sustainable energy for improved healthcare delivery in Nigeria. The panelists discussed what needs to be done to ensure that Primary Health Centers (PHCs) have access to energy for better health outcomes. Acknowledging the challenges most PHCs face, the panelists elaborated more on how the lack of electricity in primary health centres has led to more medical emergencies and increased mortality rates.

The panel discussion sparked the much-needed, cross-sector thinking around how to deliver energy to health facilities, especially in resource-constrained environments. A resounding takeaway was that distributed solar power and energy-efficient devices hold great potential for creating stronger and more resilient health systems in Africa and beyond.

We Care Solar's deployment of solar suitcases to Primary healthcare centers has had a tremendous impact on reducing child mortality and maternal mortality rates. According to the company’s representative on the panel, “a lot of our health facilities do not have access to a reliable power supply. We have seen cases where surgeries are turned down because of a lack of power. Sometimes surgical operations are suddenly interrupted, leading to the death of the patient, due to power failure”. This she said, “prompted We Care Solar to develop the Solar Suitcase”. 

Another speaker, Mohammed Bello, a project manager at eHealth Africa, identified solar energy as the reliable solution to these challenges. He highlighted some projects implemented by eHealth Africa with support from partners and stakeholders to ensure health facilities across the country have access to a reliable power supply. According to him, eHealth Africa is working with the Nigerian Energy sector and Integration Consulting firm, which are critical players on issues concerning energy.

The panel speakers and moderator after the session hosted by eHealth Africa at the Nigeria Energy Conference 2022

Key lessons from the panel session hosted by eHealth Africa at the Nigeria Energy Conference 2022:

• There is a dire need to increase renewable energy access in primary health centres, especially those in remote areas.

• The use of solar panels as an alternative source of electricity in primary health centers will help mitigate the energy challenges faced by primary health centers.

• Health facilities should be a top priority in electrification plans for both national governments and development partners. Off-grid renewables offer rapidly deployable, reliable, cost-effective solutions.

• In order to address the energy access needs of healthcare facilities, the energy and health sectors must work together. This should happen at all levels, from strategy and planning to policies, budgeting, procurement and implementation.

• Innovation has to be encouraged and promoted, as in the case of the solar-powered suitcases by We Care Solar. Also, in the design of robust, low maintenance, efficient, user-friendly medical devices suited for remote off-grid areas.

• Energy-efficient medical devices, combined with off-grid renewable energy and telecommunications, can expand the services offered by primary health centres in under-served communities. This also reduces the need for patients to travel to larger, more distant facilities.

• There are funding opportunities from donors as long as the organization involved can provide evidence of work done in this field.

Women at Work - 3 Ways eHA supports women in the workplace

By Favour Oriaku

One of our focuses at eHealth Africa is to increase the number of women in our workforce. While we work on getting more women into eHA, we also focus on retaining the talented women who currently work at the organization. Here are three ways we support women at eHealth Africa. 

Early career programs

As an organization, we are committed to building a more diverse and fair workplace, and we have implemented strategies to increase the number of women in our workforce. We are actively building a pipeline of talent through early career programs to help young women jumpstart their careers. One of these programs is our just concluded all-female paid internship program that lasted for six months. The program exposed young women to an early career within the International NGO space. Juliana Okoro, who was a part of the 2021 all-female internship cohort and now works full time as an associate with the communications team, has this to say

Juliana Okoro

Coming as an intern helped build my confidence and my career path. Before the internship, I didn’t know what to make of my career or which direction to go, but the internship gave me the clarity and experience I needed. My internship exposed me to a lot of opportunities and I am forever grateful to eHA for the opportunity.

Open Door Policy

Past research and society advise women to stand out if they want to get ahead. But taking on visible roles in the workplace may expose women to risk, and we know this. And that is why we have policies in place that promote unconventional forms of leadership, fight implicit bias, and create an equitable working environment where everyone’s ideas are valued and respected. Our Human Resources department maintains an open-door policy that ensures that staff, especially female employees, do not suffer in silence when marginalized or ill-treated, either by their colleagues or bosses. 

We constantly encourage female employees to take on tasks and roles that put them in the spotlight, and this has ultimately reflected on the senior leadership team, as we have just as many women at the decision-making table as we have men. An offshoot of this is that we now have more senior female employees who the younger ones not only look up to but also get mentorship from.

A Work/family balanced life

One initiative we put in place to ensure employee wellbeing, fairness, and gender inclusivity is flexible work (remote) and work/life balance. 

We have constant check-ins between managers and the employees they manage. In these sessions, employees get to discuss issues relating to their overall well-being and how they may affect their productivity at work, and managers help them through it by providing feedback and guidance. We also have a remote working option in certain cases where your job does not require you to be physically present at the office. With this process in place, female employees who’ve completed their paid maternity leave can spend more time bonding with their families while working from home.

At eHealth Africa, we recognize that talent development is crucial to our success as an organization which is why we have invested in programs that continue to up-skill and re-skill employees at all levels. These programs are easily accessible and we constantly encourage employees to take advantage of them so they can stay current and relevant in their fields.  We don’t just pay lip service to gender inclusivity and to building an equitable working environment; we constantly live into those values. 

eHA Academy: The Journey So Far

By Favour Oriaku

If you are someone who’s interested in a tech program that builds the capacity of young people in software development, then you are probably familiar with the name eHA Academy, our brainchild academy that has successfully trained several aspiring tech enthusiasts in software and web development. Here is a walkthrough of our journey so far.

The Birth of eHA Academy in 2016

In 2015, eHealth Africa was one of several organizations working in the three main West African countries that were affected by the Ebola epidemic - Guinea, Sierra Leone, and Liberia. We primarily provided support for the EVD outbreak response by building and customizing software-based solutions for contact tracing and disease surveillance. By the end of 2016, the epidemic was declared over, and as we finalized the response effort in Guinea; we identified a need. Who would maintain and improve the solutions we introduced to Guinea? There were not that many software developers living in Guinea and we decided we needed to build human capacity in-country to maintain or upgrade the digital solutions we introduced in Guinea during the epidemic. This led to the eHealth Africa team designing a program to build the capacity of young people and equip them with the skills needed to do this.  

In-person class session at eHA Academy in Conakry, Guinea

In August 2016, we launched the inaugural eHA Academy in Conakry, Guinea. The software team at eHA designed an eight-week curriculum in software development and network engineering and staffed the course with expert instructors, bringing international software design and development expertise to Guinea. 

The Academy was offered free of charge to all participants who were successfully admitted into the program. By the end of the first cohort, 100% of the participants completed the entire 8-week program, 15 software developers took part in eHealth Academy and three of them were so skilled that we offered them full-time positions with eHealth Africa.

Pioneer graduates, tutors, and management of the eHA Academy in Conakry, Guinea

eHA Academy Re-designed In 2019

After the successful interventions in Guinea, Sierra Leone, and Liberia, we wrapped up operations in those countries. As we focused on our operations in Nigeria and on eradicating the wild poliovirus; we continued to build a larger physical presence in Kano state. Members of a small but growing tech ecosystem often contacted us to provide resources, including space for their meetings, expert speakers, and mentorship. By 2018, we were full members of this community, and our head office was an unofficial meeting space for the monthly tech meetups. Every month we had speakers come and give talks about different topics in tech and people came from neighboring states to attend the meeting in person and several joined online. Again, we noticed a need. 

The need we noticed was the large number of tech enthusiasts seeking additional training for software and web development skills.

Students of the 1st Nigeria cohort of eHA Academy.

In 2019, our management team reintroduced eHA Academy to address this need. We then redesigned a new version of eHA Academy. This time we focused primarily on building the top requested skill-set, web development. In the redesign version, we introduced self-directed learning. Each participant was required to focus on completing coursework on our eLearning platform, prior to in-person workshops and sessions. We also paired each participant with a mentor, and we matched the most successful participants to an internship opportunity.

The Switch to 100% Virtual Learning Sessions

When COVID-19 Pandemic forced the world to shut down, we were 3 weeks into the 2nd Nigeria cohort of eHA Academy. We quickly pivoted to all online learning sessions, mentoring, and even internships and have a few success stories. Watch Jamiu Musa’s success story here.

After successfully completing two eHA Academy cohorts in Nigeria, we took a pause to re-evaluate the number of students we’ve trained so far, and we realized that over 70% of the total number of students trained were male. As an organization, we recognize the importance of having diversity in all sectors, especially in the technology sector. To address this, we hosted an all-female cohort of the Academy. This attracted several female participants across Africa. We recently completed the all-female cohort and here are a few testimonials from some participants.

Juliet Odogwu, eHealth Africa's Executive Director, with mentors and some graduates of the all-female cohort who attended the graduation ceremony in person.

So what is next for eHA Academy? 

The academy’s primary goal is to create a platform for young people to gain first-hand experience and training in technology. We are also working with partners to expand our curriculum to train more people in more aspects of innovative technology, from data science to artificial intelligence to machine learning.

The schedule of the Academy is to implement two cohorts every year, and young people interested in web and software development are welcome to apply. To better prepare yourself and increase your chances of being selected to be part of the next cohort, here is a free course we recommend for you to take.

We invite you to get involved

We are constantly looking to increase the number of participants we take on for every cohort we implement. eHA Academy needs your donation to increase the number of software and web developers in Africa. We have an ongoing donation campaign on the GlobalGiving platform where you can either make a one-time donation or commit to a monthly or yearly donation. We are also accepting donations on academy.ehealthafrica.org as well.

Another way to get involved is by signing up to be a mentor. To find out more about becoming a mentor and to apply, click here.

How eHealth Africa is implementing the Geolocation Health Facilities Database Initiative (GHFDi) Project in the Republic of Togo

By Friday Daniel, Chinedu Anarado and Munachi Okoro

The public health space has relied on platforms from multilateral agencies and nonprofits to plan interventions. Platforms such as the Humanitarian OpenStreetMap, the WHO Integrated Supportive Supervision (ISS), and electronic surveillance (e-SURV) database, GRID3, and the Global Health mapping platforms were some of the only sources of information on health facility data. But these data sources can be inadequate, rarely reflect the realities on the ground and do not have the imprimatur of relevant government authorities. Equally, Ministries of Health in most WHO countries lack the capacity to curate and manage their health facility data, leaving a critical information gap in the health planning process. 

The WHO conceived the Geolocated Health Facility Data initiative (GHFDi) project as a public good to enhance access to information on the status, location and functionality of health facilities across participating WHO member countries. The overall idea is to deepen capacities in each country to manage this data, ensure its openness and availability in planning public health interventions. 

The GHFD project requires participating countries to grow their capacity to curate and manage their health facility data. But first, an assessment of the existing health facility list or registry is essential. This is expected to provide insight into the efforts required to achieve an ideal scenario which is a database of health facility information, with name, location, unique identifier, geographic coordinates and hosted in an open source platform. Countries may then choose to share this information with a global database managed by the WHO, and then invest in an ongoing process to grow their capacity to ensure the information is updated periodically. 

eHealth Africa is one of the implementing partners of the AFRO region responsible for implementing this project in the Republic of Togo. On the 9th of August 2022, an introductory meeting was held at the headquarters of the Ministry of Health in Togo. This meeting was organized by eHealth Africa in partnership with the Ministry of Health and the WHO country office. 

It brought together various stakeholders responsible for establishing and updating the health facilities database in Togo, including the Ministry of Health (MSPAUS), the National Institute of Statistics and Studies and Demographics (INSEED), as well as the delegate ministry in charge of Territorial Development.

Landscape assessment and data collection session during the workshop in Togo

With an introduction by Dr. Ouedraogo Romain Hilaire, health systems coordinator at the WHO country office, Mr. Compaore Fabris, eHealth Africa representative in Togo and Chinedu Anarado, program manager, eHealth Africa, discussed with the participants on how GHFD seeks to strengthen the capacities of the Ministry of Health to guarantee the availability, quality, accessibility and use of a health facilities master list (HFML) in countries. 

This capacity building should enable the Republic of Togo to have a standardized database open to the public. Participants discussed the seven strategic pathways through which the GHFD initiative will strengthen the Ministry of Health, including governance and policies, partnerships and collaboration, technical capacities, innovation, financial sustainability, communication and advocacy, interoperability, and data management.This introductory meeting led to the conclusion and agreement to hold a participatory landscape analysis workshop on August 30th and September 2nd.

At the end of this workshop, it was discovered that Togo has a unit in charge of the health services mapping, who oversees the health facilities master list (HFML). The Ministry of Health in Togo appreciates the initiative and sees it as an opportunity to strengthen the government's efforts to ensure universal access to care.

Group photograph of the workshop participants

eHealth Africa has since implemented a landscape assessment and is currently developing a report and cost work plan that will itemize the efforts required to bring Togo to the ideal scenario. 

To learn more about the GHFD initiative: https://www.who.int/data/GIS/GHFD 

Conducting successful Remote Energy Survey in security/network challenged environment

By Mohammed Bello, Tope Falodun and Busayo Fashoto

Remote Assessment of Energy Gaps in Selected Health Facilities: Identifying Potential for Alternative Energy Sources (Part 2)

Energy access is needed to maintain health, especially during pandemics. A prompt emergency response also depends on reliable energy access; health facilities have two main energy requirements: electricity for health services and medical equipment and thermal requirements related to sterilization, space and water heating, and incineration. However, lack of energy access poses additional challenges for the provision of emergency care services and the functioning of intensive care units.  When basic energy services are unavailable, essential components of emergency responses become compromised, including night-time care, refrigeration to keep samples, sterilization facilities, or electricity to power simple medical devices.

This expanded phase was implemented in Nasarawa states and is also part of the Nigerian Energy Support Programme (NESP), a technical assistance program co-funded by the European Union and the German Government and implemented by the Deutsche Gesellschaft fürInternationaleZusammenarbeit (GIZ) GmbH in collaboration with the Federal Ministry of Power (FMP), in partnership with eHealth Africa. It was conducted in close cooperation with geospatial data experts from INTEGRATION energy and environment. Still part of the effort of the NigeriaSE4ALL to bring you the most up-to-date, ground-truthed, electrification data available in Nigeria.

Following the successful first phase remote survey of 291 health facilities in Kano and Osun states in September 2020, INTegration contracted eHA to conduct a second phase of the remote survey in 300 Health facilities (HFs) of Nasarawa state.  This next project phase analyzes the energy status of communities in Nasarawa state.

In recent times Online surveys have been the most popular way of conducting survey research as opposed to the traditional face-to-face surveys widely used before now.  Although the face-to-face survey gives you more advantages in capturing additional emotional and behavioral clues, online surveys are cheaper.  The migration in recent times to remote surveys is a result of the migration of many organizations to digital solutions. This type of survey is less expensive and gives you some of the elements obtainable in the traditional face-to-face survey, such as the accuracy and efficiency of the data gathered.  It is also reliable in security-challenged environments. This result cannot be achieved without the expertise of agents trained to perform all the aforementioned.  At eHealth Africa (eHA), we have specially trained helpdesk agents specifically for these purposes.  In addition, our specially trained GIS and program delivery staff for the same purpose. They work collaboratively with stakeholders/beneficiaries to get accurate and efficient data based on planned activities.  The methodology and learnings from the first successful survey led to the successful planning of activities to conduct the grid supply quality in this second phase.

The following activities led to the success of the second phase survey in the 13 LGAs in Nassarawa State;

• Engagement with the state Team; Trained program staff to conduct a high-level stakeholder engagement with the state to introduce the project to the state team, get their buy-in, and discuss necessary data needed for the successful survey implementation.

•  Identification of Health Facility OICs Lead; following the high-level engagement is the identification of the health facilities officers in charge leads.  These are chairpersons of each LGAs OICs responsible for all OICs under their jurisdiction.  They assist in reaching out to the OICs to pre-inform the OICs of the implementation commencement and are relevant in following up with the OICs where the latter are unreachable.

• Health facility data gathering, verification/validation, communication with the LGA leads for HFs list sharing. HFs were then sorted, and some HFs not included on the list were verified following validation of all the selected HFs.

•  Training helpdesk agents for a successful survey;  The eHA helpdesk agents experts were trained on the survey tools and how to administer them. This includes what to look out for, understanding the tools, and further probing where necessary.

•  Conducting remote Survey; We completed the survey within three weeks of the project implementation with the helpdesk team working collaboratively with the GIS and program team to ensure the activity's success.

•  Continuous communication/collaboration with the state team;  The program team continued to communicate with the state team regularly to escalate issues encountered and collaboratively sought solutions to such problems.

Challenges:

There is no activity without its peculiar challenges; however, the excellent collaboration between the program team and the LGA/State team enabled the team to proffer solutions to address challenges such as unreachable OICs, wrong numbers of OICs, wrong OICs in actual HFs, non-network communities, etc.

Despite the challenges mentioned above, the lessons from the first phase of the project and other similar projects gave room for the team to be prepared for risks and challenges ahead of implementation.  This led to about 85% HFs data gathered at the end of the first two weeks, with only the unreachable HFs due to the earlier listed factors.  Communication platforms include Whatsapp chat, voice calls, SMS messages, etc. Intensive follow-up and the positive relationship between the team and the state team assisted greatly in successfully implementing the survey. At the end of the 3rd week, the group gathered the entire 300 HFs data, including geo-coordinate for HFs initially without geo-coordinates.  You are assured of the cost efficiency, especially considering Nigeria's current insecurity challenges.

The Program Partners

#BestPlacestoWork - How eHA builds a healthier work environment for its employees.

By Munachi Okoro

Four out of five employees worldwide are not flourishing at work, according to a survey of over 14,000 people from 37 countries by Great Place to Work® and Johns Hopkins Carey Business School. This fact bolsters the need for employers to create an enabling work environment for their employees to thrive and be productive. Conversations on #TerribleBosses and workplaces have seen a rapid global shift in organizational work cultures and policies. Organizations are evolving from embracing new policies like remote working during the COVID-19 pandemic to adopting a more inclusive workforce. 

This year,  eHealth Africa (eHA) got certified as one of Nigeria’s best places to work. eHA employees ranked the organization high on employee conditions, workplace culture, and policies recognizing the organization as one of the rewarding places to work where people can unlock their potential in a diverse and inclusive workplace. 

The certification is no surprise because of the policies eHA has in place to create an enabling environment for its employees. According to eHA’s Chief Financial Officer and Senior Director of Administration, Zahir Baloum, the eHA management team has prioritized 

employee satisfaction and growth for the past four years. We believe this significantly impacts employee attitudes about their jobs, coworkers, and organization, enhancing productivity and mental health.

What do our employees think about the work culture at eHA?

According to a business day article published in July 2022 on Mental Health and Employees’ Productivity in Today’s Workplace, A happy and healthy workforce will produce vibrant, and enthusiastic employees focused on delivering beyond business goals and expectations.  When asked how she feels about eHA’s work culture, Fatima Mohammed, a project coordinator, said that The eHA work environment has been friendly, and the organization has prioritized the work-life balance policy. It ensures that staff appropriately utilize their leave days and introduces activities that provide good work-life balance practices.

Fatima started her career at eHA as a phone logistician for the Vaccination Tracking Project over seven years ago and has since grown to the position of project coordinator, a testament to the growth opportunities within the organization. She says that the newly adopted people-focused culture has allowed for employee cohesion. They feel more comfortable and valued because the organization carries them along, is ready to listen to their voices, and uses that to gauge and improve.  There’s no doubt that employees feel happier and are more productive when their voices are heard. I appreciate the organization for employing this approach to creating a healthy work environment. 

For Juliana Jacob, a Senior Knowledge Management Associate at eHealth Africa, the work culture at eHA encourages teamwork and innovation, creating a healthy work-life balance. It promotes continuous learning and development as well as career growth. Juliana started her career at eHA as an intern with the Helpdesk team and has since transitioned to her current role.

Living the eHA values 

Aligning an individual’s role with the organization’s mission can foster a higher sense of purpose or fulfillment. That is why it is no surprise that eHealth Africa tries to foster an environment where its employees can lead to its core values of integrity, impact, quality, problem-solving, and innovation. In ensuring that the organization's influence is felt in its immediate environment, eHA embarks on community development initiatives with its staff on a mission to ensure that people in underserved communities can lead healthier lives. Early this year, one of the community development initiatives embarked on was the renovation of  22 boreholes across 10 LGAs in Kano, Borno, and the FCT. 

Another initiative within the organization that strives to create a healthier work environment at eHealth Africa is the Culture Club. According to Mohammed Bello, a project manager within the organization and the Culture Club head, eHA created the club to provide a more definitive and strategic pathway for culture stewardship and collaboration within the organization. It has been used as a mechanism to support the achievement of the organization’s result framework of ‘making eHA the best place to work through several Employee engagement activities such as Employee recognition, where eHA reward and recognizes the best employee of the month. The culture club organizes activities within the organization from time to time. One of those activities was the planting of 500 trees planted in Kano and Abuja during the  2022 Earth Day celebration. 

Undoubtedly, eHealth Africa is committed to building a healthy work environment for its employees through its policies, initiatives, and commitment to building the capacity of its staff as well as the communities impacted by its work across Africa. 

We gave back to our communities again!

Giving back to the community is one of the many ways eHealth Africa tries to improve the lives of people in the communities in which we live and work. This June we held two medical outreach events for our community service that served over 1000 people.

Our team members visited  Chirenchi and Dutse-Alhaji communities in Kano and Abuja, FCT., in collaboration with EHA Clinics. We provided free eye exams, basic lab testing, and pharmaceutical counseling to people in those communities. We also offered relevant family planning, water purification, and personal hygiene education.

Here are pictures from the events in Kano and Abuja, FCT.

Work Hard, Play Hard - how we have fun at eHA

By Juliana Jacob

Winning as little as a candy or a bar of chocolate from playing trivia games during a busy day at our workstations makes all the hard work easy. At eHealth Africa, while we believe in working hard, we equally believe in striking a balance. Having fun while working reduces fatigue that may result in burnout.

A study by Ford et al, suggests that an environment is considered fun when it intentionally encourages initiatives and supports a variety of enjoyable and pleasurable activities that positively impact the attitudes and productivity of individuals. Because we prioritize the happiness and well-being of our team, we strive to create an environment where everyone can take a few minutes out of their busy schedules to unwind; no meetings, no scrolling through our task management tool, or not even reading emails.

Here are 3 employee engagement initiatives we introduced to revitalize our workplace to decrease stress and promote fresh creativity and job satisfaction. 

We get everyone involved
Thank God it’s Friday (TGIF) is a favorite of many of our staff because of the rationale behind it. We organize a series of activities every last Friday of the month to allow our team to unpack their month and approach the new month with a relaxed and fresh mindset. While some employees spend the time relaxing and unwinding, others engage in healthy competitions to determine which team wins the title for the month. Different departments take turns hosting the TGIFs.

We go outside
Our mission as an organization is to ensure that people in underserved communities can lead healthier lives through our work. We started our Community Development Initiative (CDI) as part of our efforts to give back to the communities where we work and live in. We identify the needs of these communities and look for ways to support them. These CDI projects also serve as team bonding opportunities outside our work. Recently, to celebrate Earth Day we planted 500 trees in Kano and Abuja. Also, we renovated 22 boreholes across 10 LGAs in Kano State, Borno State, and Abuja.   

The conversation-starter
What started as an informal lunchtime trivia game has since become the norm at eHealth Africa. Some Fridays, a subset of our team gather to play trivia games. You can simply call this learn and play, while everyone involved has a good time, they update their knowledge of projects, programs and solutions.

For us at eHA, fun at work is essential to our employees' happiness. We know fun means different things to different people on our team. From a random joke from a colleague to just gathering around the workstation for trivia games. But whatever their concept of fun is, we are leaving no stone unturned in the pursuit of our team’s happiness.

When GIS and public health experts converged in Geneva

By Chinedu Anarado

On May 9th, the World Health Organization (WHO) formally launched the GIS Centre for Health. The center will manage the production and use of geospatial data and geographic information systems (GIS) towards strengthening public health interventions. Before now, WHO programs and units ran their health data independently. The center will now ensure a dedicated approach to producing and using essential GIS data through the various projects implemented at the center. In addition, it will drive capacity building, partnerships, and collaboration, expansion of GIS infrastructure, and deepening of the geospatial culture within the WHO.

Cross-section of WHO GHFD staff and the GHFD implementing partners (IPs) during the GIS Centre launch in Geneva

eHealth Africa (eHA) participated in this event as a key implementing partner on the Global Health Facility Database (GHFD) project. The GHFD project is one of the projects managed by the GIS Centre. It is also a crucial proof of concept on the value of a center with responsibilities to drive geospatial data generation and usage. The open-access Snakebite and Envenoming Platform is another initiative that leverages support from the GIS Centre, using the latest ArcGIS software. The platform addresses the lack of antivenom in vulnerable communities and improves available information about local snakebite risks.

Screenshot of the Snakebite GIS story map

The database operates as a global reference for anti-venom and snakebite health information. It was established in September 2021 and currently provides snakebite data, risk, nearest health facility for anti-venom etc. The solution is now being expanded to seven countries in East and West Africa, where priority health facilities will be analyzed for accessibility and anti-venom stockpiling. With a GIS-based web mapping, venomous snakes, their distribution ranges, venoms, anti-venoms, and manufacturers of anti-venoms with be available at the click of the button. In the next phase, the database will include data on health facilities and drive time relative to the victim's location. Anyone with internet access can access the platform for information and contribute photos and data to update snake habitats, ranges, and behavior.

The GIS Centre launch was also a gathering of key stakeholders in the GIS, public health, and humanitarian space who identify with the increasing value of geographic information systems (GIS) and the various use cases that will benefit their efforts beyond public health. In addition, we discussed support functions such as data collection tools, GIS usage case studies from the WHO Africa Regional Office, and new GIS features on open data collection kits.

The GIS Centre will leverage WHO's historical experience and knowledge in deploying GIS capabilities in driving public health delivery. Some of these are seen in the distribution of COVID-19, the polio eradication campaign, and the deployment of geospatial maps to support malaria programming.  

eHealth Africa is excited at the prospects of deepening its GIS capacity by partnering with the WHO GIS Centre for Health. Our extensive experience implementing vaccine tracking systems, mapping hard-to-reach localities, supporting immunization campaigns, and microplanning with geospatial maps and data signposts our commitment to using geospatial technologies in public health practice.

Partners’ role towards renewable energy accessibility in rural communities: A case study of 12 selected states in Nigeria

By Mohammed Bello and Tope Falodun

The focus on renewable energy in recent years has been on the rise, this is largely due to the bedeviling problems surrounding nonrenewable energy sources. It has been ascertained that the world will face severe problems related to the depletion of traditional (non-renewable) energy resources (Kahia et al., 2016) as a result of the exhaustive nature of the resources viz a viz growing population and industrial activities. Apart from the finite availability of this energy type, it has environmental issues, the increasing magnitude of global energy consumption and its rapid growth have severe environmental implications (Irandoust, 2016), It is now well established that oil and coal exploitation have ultimately led to forest destruction, biodiversity extinction and natural disasters. (Kahia et al., 2016) the consumption of this energy type also increases carbon dioxide emissions. These emissions are considered the main cause of global warming (Ben et al., 2017). These necessitate the surge of suitable energy for the environment and are inexhaustible.  

Renewable energy forms a key milestone in Africa for social and economic development.  The lack of access to electricity by most people - “600 million in Africa'', and one of the targets of the Sustainable Development Goals (SDG) No. 7 is to expand infrastructure and upgrade technology for supplying modern and sustainable energy services for all in developing countries, brought about the need to improve access to electricity. A common method to assess latent electricity consumption already being applied in Nigeria bringing in existing knowledge from various disciplines to the  Nigerian and West-African context and sharing results and tools openly with all stakeholders from questionnaires and interviews with relevant stakeholders forming partnership with several local (Covenant University, Obafemi Awolowo University,  Université Abdou Moumouni - WASCAL program,  PowerGen Renewable Energy, Creeds Energy,  Clean Technology Hub, Rural Electrification Agency, the Government of Nigeria) and international (Technical University Berlin, Wuppertal Institut,  MicroEnergy International,  Fosera) for the PeopleSuN,  a highly inter- and transdisciplinary project which seeks  to improve on this status quo, having Reiner Lemoine Institut (RLI) an independent non-profit research institution  whose mission is to find paths to a sustainable energy supply based on 100% renewable energy  sources partnering with the Funders - ‘PeopleSuN project funded under “CLIENT II - International  Partnerships for Sustainable Innovation'' in the Framework Program Research for Sustainable  Development towards goal number seven (7) engaged the expertise of eHeath Africa (eHA) a non-governmental organization focused on improving health systems with core technical expertise in Health Delivery Systems, Public Health Emergency Management Systems, Disease Surveillance Systems, Laboratory & Diagnostic Systems, Nutrition, and Food Security Systems, and sustaining program interventions with a mission to build stronger health systems through the design and implementation of data-driven solutions that respond to local needs and provide underserved communities with tools to lead healthier lives.

Scope

eHA as the consultant was ‘responsible for the turn-key implementation of detailed energy surveys of  households and enterprises across 247 non-urban enumeration areas of three geo-political zones in Nigeria’ involving a total of 12 states as follows; 

• Kaduna, Kano, Katsina, and Zamfara within the North-Western zone

• FCT, Nassarawa, Niger, and the Kogi states within the North-Central zone

Akwa-Ibom, Delta, Edo, and the Rivers states within the South-South zone.

Fig 1. Map showing implemented states

Methodology/ Implementation Approach

The methodology used in collecting the data was using a customized Kobo Collect smartphone and a conjoint laminated sheet. eHA conducted detailed energy surveys in Households and Enterprises within these zones.

Field Data Collector administering Household survey in one of the EAs at Malumfashi LGA of Katsina State

From the outset of the survey, one of eHA’s innovative data-driven products, Planfeld was leveraged for planning and monitoring of the survey field activity. A total of 60 enumerators and 12 State supervisors were engaged in the quantitative survey activity. 3,952 Households and 1,235 Enterprises were targeted and data collection started on August 7, 2021. A team comprising 2 enumerators (mostly paired male and female) worked in an EA to cover 16 households and 5 enterprises in each EA. They were to cover 1 EA daily including travel time. Teams set out daily to cover EAs as planned and moved into new EAs to continue coverage, with plans to complete unfinished ones the following day. Gatekeepers, including community leaders and local authorities, were consulted before enumerators’ visits and commencement of activity at the LGA and community levels.

Fig 3. Table showing targeted enumerating areas (EAs)

Data Quality Control and Quality Assurance procedure

To ensure accurate and reliable results from the fieldwork, three categories of validation were used. Attribute validation control, Lineage validation, and spatial validation. All these validations serve as data quality control (QC) for the survey. These controls were checked at three (3) levels of data quality.

Fig 4: Quality Assurance procedure

Three levels of controls:

• Field Enumerator checks: Field enumerators ensured that all Quality Control (QC) checks were completed.

• Supervisor checks: Supervisors ensured that all the enumerators met their daily target, also ensured that all QC checks were passed. The supervisor ‘approved’ the forms from the Kobo toolbox platform after validation

• Data Analyst checks: The Data Analyst runs the quality control check on the forms and is sure that all validations were done. Then the data was released to the partners to ensure the data was valuable, complete, and precise.

The 3 cycles of data validation continue until a desirable result was met.

Data Process and Analysis

The workflow of the data process started from the Open Data Kit (ODK) forms development. We produced the forms in 3 different languages, English, Nigerian Pidgin, and Hausa. This was followed by the deployment of survey tools on the KoBo ToolBox platform. The two survey components- Household and Enterprise- possessed a questionnaire file each. The survey platform was then ready for submissions from the field which were made by the enumerators. After the data collection, the data cleaning exercise commenced which marked the end of data process activities as required by the partner.

Fig 5. A map depicting all implementing states with points collected overlayed

Results

The data were collected in a total of 3,961 Households and 1,232 Enterprises across the 12 states, with 9 EAs that were not visited due to insecurity amongst other issues.

Challenges

There were various challenges encountered during the implementation exercise across the 12 states. Insecurity cuts across the states as some secured areas before implementation became insecure while others are uniquely specific, these challenges are not limited to the following;

• Enumerators' inability to complete targeted H/H and  Ent in specific EAs as a result of security attack while conducting the survey.  The states affected are Akwa-Ibom, Katsina, and Kaduna.

• Torrential rain in Akwa-Ibom, Delta, Edo Rivers, and FCT led to obstruction to daily implementation with re-visit plans rescheduled.

• The bulkiness of the survey led to the refusal to consent or complete the questionnaire in some households across the implemented states.

Lessons Learned

• Communities were reluctant to willingly cooperate with enumerators without the presence of a known local guide at the initial stage. This was later resolved by the collaboration of supervisors and the enumerators who worked hard to engage and onboard local guides, despite the lack of payment factored for local guides.  Provision of incentives (payment)  for local guides should be considered and budgeted for in surveys to get the buy-in of communities.

• Secure enumerating areas (EAs) before implementation become highly insecure after commencement.  information from the security situation reports by the Security Adviser is shared with the team daily in addition to pre-training/instruction to source valid information about the environment locally before moving out daily.

• In this case, the client is the one to provide EAs to be implemented by a consultant, adequate EAs as backup is to be provided for the exchange of inaccessible ones due to whatever reasons. Alternatively, pre-agreement of additional EAs is to be provided by the consultant and agreed upon before the implementation planning phase.

The Program Partners

eHealth Africa planted 500 trees for Earth Day

Last week, just in time for Earth Day 2022, our team in Kano and Abuja embarked on a “plant a tree” campaign. We believe that one of the most significant ways we can help to address the concerns of climate change is to plant trees. As an organization, while we strive to be more energy-efficient to reduce our carbon footprint, we also take other actions to improve the communities we work and live in. For this campaign, we took to some selected communities in Kano and Abuja to plant 500 trees, 300 in Kano, and 200 in Abuja.

About the “plant a tree” campaign, Dr. Kabir İbrahim Getso, Kano State Commissioner for Environment, had this to say, “The essence of Earth Day is to awaken our consciousness to create awareness to protect our environment and engage in practices that will ensure sustainable management of our environment. The very high temperatures we are experiencing and the flooding in Nigeria and around the world are some effects of climate change. Organizations and individuals need to join hands with the government to safeguard the environment and I would like to appreciate eHealth Africa for joining hands with the Kano State Ministry of this environment to carry out this tree planting exercise.”

Here are pictures from the plant a tree campaign in Kano and Abuja

Harnessing Innovation to reduce malaria

By Faridah Tajuddeen

According to the World Health Organization, there were an estimated 241 million cases of malaria worldwide, with an estimated 627,000 deaths in 2020, and 80% of these deaths were children under five years from Sub-Saharan Africa.

The populations with the highest malaria mortality tend to reside in hard-to-reach regions of Africa, with limited access to health facilities. Is there something that needs to be in place to reduce the number of malaria deaths? How do we as an organization use innovation and data to reduce the malaria burden and save lives?

Here are three ways we have harnessed innovation to reduce the malaria burden.

Adequate tracking saves lives

In October 2021, the World Health Organization engaged eHealth Africa to support the Seasonal Malaria Chemoprevention (SMC) Cycle 4 campaign with GIS eTracking across all the 21 Local Government Areas (LGAs) of Adamawa State, and 4 selected LGAs of Yobe State. The campaign was house to house, and we employed the services of Community Drug Distributors (CDD) for drug delivery.

eHA provided technical, equipment, and human resources to support the cycle 4 campaign by collecting and analyzing the passive tracks of the Community Drug Distributor (CDD) teams during SMC Cycle 4 campaign using Vaccinator Tracking System (VTS). We provided VTS for coverage, and this helped with the numbers of houses reached, as the tracker shows any missing location for mop-up. We also tracked the drugs to ensure effective utilization.

Identifying coverage gaps with GIS

We supported the Malaria Consortium in mapping out nine hard-to-reach local government areas in Kaduna and eleven hard-to-reach local government areas in Kano to make them eligible for ICCM (Integrated Community Case Management). ICCM is a strategy that focuses on training, supporting, and supplying community health workers (CHWs) to provide diagnosis and treatments for illnesses such as malaria, pneumonia, and diarrhea for children of families with difficult access to health facilities. Research has shown that ICCM can potentially decrease the child mortality rate of these three illnesses by a whopping 60%.

We leveraged our expertise in geographic information systems to collect geospatial data relating to settlement names and locations, and the nearest functional primary and secondary health facilities to the settlements for two weeks.

Access to geospatial data can reduce the malaria burden

We are increasing access to geospatial data in public health planning by opening access to the data we have collected over the years to the public, to allow a wider cross-section of people and organizations access to data that can assist them in decision making and resource planning. We created a tool called the Data Portal, which is a collected catalog of a wide variety of geospatial data and other datasets in the countries and regions eHealth Africa has worked in. We developed this to serve the data access, routine analysis, and informed decision-making needs of government, private sectors, donors, partners, and individuals.

The data is accessible to all for non-commercial use.

With access to this data, the government, non-governmental organizations, relief, and charitable organizations have information on boundaries, settlements, and health facilities; this makes field operations and deployment of resources a lot easier. So when mosquito nets distribution or chemoprevention campaigns are planned, there’s enough data available to serve as a guide, providing information on different settlements and how many health facilities are accessible in those areas.

The fight against malaria is global and still ongoing, and thanks to better prevention and treatment tools, there has been a drop of 44% in the malaria mortality rate in the last two decades in Africa.

Addressing Gender Bias Around Adolescent Girls’ Contraceptive Use

By Sunday James, Fatimah Abdullahi, Hafsat Jafaar and Stephanie Okpere

Adolescent woman receiving counseling and contraceptive from an eHA-ANRiN service provider during routine Adolescent Health Service delivery in Kaduna

Around the world, Gender and other Social norms have had a tremendous impact on the Sexual and Reproductive Health (SRH) of young people, especially Adolescent Girls. Cultural constructs of gender shape expectations related to sexuality and play an essential part in defining what roles and behaviors are considered appropriate for Adolescent Girls and Boys.

Normative expectations embedded in many societies about gender and sexuality create a double standard – which may manifest differently in various settings – that typically encourages sexual liberty for men and demands sexual constraint from women. This values purity and virginity above all else for girls while giving adolescent boys more freedom, including the room to explore, experiment, and engage in sexual relationships. This double standard also places the majority of the burden on females to reject sexual advances from males and to take precautions to avoid pregnancy and sexually transmitted infections (STIs), with females often blamed for STIs and unintended pregnancies. This contributes to the idea that reproductive health is a female responsibility with no role for men. Existing social norms that place men at an advantage with increased access to opportunities also affect young women. Due to these norms, men are more likely to control resources and make decisions for their partners, and may not allow their partners to use contraception. These norms also limit the educational opportunities for young women, marginalizing them from obtaining access to accurate information on sexual and reproductive health.

To make SRH services more accessible to young people, especially adolescent girls and women, eHA ANRiN is addressing gender norms at the community level and building a supportive environment by addressing social and gender norms in addition to increasing individual knowledge that helps in reducing stigma. This effort aims at improving youth-friendly health services at the community level through a more holistic package of interventions that include comprehensive sex education, raising awareness about services to generate more demand among young people for sexual and reproductive health services, and building community support that will decrease stigma and encourage youth to engage in discussions about SRH and seek out services through advocacies, stakeholders engagement, awareness creation at key live events. In addition, eHA ANRiN is providing AHS services and a variety of contraceptive methods to Adolescent Married Women aged 15-19years old to bridge the existing unmet need for contraception. These actions are already having a greater cumulative impact on improving uptake of AHS services, thereby increasing the state’s modern Contraceptive Prevalence Rate (mCPR) and explicitly challenging discriminatory gender norms that put Married Adolescent Girls at a disadvantaged position through awareness creation and balanced counseling services. 

How a Global Health Facility Database can improve the timely delivery of health services

By Chinedu Anarado

The COVID-19 pandemic amplified gaps in global capacity to respond to public health events of such dimension and scale. The world was slow to respond, and when it did, wealth inequalities ensured that some countries had access to life-saving support before others. Poorer countries largely bore the burden of COVID-19 as they grappled with huge infrastructure gaps while trying to ensure their people were safe from COVID-19. At the same time, global health strategists did not have access to the information they needed to deploy appropriate interventions to support developing countries. 

Bamali Nuhu Hospital, Kano Municipal, Kano, Nigeria

The impact of this scenario was predictable. Vulnerable populations were more affected, while those living far from health facilities required more effort to get vaccinated. In Africa, the average readiness rate for vaccine rollout was 40 percent. These issues highlighted the pressing need for improved data that can provide relevant insights into the location of health infrastructures and the distribution of healthcare services. The world needed definitive answers to a straightforward question: where are the health facilities?

Quality data about the location and status of health infrastructures at the local, national and international levels could have improved global efforts to contain COVID-19. With reliable information on health facilities, Governments can improve their vaccine logistics, distribute personal protective equipment (PPE), and expedite vaccine and therapeutics rollout. It became evident that if we want to rapidly reach the needed populations with the necessary support, we must understand their accessibility to health facilities. 

In December of 2021, the World Health Organization (WHO) launched a global campaign to improve access and visibility of health facilities among member states. This global initiative is being implemented across WHO regional offices in Africa (AFRO), South East Asia (SEARO), Eastern Mediterranean (EMRO), and the Western Pacific (WPRO) regions. The goal is to help countries collate and validate their health facility master list and contribute this information to a global database of health facilities. 

“In this age of information, member states need updated database tools to reach the World Health Organization’s triple billion targets for healthier populations, universal health coverage (UHC), and health emergencies protection.”

— Steve Macfeely, Director, Data and Analytics ,World Health Organization

Republic of Tanzania’s Health Facility Registry

We can achieve these challenging targets with robust and authoritative data collection, integrated into a collaborative system that allows citizens and municipalities to identify the locations and services provided by health facilities in their vicinity.

This Global Health Facilities Database (GHFD) will serve as a central repository, providing information such as the health facility’s name, location, and type while assigning a unique identifier to each. In addition to improving aspects of primary care, this data can improve response time, identify gaps in quality, and support advanced health emergency efforts, such as the COVID-19 response.

The public health space has relied on platforms from multilateral agencies and nonprofits to plan interventions. Platforms such as the Humanitarian OpenStreetMap, the WHO ISS, and e-SURV database, GRID3, and the Global Health sites mapping project were some of the only sources of information on health facility data. But these data sources can be inadequate and often do not reflect the realities on the ground. Hence, the WHO has conceived the Global Health Facility Database (GHFD) project as a public good to enhance information access on the location and status of health facilities across all WHO member countries. 

The GHFD project will require participating countries to update their health facility data, participate in an assessment of the existing health facility list or registry, sign an MoU with WHO to share that information with a global database managed by the WHO GIS office, and receive capacity support to ensure the information is updated periodically. A standard health facility list should bear information on the status, location, and capacity. 

Each facility in each country will come with a unique identifier on the GFHD database. Thirty-two countries in Africa are participating in the project’s first phase, which will run for five years. eHealth Africa is implementing this project in five countries: Cameroon, Chad, the Gambia, Seychelles, and Togo. For eHA, this is one of the ways we support the strengthening of health systems and ensure that we can improve access to care for vulnerable populations.

“Supporting WHO member states with establishing and maintaining a master list of health facilities and combining them into a standardized health facility registry will not only strengthen national healthcare delivery systems but also provide a critical resource needed to respond to any public health emergency of international concern (PHEIC).”

— Vince Seaman, Senior Program Manager, Polio, The Bill and Melinda Gates Foundation

We believe that the time has come to support establishing and maintaining a master list of health facilities in each WHO member state and the creation of a global health facility database (GHFD). The availability, quality, and accessibility of the master list of health facilities and the Global health facilities database will transform our capacity to deliver interventions and ensure that wastage of health consumables such as vaccines reduces and health support is prompt and timely.