Author: eHealthAfricaAdmin

Disease Surveillance, Laboratory Systems, Health Delivery Systems, Polio Eradication, Public Health Emergency

Hypertension is a major public health problem in Nigeria, with prevalence of 37.5%. This means that nearly 4 out of 10 Nigerian adults have hypertension. Similarly the prevalence of diabetes is increasing worldwide, and Nigeria is no exception; an estimated 7% of adults in Nigeria have diabetes, making it among the most common cardiovascular diseases in the country.

Unfortunately,  lack of access to quality and affordable hypertension and diabetes services in rural communities and primary health care is a major concern. This is largely due to  disparity in access to quality healthcare, especially between rural and urban areas in Nigeria as a result of  economic, social, geographic, and health workforce factors. For instance, the secondary health facilities where the few drugs are, with the facility for testing and the medical professionals are far from the rural communities, making access difficult. This is exacerbated by the high cost of medications, making it difficult for some clients to afford the treatment they need, resulting in low treatment outcomes.

Thus, adapting and digitizing  the World Health Organisation Package of Essential Noncommunicable (PEN) disease interventions for primary health care, eHealth Africa is collaborating with the EHA Clinic Reaching Everyone with Accessible Community Healthcare (REACH) program to reach out to marginalized communities with healthcare interventions. This, according to the Project Manager Lucy Okoye, is aimed at improving access to quality care and affordable services for persons with hypertension and diabetes and others at risk.

She said, “Social mobilization activities will increase rural communities’ knowledge of hypertension and diabetes”, saying  the identification of risk factors and the signs of hypertension and diabetes will likely result in the adoption of a preventive healthy lifestyle and prompt seeking of treatment. Another potential impact of the intervention according to her is to reduce the prevalence of hypertension and diabetes and improve the health and well-being of the target communities, helping people to live longer and lead healthier lives.

In February, eHealth Africa supported the free medical outreach conducted in the Kuje community of the Federal Capital Territory and Gyadi-Gyadi community of Kano state. According to Adawiya, Mahmud Ila, Product and Quality Assurance Coordinator at the EHA REACH clinic said the outreach is an opportunity to reach the people accessible and  to provide free healthcare within the community.

“We are having an outreach where we see hypertension and diabetic patients,we measure the blood pressure and fasten blood sugar.”  If there is a need for us to give hypertensive and glycine medication we give them which is going to be free for 6 months”, she said.

She said, the economic realities in developing countries like Nigeria limits citizens especially the older generation from accessing good medical care.  She said, “You know how the economy is in Nigeria; economically it’s hard for them to go to the hospital so we are just trying to make an impact in the community”.

Speaking on community acceptance and mobilization strategy for the outreach, Adawiya said, the partners leveraged on its Community Health Extension Workers (CHEW) to discuss the impact of the intervention  with traditional leaders and community influencers.

Community Feedback

Zainab Abdullahi is  a resident of Kasuwan Dare area of Gyadi-Gyadi community of Kano state. She heard of the REACH Clinic Outreach through community influencers. “Now they checked our BP,Blood sugar level and from here we will proceed to see the doctor”, she said.

Zainab lauded the outreach initiative saying the community is receptive to ideas like this. “the hospital environment is clean and welcoming and this is why you can see close to 100 people coming for this outreach”.  “If they can spread their tentacles and establish  this kind of hospital in all areas, we will be happy so that everyone will visit the nearest hospital rather than going far from home to access healthcare”, she said.  There is also a need to have additional doctors to attend to a growing number of patients in a bid to reduce waiting time, she said.

Ahmed Salisu Musa has spent 45 years in the community.  He expressed his excitement saying the outreach has brought good healthcare delivery to his doorstep. “They took my blood samples, gave me some medications and I was told, I am not diabetic”, he said

He said, “as a community leader myself, I am glad to  have witnessed what is happening and will pull  in more people to come and get checked.” Musa called for increased mobilization of citizens and more importantly expansion of the intervention to reach other communities.

Source: OutREACH: eHealth Africa, Clinic Collaborate to Tackle Non-Communicable Diseases

Tagged: Polio eradication

Disease Surveillance, Laboratory Systems, Health Delivery Systems, Polio Eradication, Public Health Emergency

The race to  ensure accessibility to  COVID-19 Vaccine and  intensive campaigns to promote the uptake of the vaccines led to its routinization especially in developing countries.   To further ensure the successful implementation of its COVID-19 vaccine deployment plan and address existing challenges of data management, Nigeria developed the Electronic Management of Immunization Data (EMID) system in 2021. By the end of the year,  the National Primary Health Care Development Agency (NPHCDA) revealed that Nasarawa state, located in North Central part of Nigeria has again overtaken other states in the COVID-19 mass vaccination campaign in Nigeria.

However, recent experience has also revealed that manual data collection remains vulnerable to damage or manipulation. Digital solutions remain mostly more recommended as it enables more accurate data capturing and better storage process.  However, the potential challenges that could hamper the progress of development and utilization of digital solutions for management of immunization data are likely technical glitches and capacity limitations of health officials, especially in underserved communities.

To Address these challenges, eHealth Africa in partnership with National Primary Health Care Development Agency supported by GAVI developed an optimized version of the EMID mobile application, incorporating routine immunization to further standardize and harmonize data collection and storage. Thus, eHA successfully completed the training of healthcare personnel across the country, in the use of the EMID Native App.

Speaking during the training session for healthcare personnel and immunization recorders across over 300 Primary Health facilities in Nasarawa state, key stakeholders highlighted how the optimum utilization of the EMID application will sustain vaccination progress in the state.

Health Delivery Systems

Less than a fortnight ago, the  World Health Organisation,  Director-General, Dr Tedros Adhanom Ghebreyesus warned that the impact of climate change may reverse the progress made in the fight against malaria. This according to him is due to “COVID-19-induced public health disruptions, humanitarian crises, drug and insecticide resistance, and global warming impacts”. As contained in the recently released World Malaria report, the changing climate poses a substantial risk to progress against malaria, particularly in vulnerable regions. This may just be another critical reason needed to lift the climate change/health nexus while ensuring effective mainstreaming of  health in the global climate change agenda.

There is no gainsaying that developing countries like Nigeria and others  must be on the alert to prepare for the potential impact of this new development necessitated by climate change. Despite the hysteria that greeted the reported number of Africa’s delegates (especially Nigeria) to the just concluded 28th United Nations Climate Change Conference otherwise referred to as  Conference of Parties (COP28), It is pertinent to reflect on the economic and human resources invested in the event to explore actual opportunities.

The conference was no doubt a huge platform  where thought leaders and experts across the  world come together to chart pathways  to address the climate crisis, and proffer succor on how  vulnerable communities can adapt to the effects of climate change. This is in a bid to achieve the  overall goal of  net-zero emissions by 2050. With over 70,000 delegates expected to attend this important event every year; from business leaders, young people, climate scientists, Indigenous Peoples, journalists, and various other experts and stakeholders; the opportunities are boundless.

With the 2023 Intergovernmental Panel on Climate Change report revealing that over 3.5billion people live in areas that are vulnerable to climate change, it’s just a matter of time before nations feel the impact if there are no effective measures for early preparedness and response against climate change.  This may have contributed to the call for urgent action on climate change and health by  the Global Health Community.  This is also not a coincidence as similar calls were made before the 2022 Conference as the World Health Organisation reiterated the fact that,  climate crisis continues to make people sick and jeopardizes lives. This yet again buttressed the call to make healthcare delivery amidst climate change  a critical area of discussion during the conference.  Thus it was not surprising when the COP28 Presidency joined with the World Health Organization to announce a new ‘COP28 UAE Declaration on Climate and Health’ (the Declaration) to accelerate actions to protect people’s health from growing climate impacts.

Thus developing countries like Nigeria have a huge opportunity to build on their participation in the conference to explore ways to alleviate the grueling impact of climate change on healthcare delivery and policies.  One of the first signatory to the Declaration on Climate and Health, Malawian President Lazarus Chakwera revealed that  extreme and unfavorable weather events have consistently displaced citizens, causing the spread of infectious diseases that has led to the death of thousands in countries like Malawi.

Nigeria specifically in recent times witnessed increased flood and rapid desertification. For instance, in the last 18 months, Nigeria experienced massive floods caused by global warming with huge economic and health implications like loss of lives, properties leading to chronic hunger and vulnerability to water-borne diseases.  Also, the potential threat to  livelihoods like agriculture and  fishing is no doubt cause for concern with potential challenges of food security which negatively impact health and nutrition.

While a handful of organizations are taking both intentional and unintentional steps to combat the impending impact of climate change, it is vital to galvanize important stakeholders  across all sectors to discuss their role in supporting the process.  A typical example of such steps is eHealth Africa’s deployment of a modular solution that involves the design and implementation of renewable energy solutions for healthcare facilities, especially in low-resource settings. The  Renewable Energy for Public HealthCare (RE4PHC) solar system is designed to be deployed to health facilities with minimal access to power but at the same time reducing the emission of greenhouse gas from generating sets due to lack of electricity.

However there is need for public and stakeholder sensitization and coordination on the potential impact of climate change in the African region especially in Nigeria. Organisations and government agencies like Nigerian Park service, Great Green Wall, ministries of Agriculture, Marine and Blue economy amongst other Non governmental organizations both within and outside the region must coordinate to ensure effective action against climate change.

This is in a bid to further explore the causes and impact of climate change within and around the African context while educating the people on activities that have consistently escalated the current risk. A basket fund can also be created to pull resources from the public and private sector, especially companies whose activities contribute to emission of greenhouse gasses and global warming with support from international thought leaders and experts in climate change interventions.

The idea of dissecting the nexus between climate change and health is to ensure that Low and Medium Income (LMIC) like Nigeria to advance its aspiration to meet up with acceptable global standards as regards critical actions that aides early preparedness and response.

Atef Fawaz is the Executive Director of eHealth Africa. He is a Complex operations Management and ICT expert with experience in Humanitarian Response and Digital Health

#Child Health, #SARMAAN, #Data Management

By Mohammed Bello

In a bold move to address infant mortality, the Nigerian government through the Federal Ministry of Health, in collaboration with implementation partners, initiated the Safety and Antimicrobial Resistance of Mass Administration of Azithromycin on Children 1-11 months in Nigeria (SARMAAN) research project. The project’s focal point is the mass administration of Azithromycin to children aged 1 – 11 months to understand its impact on safety, antimicrobial resistance, and overall reduction in infant mortality.

The SARMAAN project unfolds in two phases: firstly, to investigate the safety and pattern of antimicrobial resistance (AMR) resulting from Azithromycin administration, and secondly, to assess the cost, feasibility, and acceptability of the drug delivery through various platforms. With three (3) successful cycles completed across six states, the project is well on its way to achieving its milestones.

The study areas – Jigawa, Kebbi, Kano, Sokoto, Akwa Ibom, and Abia are a microcosm of the diverse challenges and opportunities in Nigeria. Their unique characteristics- geographical features to economic structures, provide a rich backdrop for a comprehensive understanding of the SARMAAN project’s impact on healthcare delivery. The research looks at the interplay of factors such as regional health disparities, cultural nuances, and existing healthcare infrastructures. This nuanced examination allows for a more profound appreciation of the project’s significance within the context of Nigeria’s varied landscapes and sociodemographic compositions.

eHealth Africa worked on data management in six implementing states, using digital tools to streamline processes. Key deliverables included the digitization of paper-based case reporting forms, the creation of a study database, and the training of data collectors. The meticulous approach ensured data accuracy and reliability.

The implementation approach, outlined in the document, emphasizes a systematic methodology. With a focus on data processing, storage, and dissemination, the project leveraged digital platforms like Kobotoolbox and Tableau to ensure a smoother information flow.

The raw data is collected, filtered, sorted, processed, analyzed, stored, and then presented in a readable format. The stages deployed to process the collected data.

For this study, data uploaded to the Kobo server is first processed in the Feature Manipulation Engine (FME) before being sent to the study’s Postgre SQL database. The next stage is GeoServer, where fields are exposed as needed and finally disseminated using Tableau.

The SARMAAN project has seen significant achievements in its implementation, with over 18,100 children reached out of the 17893 children targeted across 3 cycles. Training initiatives, data processing, and cleanup were conducted meticulously, contributing to the success of the project. The Tableau dashboard provided a comprehensive overview of the progress, ensuring transparency and accountability. The SARMAAN project dashboard can be accessed via the link.

Despite the successes, the project encountered challenges, including violations of daily community visitation targets, inadequate training facilities, and security concerns. In addition, some data collectors needed more essential tools. Stakeholder engagement gaps existing in certain states also hindered compliance.

The project offers valuable insights, highlighting the importance of daily visitation plans, group training approaches, and adapting to cultural norms. Recommendations include the need for targeted outreach strategies, increased female data collectors in specific regions, and an extended training period for enhanced proficiency.

The SARMAAN project stands as a testament to the power of research and collaboration in addressing critical health challenges. By navigating challenges and incorporating key lessons, the project is poised to continue making a positive impact on infant mortality rates in Nigeria. The journey so far reflects a commitment to innovation, data-driven decision-making, and the well-being of the nation’s children.

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