GIS

Strengthening Routine Immunization using Lessons learned from Polio Emergency Support

By Joshua Ozugbakun & Emerald Awa-Agwu

In July 2016, after over two years of being polio-free, two wild poliovirus cases were discovered in Borno State, Nigeria. This launched fresh efforts to strengthen the four pillars of polio eradication including Routine Immunization (RI), Supplementary immunization activities (SIAs) (including national Immunization Plus Days (IPDs)), Surveillance and targeted mop-up campaigns.

A health worker vaccinates a child with the Oral Polio Vaccine

A health worker vaccinates a child with the Oral Polio Vaccine

Partners, both local and international, collaborated with the Nigerian government at state and national level, through various interventions and projects to increase the coverage and effectiveness of IPDs and mop-up campaigns in order to increase herd immunity and stop polio transmission, especially in high-risk states like Adamawa, Borno and Yobe states. These interventions were coordinated by the State Emergency Routine Immunization Coordination Centers (SERICCs). Each SERICC is led by individual state governments and help to improve information sharing, joint programming of public health emergency management activities (planning, implementation, monitoring, and evaluation) with partners. The National Emergency Routine Immunization Coordination Center (NERICC) is responsible for strategy development and oversees the activities of all the SERICCs. With this coordination mechanism in place, the menace of polio is being tackled collaboratively and Nigeria is well underway to being declared ‘Polio Free’, a major milestone in its vaccine-preventable disease management efforts.
A major takeaway for Nigerian polio eradication stakeholders after years of battling polio is the need for data collection, management and storage systems to be upgraded. As the need to halt poliovirus transmission increased, it became increasingly obvious that paper-based data management systems were incapable of providing decision makers with the reliable, actionable data which they needed for effective programming. eHealth Africa responded to this challenge by supporting states across Nigeria to develop comprehensive, digital maps using our expertise in Geographic Information Systems (GIS). The accuracy of these maps improves the microplanning process and guarantees a greater coverage of settlements during campaigns.

Our GIS technology has improved the quality of maps used for polio campaign planning

Our GIS technology has improved the quality of maps used for polio campaign planning

In addition, through our Vaccinator Tracking Systems (VTS) project, GIS-encoded Android phones are used to record and store passive tracks of vaccinators as they conduct their house-to-house visits; allowing decision-makers to have an accurate picture of the settlements that have been covered during IPDS and mop-up campaigns. This data can easily be accessed through dashboards for a more detailed analysis and breakdown of coverage information.


Supporting polio emergency response activities also highlighted the need for the Nigerian health system to move from an emphasis on SIAs and campaigns to strengthening the RI and disease surveillance systems. Sound routine immunization and disease surveillance systems are necessary to sustain the herd immunity built through polio campaigns.

In Kano state, the LoMIS Stock solution helps the State Primary Health Care Management Board to ensure that the vaccine supply chain is maintained. Health workers at the facility level use the LoMIS Stock application to send reports on a variety of vaccine stock indicators including vaccine utilization, vaccine potency, stock levels, wastage rates, and cold chain equipment status. Supervisors access the reports through the LoMIS Stock dashboard and are able to respond appropriately. This ensures that the RI system is maintained and that health facilities are never out of stock.

In the past, Acute Flaccid Paralysis (AFP) surveillance in health systems across Africa was passive. This meant that disease surveillance and notification officers (DSNOs) only reported or investigated suspected AFP cases that were presented at the health facility. According to the U.S Centers for Disease Control and Prevention (CDC)1, over 72% of polio cases are asymptomatic and as such, will not present at the health facility. In addition, DSNOs are unable to visit every single community to actively search for AFP cases due to logistics and security challenges. Relying on data from passive AFP surveillance causes programs to be designed based on data that excludes the asymptomatic polio cases. Auto-Visual AFP Detection and Reporting (AVADAR) reduces the burden on the DSNOs by enlisting members of the community to actively find AFP cases and report using a mobile application on a weekly basis; thus, providing accurate real-time surveillance data that can be used for program planning and implementation.

An often overlooked factor that promoted the transmission of the poliovirus was the rejection of the polio vaccine by mothers and households due to various myths and socio-cultural barriers. By engaging traditional and religious leaders as ambassadors of vaccination, more mothers and households are accepting the polio virus.

The central lesson in Nigeria’s journey so far towards polio eradication is the importance of collaboration and engagement at all levels including communities. eHealth Africa is proud to be supporting governments and health systems across Africa to respond to the polio emergency.

Technical Career Development at eHealth Africa

Health systems, especially in within Africa, face the challenge of delivering high-quality services to an ever-growing population with limited resources. This has necessitated the development of innovative approaches to expand access to healthcare to larger numbers of people, even in the most difficult-to-reach locations. The role of electronic and mobile technologies, ranging from simple SMS messaging for reporting and complex information and data management systems for studying patterns in disease prevalence, in the transformation of healthcare delivery has become more evident.

eHealth Africa was founded in 2009, on the belief that adapting technology to meet local needs and settings, is the key to delivering better health services. A decade later and with projects such as the Geo-Referenced Infrastructure and Demographic Data for Development (GRID3) and solutions such as LoMIS Suite and Gather under our belt, eHealth Africa is an established leader in the Global Health Informatics (GHI) space.  Our approach to technology is that systems designed in proximity to the environment in which they are needed are stronger, more effective, and help close the gap between design and use.

Our GHI program spans several technical areas including software development, Geographic Information Systems (GIS) & Analytics, Information Technology & Engineering Operations, Business Analysis and DevOps Engineering. We therefore constantly seek to connect and leverage our work across focus areas while attracting and retaining the best employees. Through a more deliberate focus on employee development, we focus on building and keeping an outstanding Africa-based team to execute our work.

There’s always time to laugh when you love your job

There’s always time to laugh when you love your job

Some members of our GHI team share some of the ways that eHA supports the development of careers in tech.

Evance, Senior Software Developer in Software & Solutions Development

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Working at eHealth Africa is by far, the most rewarding career experience I have had. I joined eHA two years ago and before that, I had several years of experience developing software for customer-oriented companies. At eHealth Africa, the focus is on saving lives in the most constrained environments in Africa. Not only have I worked on many projects, all requiring different technical specifications and I have done so in three countries namely, Guinea, Liberia, and Nigeria, using some of the coolest technologies available in our age such as Big/Sensitive data management, Offline- aware apps, Biometric identification). Creating software for various contexts and needs, motivates and challenges me to be more creative and to try new methods. I have grown as a software developer because of the work that I do at eHA. It is an amazing feeling for me to see how the codes I write contribute to improving healthcare among underserved populations.
— Evance

Sandra, Senior Business Analyst in Software & Solutions Development

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As a Senior Business Analyst with the GHI program, I work in the capacity of a project manager, responsible for planning and executing a project. I am also responsible for the requirements analysis and documentation, specifications, development cycle and execution of a variety of GHI projects. eHA has provided me and my colleagues with a platform to excel. I have been given way more opportunities in just 1 year working with eHA, than in the two years I spent working with other organizations. At eHealth Africa, there are a lot of opportunities for career growth within the organization, irrespective of your tech inclination. I joined eHA as a Business Analyst in 2017 and by the end of 2018, I had been promoted twice. I have worked on many projects and last year, I was made the project lead for an eLearning initiative for employees and clients. Thanks to eHealth Africa, I and other colleagues were trained and have received the Projects in Controlled Environments (PRINCE2) certification, which is invaluable for a career in project management. The organization expects great results from their staff but what is most important is that eHA pushes and supports us to achieve our personal development and career goals.
— -Sandra

Oluwafemi, Associate Manager, DevOps Engineering

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DevOps is a growing culture which was born out of the need to roll out incremental changes to software several times daily. In the past, it was not scalable or automated; now with new technologies in cloud computing, automation and deployment, development and operations process are easier and more cost-cutting.
At eHA, we use open source technologies to solve health-related challenges in contexts which are constantly evolving. It is very important for the solutions that we create to move from writing to pushing to production within minutes. DevOps simply eliminates the barrier between the people who develop software and those who operate it, allowing the development of solutions that integrate functionality with enhanced usage and minimal error. I joined eHA about 2 years ago as a DevOps engineer and in that time, I’ve worked with the team on the best and most cost-effective way to evolve and improve our solutions at a faster pace.
The best part of working in eHA, for me, is that there’s always room to learn and grow. I am continuously exchanging knowledge and learning about the latest technology trends to keep up with the ever-growing DevOps culture.
— Oluwafemi

Detan, Associate Manager in Geographic Information Systems

There is a tendency for techies to be somewhat distant from the clients who use their software or solutions. eHA allows members of the GHI team to be seconded to other eHA offices in Berlin, Sierra Leone, and Liberia and to clients in different parts of the continent (Chad, Cameroon, Niger) in order to ensure that the team is fully embedded with clients and fellow technical consultants. This provides a deeper grasp of the context and increases empathy towards the client and the work that we do, making work enjoyable, irrespective of the inherent challenges and risks in implementing a project.
In addition, jobs roles within the organization and division allow for flexibility and adaptability to suit project requirements and career goals. For example, business analysts may double as project managers on a small project, and there are opportunities for project managers and UI/UX designers to transition into product management roles if they are interested in such career paths, while technical leads may also double as technical project managers if need be. Members of the GHI team attend and plan conferences, hackathons and other meetups within the technology industry. This helps our team stay abreast with new trends in our field so they can improve themselves, and deliver better results.
— Detan

eHealth Africa is committed not just to delivering data-driven solutions that address systems-level issues across Africa, but to providing career and learning opportunities to tech enthusiasts. We are passionate about sharing our knowledge, experience, and skills with the next generation in order to inspire positive change. eHealth Africa frequently hosts tech meetups in Kano and Berlin to bring together individuals who are interested in developing technological tools for development.

If you are interested in pursuing a career in tech or global health informatics with an established leader in the field, visit the careers page on our website to keep up with internship or job opportunities.

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.







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.

"Connecting the Dots - Geodata in Healthcare"- The eHA Meetup in Berlin

By Benedetta Ludovisi

Geographic data and accurate maps are essential for improving public health outcomes. Up-to-date information on where people live, the best way to reach them, and the location of nearby medical facilities is fundamental to enhancing healthcare systems. When settlements and points of interest are surveyed and mapped, frontline healthcare workers and medical supplies can reach even the most remote communities. The proliferation of geographic information systems (GIS) technology and spatially enabled data collection tools have helped governments and NGOs connect the dots in public health and improve effectiveness of health interventions.

Connecting the dots - Geodata in Healthcare” audience ready for the Q&A session

Connecting the dots - Geodata in Healthcare” audience ready for the Q&A session

Johanna Roegele, the Managing Director of eHA German office, welcomes attendees and introduces the speakers for the evening

Johanna Roegele, the Managing Director of eHA German office, welcomes attendees and introduces the speakers for the evening

In order to take a closer look at this topic, our Germany-based office partnered with Viderum to host "Connecting the dots - Geodata in Healthcare" on September 19 at the co.up coworking space in Berlin, the second in a series of technology and global health meetups in Germany.

Johanna Roegele (Managing Director, Germany Office, eHealth Africa) welcomed attendees and introduced eHA’s and Viderum's speakers for the evening. She also shared her vision for these meetups—a forum to share the work eHA does with Berlin’s tech and global health communities, and to create opportunities for innovative organizations to partner and learn from each other.

Sebastian Moleski, Viderum's CEO, introduces their mission to the audience

Sebastian Moleski, Viderum's CEO, introduces their mission to the audience

The second speaker was Sebastian Moleski (CEO, Viderum) who introduced Viderum as an expert in Open Data working with high-profile partners in the field of data and health. He explained that their mission is to make the world's public data discoverable and accessible to everyone by providing data management solutions and tools that not only allow the strategic use of data, but also play a crucial role in analyzing, tracking and predicting public health trends.

Dave Henry, eHA’s Director of Global Health Informatics, gave a presentation on eHA's use of GIS technology for the VTS project, aimed at polio eradication, a disease for which immunization requires at least three vaccine doses within a child’s first year of life. GIS technology has enabled vaccination campaigns to locate, reach, and vaccinate children in hard-to-find settlements.

Adam Butler, eHA Technical team lead in Berlin, gives a demonstration of eHA's data collection tool Gather

Adam Butler, eHA Technical team lead in Berlin, gives a demonstration of eHA's data collection tool Gather

After Dave’s overview of the effort to eradicate polio, its challenges, and the role of GIS technology in the initiative, Adam Butler (Technical Team Manager, Germany office, eHealth Africa) and Marko Bocevski (CTO, Viderum) got ready to demonstrate how geodata can be collected, shared and visualized using eHA’s and Viderum's tools.

Adam demonstrated eHA’s latest data collection tool Gather, built for secure, real-time, spatially-enabled data collection and map-plotting, to show how GPS-enabled devices can easily capture coordinates of health facilities, settlements, and roads.

Marko Bocevski, Viderum's CTO, shows the functionalities of Viderum's visualization tool for CKAN

Marko Bocevski, Viderum's CTO, shows the functionalities of Viderum's visualization tool for CKAN

Following Adam’s demo, Marko demonstrated the technology Viderum developed to enable the visualization and analysis of collected data. The tool, which can be connected to Gather, facilitates data-driven decision making, project planning, and implementation.  

Following the demos, we had time to engage with the audience and answer few of their questions that animated discussions around topics related to data privacy and local community engagement.

We would like to extend a special thanks to the speakers and audience members whose participation and collaboration were essential for the success of the event.