The Importance of High-Quality AFP Surveillance Data in the Fight to Eradicate Polio

Polio is targeted for eradication because the presence of the virus anywhere means that children everywhere are at risk. The Global Polio Eradication Initiative (GPEI) focuses on strengthening Acute Flaccid Paralysis (AFP) surveillance worldwide to detect and respond to the poliovirus, to build herd immunity to protect the population and to halt the transmission of the virus. The data on the spread of AFP is invaluable especially for polio-endemic countries like Afghanistan, Pakistan, and Nigeria because it helps in determining whether they can finally be certified polio-free.

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There are four steps involved in AFP surveillance and the Auto- Visual AFP Detection and Reporting (AVADAR) project responds to the first step—finding and reporting children with AFP—in eight priority countries in Africa. In many of these countries, disease surveillance and notification officers (DSNOs) at the health facilities are unable to actively find AFP cases for reasons ranging from difficulty in accessing settlements to security challenges. AVADAR trains community informants to search for and report the presence and/or absence of children with AFP in their community, using a mobile application. The application also has an embedded video that shows a child with AFP so that community informants can better recognize an AFP case. This reduces the burden on the DSNOs and allows them to focus on confirming if the case is truly AFP or not.

How AVADAR works

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To ensure that AFP surveillance is conducted impactfully and that the AFP surveillance data collected is accurate, timely and of high quality, the GPEI defined five global indicators: Completeness of reporting, Completeness of case investigation, Completeness of follow-up, Sensitivity of surveillance and Laboratory performance.

Global Polio Eradication Initiative: AFP Surveillance indicators

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AVADAR was designed by eHealth Africa, NovelT, the World Health Organization (WHO) and other partners, to contribute to the achievement of the above targets. Below are the measures that have been put in place to ensure the collection and use of high-quality data to track and reports suspected AFP cases, and to inform decision making for polio eradication.

  • Coverage: To decide where to site an AVADAR system, WHO carries out an assessment of the target country/districts to identify rural, hard-to-reach and underserved communities which are typically more predisposed to poliomyelitis. The AVADAR system, equipped with geospatial tracking capabilities is then deployed to community informants/ AFP reporters. This unique feature of the application helps to validate the location of the suspected AFP case, independent of the reporter.  

  • Reporting: The AVADAR application allows informants to deliver reports anywhere and anytime in order to prevent data loss and to ensure near real-time, accurate reporting.  The app is designed to be used by people with basic literacy levels and is available in eighteen local African languages for ease of understanding. A report is better able to provide insight and enhance planning or decision making when it is timely. One of the key weekly metrics captured on the AVADAR dashboard is the number of complete results that were submitted as at when due, thus ensuring that all informants are actively engaged. Informants are expected to look out for and report cases of children aged 15 years and below, who have any form of physical deformity on the limbs or arms. In the event that no AFP case has been sighted within a week, the informant must send a ‘no report’, to validate his presence on the system.  

    AVADAR has improved the rate of AFP reporting compared to the traditional system of AFP reporting. For example, between June 2017 and June 2018 in the Lake Chad Basin countries(Chad, Niger, Nigeria, and Cameroon), the AVADAR system recorded 589 supsected cases against the 213 cases recorded by the traditional AFP Surveillance system.

  • Verification: Paralysis in children can be caused by several agents including the Poliovirus. After the community informants submit their reports of suspected AFP cases, trained health workers carry out further investigations to confirm if they are true AFP cases. The WHO has designated laboratories all over target countries that are certified to test fecal samples and isolate the poliovirus. AVADAR weekly reports show how many suspected AFP cases were reported, how many were tested and the number of cases confirmed to be true AFP cases. This sort of data measures the cost of a single confirmed AFP case, the prevalence and incidence of AFP in target areas, thus enhancing the quality of AFP surveillance data for decision making.

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Having data on the spread of AFP in a geographic location helps with planning towards its containment. Since Poliomyelitis is mainly oral-fecally transmitted, sanitization and sensitization of the environment and inhabitants respectively can help reduce the spread of polio.  AFP data gathered across different locations has been used in making an informed decision on determining the number of health workers that can effectively manage its spread to neighboring communities. On the contrary, no data or false data could lead to health workers focusing their energy in wrong locations thereby risking the spread of polio and the extension of its existence.

Without reliable and accurate AFP surveillance data, true progress towards polio eradication cannot be measured. AVADAR’s impact in high-risk countries across Africa demonstrates how context-appropriate interventions and solutions can transform disease surveillance and emergency management systems.

One of the most important features of the AVADAR system is the engagement of over a hundred community informants per county. They are trained and equipped for the first time to provide timely reports that can be accessed at all levels from the county to the national level and beyond, thereby allowing suspected cases to be investigated in an accurate and efficient way.
— Dr Sylvester Maleghemi, WHO Polio Eradication Initiative Team Lead, South Sudan

Meet the Team - Ori Okibe

Meet Ori Okibe, the Operations Administration Coordinator at our head office in Kano.

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She joined eHealth Africa over five years ago as the Administrative Coordinator of the Sokoto State Polio Emergency Operations Center (PEOC), where she provided administrative support to the EOC team and partners. In no time, she rose to become the State Manager of the PEOC where she managed the daily operations of the EOC including staff, fleet, and other assets.

Currently, she supervises the administrative and operational activities of the procurement, warehouse and logistics team. She is in charge of managing vendors according to master service agreements and ensuring that the procurement and supply chain team meets delivery deadlines.

Recently, Ori worked with the team responsible for the renovation of three zonal offices of the National Primary Health Care Development Agency (NPHCDA) in Bauchi, Kano and Niger states. Ori is most proud of the role that she and her team played in the containment of the Ebola Virus disease outbreak in Lagos State in 2015. Some of her other achievements include managing the initial setup of the Sokoto Meningitis Lab by ensuring that all logistics, travel, and procurement needs were met.

Ori credits eHA with giving her and other staff opportunities to discover and showcase competencies which they may never have discovered otherwise. In recognition of her dedication and service towards the eradication of Polio in Sokoto State, she and nineteen other recipients in Nigeria were presented with the Rotary International Meritorious Award for Polio Service in 2018.

In the course of meeting my work objectives, discover skills and competencies that I didn’t know I possessed. These have enabled me to overcome several challenges and offered opportunities that I ordinarily would not think I can handle. Even though my role is mostly operational, I support core project delivery in so many ways and I know that I am giving back to the society
— Ori Okibe

We are proud to have Ori on our team. If you would like to join us, please visit our careers page.

Benefits of a Direct Delivery Model

By Adamu Lawan and Emerald Awa- Agwu

eHealth Africa's third- party logistics service, VDD ensures that vaccines are delivered to last mile health facilities in a timely manner

eHealth Africa's third- party logistics service, VDD ensures that vaccines are delivered to last mile health facilities in a timely manner

Vaccination is one of public health’s most cost-effective interventions. According to the World Health Organization1, it prevents between 2 million to 3 million deaths every year. Even though there has been great progress towards achieving universal coverage, there are still 20 million unvaccinated and under-vaccinated children worldwide. To reach these children and to meet global disease elimination targets, all countries must provide an uninterrupted supply of potent vaccines to the most hard-to-reach and conflict-affected areas.

Nigeria has experienced challenges in maintaining functional vaccine cold chains and supply chains, leading to low vaccination coverage rates. Nigeria’s cold chain system consists of five levels: a national cold store which stores all vaccines in the country and supplies six zonal cold stores located in each of Nigeria’s six geopolitical zones. The zonal stores supply vaccines to the state cold stores, which in turn supply the LGA cold stores. The primary health care facilities staff have to visit the LGA cold stores to collect their vaccines on a weekly or daily basis depending on the status of their cold chain equipment.

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This system was inefficient and time- consuming because health workers from over 9,000 health facilities in Nigeria often had to leave work to collect vaccines when they could be treating patients instead. In addition, the system was fraught with high operational costs and poor vaccine stock visibility, especially in transit.

To alleviate this problem, the Nigerian government adopted a direct delivery model called Push Plus in 2013, to transform its supply chain at the state level. A direct delivery model is one which delivers vaccines and dry goods directly from the state cold store to the last mile health facilities according to customized schedules, bypassing the LGA warehouses completely and preventing stock-outs.

The benefits of this model have been enormous. The direct delivery model has freed up an additional 1- 6 hours each week for health workers to attend to patients—time previously spent by health workers in transit to obtain vaccines. In addition, vaccine availability at the last mile health facilities has improved. By increasing the number of health facilities that have functional cold chain equipment, health posts and smaller health facilities can receive vaccines from closer health facilities instead of going to the LGA cold store every day. This has led to a massive drop in the stock-out rate. In Kano state, vaccine stock-out rates dropped from 93% to 3% and in Lagos State, from 43% to none. Not surprisingly, the immunization coverage of Lagos State increased from 57% to 88%. WHO2 lists vaccine shortages and stock-outs as a major cause of missed opportunities to vaccinate.

Nigeria is projected to spend about US$ 450 million by 2020 on vaccines, By increasing vaccine accountability and visibility, the direct delivery model has also reduced the amount of money that could be lost due to wastage and pilfering of vaccines.

eHealth Africa implemented Vaccine Direct Delivery, a third-party logistics service based on the direct delivery model in Kano State from 2014 to 2016 and currently implements it in Bauchi and Sokoto states. We work with the state primary healthcare development agencies to ensure that vaccines and dry goods are delivered safely and in a timely manner to health facilities. Using our LoMIS Deliver solution, eHA plans, schedules, and routes deliveries to enable health delivery officers choose the correct quantity of vaccines and dry goods from the state cold stores and deliver them to health facilities equipped with cold chain equipment. The process of determining what quantities to deliver at the health facility is fully automated to avoid manual errors. The project also incorporates reverse logistics—returning balance stock or waste, if any to the state cold store. VDD provides governments and other stakeholders with accurate, near real-time data for decision making and forecasting.

Through VDD, over 28 million doses of vaccines have been delivered to health facilities in Kano, Bauchi and Sokoto State from 2014 to date, reaching over 13 million children under the age of one. eHealth Africa continues to support governments across Africa with system-level approaches to transforming health service delivery.

Welcoming Micheline Ntiru to eHealth Africa’s Board of Directors

At eHealth Africa, our greatest strength is our people. We believe in attracting and working with passionate, motivated individuals who add value to the work that we do to build stronger health systems across Africa. We are pleased to announce the appointment of Micheline Ntiru as a member of eHA’s Board of Directors.

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Micheline joins Andrew Karlyn, My T. Le and our Executive Directors, Evelyn Castle and Adam Thompson to provide professional governance, mentorship to senior leadership, guidance on critical organizational functions, and global representation in order to support and strengthen eHA.

Micheline has 20 years of experience in small and medium enterprises (SMEs) growth, impact investment, sustainability, and public health management globally. She is a coach and business facilitator for the SEED Program at Stanford University’s Global Business School, an initiative to transform business and leadership practice among high-performing CEOs of SMEs in Africa. In addition, she provides portfolio and deal structuring advice to private equity and venture capital investors in Europe and North America.

Within the public health space, she has held several management and advisory positions with leading nonprofit organizations such as Care International and Helen Keller International, on thematic areas such as maternal and child health, Malaria and HIV/AIDS and public health nutrition.

To learn more about Micheline and the other members of our Board of Directors, visit the “Our People” page on our website. We look forward to working with her in the months and years to come.

Internship Spotlight: Justice Agbadu's Top 5 Reasons Why You Should Intern with eHealth Africa

By Justice Agbadu

My name is Justice Agbadu, a student of the African Institute for Mathematical Sciences (AIMS) in South Africa. As part of the Industry Immersion Program in my school, I joined eHealth Africa as an intern with the Geographic Information Systems (GIS) & Analytics department. Any student aspiring to begin a career knows that an internship is invaluable for gaining on-the-job skills, experience and for establishing necessary contacts. Internships help to integrate theoretical knowledge gained in school with day to day practical field application. An employer is more likely to hire a candidate with internship experience than someone who has no experience, especially at the entry level.

I have been with eHA for a little over five months and it has been a wonderful experience

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Here are my top 5 reasons why you should intern with eHealth Africa.

1. Working with some of the most genius minds across the world

eHealth Africa’s young, dynamic workforce is made up of smart people from countries all over the world. I have had the opportunity to work with people with varying skill sets and levels of experience in different fields and I am shocked by how much I have already learned. I am also gaining knowledge outside my field and learning about different cultures.

2. Conducive Working Environment

eHealth Africa is located on serene, beautiful grounds that relax you and make you glad to be at work. All staff members are provided with all the tools that they need to deliver the desired results. I love the fact that every department has its own feel and vibe. In my department, GIS, we are pretty laid back and you can often find us seated on bean bags analyzing geographic data collection tools. My favorite part of my work environment is the people—they are friendly and always ready to answer my numerous questions. This helped me to settle in quickly despite the fact that I had never visited Kano.

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3. Personal and professional development

One of my favorite quotes is by Mark Twain—”The two most important days in your life are the day you are born and the day you find out why.” I can definitely say that this internship at eHA has helped me discover my professional direction and career goals. This is really important because a lot of people are moving through the motions without having clearly defined goals and objectives.  I have also discovered personal skills and competencies that I never knew I possessed. eHA easily has the largest GIS team in Africa and there is always something new and challenging to work on; so I am gaining knowledge that most people don’t have access to, which positions me as a valuable asset in this field.

4. Opportunities for Career Growth

eHealth Africa’s team is spread across several countries in Africa as well as in Berlin and the US. We implement data-driven projects in five focus areas: Disease Surveillance Systems, Health Delivery Systems, Laboratory & Diagnostics Systems, Nutrition & Food Security systems, and Public Health Emergency Management Systems. This wide scope of work means that staff have various opportunities to grow and migrate within the organization. In the course of my internship, I have seen staff move to Nigeria from other country offices and vice versa. Some staff in the organization started out as interns just like me and have now become project managers. eHA is an established thought leader in the field of technology and data for health systems strengthening so I know that having this internship experience on my CV already highlights me as a valuable talent to other organization.

5. Solving Real-world Problems

eHA works to address real problems such as access to quality health care and services and nutrition. One of my favorite projects is the Vaccinator Tracking Systems, a project that captures passive tracks of vaccination teams during the Immunization Plus Days using a mobile application installed on Android phones. Using GIS technology, eHA is able to provide governments with near real-time data on the vaccination coverage during IPDs to aid planning and decision making. I am very glad that I am contributing in some way to the eradication of Polio in Nigeria. This internship experience has made me more passionate to do more to help underserved populations in Africa and to improve their quality of life.

The experience so far has been very rewarding and I look forward to more opportunities to contribute to the work at eHA.



Looking for or interested in an internship spot, visit our careers page for more information.







NPHCDA Zonal Office in Kano gets an Upgrade

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

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

The renovated NPHCDA zonal office in Kano

The renovated NPHCDA zonal office in Kano

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

30- seater conference room

30- seater conference room

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

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

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

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

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

Three things I learned at the 2018 ASLM Conference

By Tolulope Oginni

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

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

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

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

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

2. Increasing efficiency in lab diagnosis and testing

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

3. Collaboration in public health research

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

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

With friends at the conference

With friends at the conference

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

Partnering to Address Sickle Cell Disease in Northern Nigeria

By Muhammed Hassan

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

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

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

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

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

The Impact:

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Practical Solutions to Challenges in Reporting: LoMIS Stock and eIDSR

By Abdullahi Halilu Katuka and Emerald Awa- Agwu

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

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

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

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

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

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

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

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Meet the Team - Sonia Khalil

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

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

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

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

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

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

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

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

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

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

By Sibongile Chikombore and Sahr Ngaujah

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

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

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

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

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

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

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

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

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

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

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

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

 
I am also currently being trained to pass on the skills learned from the CHO-MLTP Program to others.
— Saidu Mansaray

Meet the Team - Charles Otaigbe

Meet Charles Otaigbe, a groundskeeper at our Kano campus!

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

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

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

We are proud to have Charles on our team.

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

eHealth Africa partners with the Global Healthsites Mapping Project

eHealth Africa is collaborating with The Global Healthsites Mapping project (Healthsites), in their efforts to build a global commons of health facility data using OpenStreetMap, a collaborative mapping initiative. The Healthsites project aims to improve outcomes in the medical and humanitarian sectors by establishing an accessible global baseline of health facility data. Taking an open data approach, Healthsites invites organizations to share health facility data and collaborate.

From routine reporting to emergency services, health facility data drives how national health ministries, international institutions, and private companies operate in a highly functioning health system.  While accuracy is vital for effective service delivery  health facility lists are frequently inaccurate, outdated, duplicated, incomplete, and not made available in open and accessible methods.

Definition of the scope, service provision capacities, laboratory capacities, and optimal catchment populations for emergency hospital care should be a priority.
— Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis - The Lancet Global Health

One of the main barriers to easily accessible and accurate health facility data is a lack of interoperability between different information management systems, which is why working with open data structures and in partnership with different organizations is important. Healthsites’ approach builds on open source standards and technologies implemented by the Open Health Information Exchange Community (OpenHIE). This data sharing strengthens the ability of health authorities in underserved areas to more easily create and update accurate health facility registries.

Data collectors in rural Northern Nigeria

Data collectors in rural Northern Nigeria

Creating a Global Health Facility Dataset

The project was launched on  March 3, 2016, at the Global Partnership for Humanitarian Impact and Innovation in response the Ebola outbreak in West Africa with support from the International Committee of the Red Cross (ICRC) and Kartoza.

By providing relevant data on health facilities around the globe we can strengthen health systems, improve emergency care, and save lives. For underserved areas, it has been estimated that improving emergency care can lead to a 45% reduction in mortality rates and a 36% reduction in disability.
— Access to emergency hospital care provided by the public sector in sub-Saharan Africa in 2015: a geocoded inventory and spatial analysis - The Lancet Global Health

Creating and maintaining a global health facility dataset requires collaboration--current project partners include the International Committee of the Red Cross (ICRC), Doctors Without Borders (MSF), The Humanitarian OpenStreetMap Team (HOT), the International Hospital Federation, and CartONG. To make the project successful worldwide, Healthsites is inviting organizations to support their work in areas including Senegal and the Democratic Republic of the Congo through the Digital Square Global Goods program.


The primary use cases include:

Epidemic Preparedness:
Accurate healthcare facility data is vital to respond to outbreaks, prepare for an influx of cases, and to make decisions regarding resource allocation.

Support for disaster response:
Accurate and up-to-date data provides the basic data that helps drive activities like service availability planning, monitoring and evaluation, and disaster risk preparedness.

Support for immunization programs:
Information on the location of health care providers is important for immunization planning on the national scale.

Maternity care:
Open and accurate health care facility data is a valuable resource for pregnant women looking for support when planning a birth.

eHealth Africa and Healthsites

eHA’s technology is key to enabling Healthsites’ vision of a health facility global commons. Gather, eHA’s human-mediated data collection and curation application will be used to crowdsource facility information and widen the scope of the project.  Healthsites will also utilize eHA’s Aether platform to facilitate interoperability and allow for a large-scale exchange of data between numerous organizations.

eHA’s extensive experience in West Africa working with health facility data collection and presentation will facilitate the advocacy of open data and data sharing with the Global Healthsites Mapping Project within the region.

The eHA team, setting out on another data collection campaign. Mobile phones are used to capture geospatial data from the field.

The eHA team, setting out on another data collection campaign. Mobile phones are used to capture geospatial data from the field.

The data life cycle starts with crowdsourcing facility data. Collected information is then sent into Healthsites platform where the data goes through a quality check and enrichment processes to make sure that the information is updated and relevant. Once validated, Aether allows the data to be shared in CKAN, OSM, HDX and later on with OpenHIE, making sure the open data community can contribute to this ambitious project as well. The idea is to foster a  "data collaborative" approach, which continuously involves more people that can contribute and benefit from information sharing.

 

The Data Cycle

 
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By enhancing the quality and accessibility of health facility data, this project can have an impressive impact on multiple sectors. Not only can the database help save lives in emergency response situations by facilitating access to emergency care, but also it can improve health outcomes in a wide variety of ways such as strengthening diseases surveillance systems or facilitating medical supply planning and the effectiveness of vaccination campaigns.

Validated open health facility data is a supporting framework for social entrepreneurs

Validated open health facility data is a supporting framework for social entrepreneurs

The public sector is not the only beneficiary; entrepreneurs in the private sector also benefit from access to this information. Healthsites provides a web API that allows applications and web services to be created or enhanced to utilize accurate health facility information.  This enables use cases that go beyond simply locating health facilities and medical services. Expanding business opportunities and enabling efficient use of available resources increases the size of the community who will help collect and maintain the data.

Healthsites is improving health capacity data in West Africa and supporting the development of data collaboratives. This is a global project that needs partners to enhance its impact. Get in touch and help us build a global commons of baseline health facility data with OpenStreetMap here.










Meet the Team - Isaac Too

Meet Isaac Too, who joined the eHealth Africa (eHA) team two years ago as the Finance Manager in our Sierra Leone office!

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Isaac is responsible for strategic and technical financial leadership to the team, policies formulation and Implementation, stakeholders engagement, accurate & timely donor financial reporting, vendor relationship management, resource management/internal controls and risk management, among other responsibilities.

Some of Isaac’s greatest achievements have been: championing a zero tolerance policy of financial mismanagement and instilling a culture of management by example; successfully managing multiple donor project closeouts, and was instrumental in the closeout and financial reporting in the Liberia office when we closed its doors earlier this year.  Additionally, Isaac has managed two consecutive external audits (for 2 years) without major queries.

He believes in strong teams and is committed to building the capacity of his team and providing the requisite skills and tools with a view to supporting and delivering strong financial management in our Sierra Leone office.

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

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

eHealth Africa wins outstanding International Non-Governmental Organization of the year

On Wednesday, December 12, 2018, the eHealth Africa team in Sierra Leone won the outstanding International Non-governmental organization (INGO) of the year award presented by the Sierra Leone CEO council at the Golden Tulip Hotel, Aberdeen, Freetown, Sierra Leone.  eHA was selected the winner of this year’s award from amongst dozens of other NGOs working in Sierra Leone.

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The Sierra Leone CEO council awards is a landmark annual event for the Sierra Leonean business, political, NGO  and diplomatic community that takes place at the end of each year. In its third year now, the event celebrates excellence, innovation, commitment and best practices in the corporate, public and NGO sectors across Sierra Leone. The theme for this year’s event was: Celebrating exceptional leadership and corporate excellence in Sierra Leone.

Organizations were selected based on the impact they are contributing to many spheres of life. eHealth Africa has been outstanding in the area of development, especially in the health sector.
— Joseph Moore, Chairman, 2018 Organising Committee, Sierra Leone CEO council Awards.

eHA has been working in Sierra Leone since 2014 and we have successfully implemented projects in the areas of Health Delivery, Public Health Emergency System and Disease Surveillance . Our most recent country report shows the progress and successes we’ve accomplished so far this year.   

At this year’s awards, eHA’s Sonia Khalil, Procurement Supervisor, won an award for Outstanding Non-Profit Professional Staff of The Year 2018.

I would like to thank my organization ‘eHealth Africa’ , for giving me the opportunity to take part in the Ebola Response Emergency Management system since the very beginning of the outbreak, wherein we used data management support which reduced the response time to procure test results, streamline the tracing & monitoring of potentially infectious individuals and ultimately contain the spread and severity of the outbreak.
Thanks to all eHealth Africa senior management staff, particular Evelyn our Executive Director, the Deputy Director and my line manager. Your contribution to my growth has made me developed a strong international field experience in supply chain and made me diplomatic, cultural and gender sensitive.
— Sonia Khalil

Internship Spotlight: Eleanor Williamson-Taylor

Eleanor Williamson-Taylor is a programs Intern at eHealth Africa (eHA) in Sierra Leone. She joined eHA in September 2018.  

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Eleanor currently works with the Public Health Workforce Development Team (PHWD). Her role involves liaising and coordinating with various PHWD stakeholders including the Directorate of Human Resources for Health, Directorate of Health Securities and Emergencies, Clinton Health Access Initiative, and U.S Centers for Disease Control (CDC), among other partners to ensure effective collaboration in developing the strategy for development of the public health workforce in Sierra Leone.

She says more in this:

World AIDS Day Spotlight

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According to the World Health Organization, 36.9 million people worldwide are living with the Human Immunodeficiency Virus (HIV) and the largest proportion of those people are in Africa.  Africa also accounts for two-thirds of the global total of new HIV infections. However, WHO estimates that over 40% of people who are infected with the HIV virus are unaware of their status. In 2014, the Joint United Nations Programme on HIV/AIDS (UNAIDS) and its partners launched the global 90–90–90 targets— to diagnose 90% of all HIV-positive persons, provide antiretroviral therapy (ART) for 90% of those diagnosed, and achieve viral suppression for 90% of those treated by 2020.

Nigeria has the second largest HIV epidemic in the world and one of the highest rates of new infection in sub-Saharan Africa. 1 There are several agencies within the country working together to meet the 90-90-90 target to help end the AIDS epidemic. This year, eHealth Africa partnered with Solina Group on the Nigeria AIDS Indicator and Impact Survey, which is focused on assessing the prevalence of HIV and Hepatitis B and C in the country. eHA developed a mobile data collection tool which is being used to monitor the activities of field survey teams to ensure that they comply with laid- down standards. The field survey teams will visit selected households across all 36 states of Nigeria, and conduct HIV, Hepatitis B & C counseling and testing. eHA trained over 40 personnel including field monitors, supervisors and data analysts to use the electronic survey tools developed to collect, access, modify and publish data.  We also set up a data collection system to aggregate and process this data, which Solina Group uses for their analysis. So far, 29 states and the FCT have been monitored successfully.

The results of this survey will provide key information that will guide the Government to plan and develop more effective programs to control HIV and Hepatitis in Nigeria leading to healthier individuals and families.

With projects like this, eHA helps to support the fight against HIV/AIDS.

Meet the Team - Abdulkareem Iyamu

Meet Abdulkareem Iyamu, a Senior Coordinator with our Operations team at our Kano Campus in Nigeria!

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Kareem, as he is fondly called, works with the Geo- Referenced Infrastructure and Demographic Data for Development (GRID3)  project that mapped 25 states in Nigeria plus the Federal Capital Territory (FCT). Currently, the project focuses on supporting states to use the geospatial data for informed decision making. The implementation of the project is mostly field-based and therefore, requires constant logistics support.

Kareem coordinates the operations side of the project. He makes sure people and resources are where they need to be at all times. He organizes travel plans, coordinates activities and event, and oversees the purchase and delivery of equipment. He ensures that the GRID3 project runs smoothly and often jokes that he could pass for the SCRUM master on the project.

Kareem joined eHA in 2017 and he has proved to be a valuable asset to his team and to eHealth Africa as a whole. He is well known and liked for his skills in organizing and is often drafted into various planning committees. He works hard to build relationships that are beneficial to the program and to eHA. Recently, he identified and helped eHA to win an opportunity for a household survey with Clinton Health Access Initiative (CHAI) in Kaduna State, Nigeria.

In Kareem’s opinion, eHA is a platform where every skill is valued and can be honed.

The GRID3 team and eHA as a whole, have done excellently. I am particularly proud of the fact that we successfully completed phase one of the GRID3 project, in record time. At the beginning of the project, it seemed like a herculean feat to map the whole country in 7 months but we did it.
— Abdulkareem Iyamu

Are you passionate about operations and logistics? Click here to read more about career options at eHA.

Meet the Winners - #KadHack2018

Maaruf Dauda, Mercy Markus & Swam Didam Bobby - Team Egress

Maaruf Dauda, Mercy Markus & Swam Didam Bobby - Team Egress

The Geo-Referenced Infrastructure and Demographic Data for Development (GRID3) project was born out of the successful mapping of 11 northern states during the Global Polio Eradication Initiative (GPEI).  Building on that, the GRID3 project scaled up to collect geospatial data and to map the remaining 25 states, plus FCT. Datasets relevant to Nigeria’s development needs across sectors such as health, education, environment, agriculture, urban planning, and investment promotion, were collected. Some of the data collected is currently being used in the health sector to support the planning and delivery of polio and routine immunization in Nigeria -  http://vts.eocng.org

To support governments, ministries, departments and agencies to identify use cases for the data collected in phase one of the GRID3 project in their states, eHealth Africa’s GRID3 team partnered with CoLab Innovation Hub, the Kaduna State Bureau of Statistics (KDBS), the  Kaduna State Budget and Planning Commission, the Kaduna State Government, and Kaduna ICTHub, to host a first of its kind hackathon, KadHack2018, in Kaduna State from November 27 - 29, 2018.

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KadHack2018 was an opportunity for stakeholders in the technology sector to engage the Kaduna state government and gain firsthand insight into the challenges in the Education and Health sectors, in order to come up with software prototypes that could be further developed to solve problems within those sectors. The hackathon was split into 2 categories - a 3-day  on-site hackathon, and an online Hackathon for people outside the state.

The winners were announced today, meet Maaruf Dauda, Mercy Markus and Swam Didam Bobby who are Team Egress.  Their multifunctional “TrackIt” solution provides real-time mobile tracking, that can be used to track goods, vehicles and can also be used to report outbreaks using geo-coordinates. Congratulations to all the teams that participated!

To view more photos from the event, please click here.



World GIS Day 2018

World GIS Day is celebrated annually on November 14. The day provides a platform for stakeholders and users of geographic information to identify, create and demonstrate context-specific applications by which geospatial data can be used to transform our society.

This year, eHA’s GIS team focused on educating the next generation of prospective GIS data collectors, analysts and user— secondary school students in Governors’ College, Kano. The team enlightened the students on the power of geography and how GIS can be used to stimulate development. The team was also on hand to answer questions from the students.

Click through the slideshow to see how it went.