The discovery of the wild poliovirus in July 2016 in the state of Borno, after more than two years without reporting a case, shocked polio eradication partners in Nigeria. Inaccessibility as a result of insecurity caused by Armed Opposition Groups (AOGs) continues to pose a great risk and impediment to the global polio eradication efforts.

The biggest challenge faced by the Local Government Area (LGA) teams was reaching missed children in the security-challenged areas in Borno, mainly because their locations (geo-coordinates) were unknown. The lack of distinct ward boundaries, further exacerbated this issue, as LGA teams were unclear on their areas of coverage and responsibility. Additionally, for the farther and hard to reach settlements, it was logistically impossible to maintain vaccine integrity due to unavailability of refrigeration units or ice packs.

Mohammed Gambo, the Local Immunization Officer (LIO) in Konduga Local Government Area of Borno State faced these battles regularly as he shouldered the responsibility of the planning, implementing, and monitoring of immunization campaigns across the 11 wards in his LGA.

In 2016, eHealth Africa along with other partners such as the World Health Organization (WHO), Bill and Melinda Gates Foundation (BMGF), eHealth Africa (eHA), Solina Health, U.S. Center for Disease Control (CDC), and UNICEF collaborated with the government of Nigeria to launch robust response strategies to expand polio vaccination from accessible areas to inaccessible areas in Borno State. eHA provided advanced GIS technology and an able team of field officers to track reached settlements using mobile devices so as to provide geo-evidence of visits by the vaccination teams. eHA consultants also worked closely with the LGA teams to collect geo-location and ever-changing habitation and security information for settlements to enable efficient planning of campaigns across varying accessibilities; thus ensuring that any missed settlements are factored into the next campaign.

Thanks to the work of eHealth Africa and other partners, more hard-to-reach settlements are being covered. Gambo and his team are better able to ensure the accountability of vaccination teams, using mobile applications developed and provided by eHA. The applications help them to track vaccination teams and to locate hard-to-reach settlements leading to greater immunization coverage in Borno State. In addition, eHA consultants are involved at every stage of the lifecycle of campaigns and provide post-campaign feedback using maps, which allows Gambo to make data-driven and informed decisions about future interventions.