In 1988, the World Health Organization and partners acknowledged the end of polio was in sight, and committed to eradicating it worldwide. In 2014, only three countries remain polio-endemic, never having stopped transmission of wild poliovirus. In 2012 there were 122 confirmed cases of polio in Nigeria. In 2014, only six children were paralyzed by the virus, largely due the hard work of the EOC and Polio Eradication Initiative.
eHA works with national, state, and local governments in Nigeria to implement complementary activities which improve data, facilitate coordination, and streamline operations. eHA’s applications and projects streamlines and strengthens immunization activities by delivering smart data, providing geospatial information, and helping vaccinators reach intended targets. Results from the field are available in near-real-time while maintaining data fidelity.
Polio Emergency Operations Centers
Polio response in northern Nigeria is led by the Nigerian government in partnership with UNICEF, Rotary International, the World Health Organization, the U.S. Centers for Disease Control & Prevention, USAID, and the Bill and Melinda Gates Foundation.
In 2012, The Gates Foundation funded eHA to build and manage the Emergency Operations Centers (EOCs) in northern states with the highest infection rates, and also a National Polio EOC in Abuja to coordinate activities between state governments and national agencies. eHA provides effective management, a fully-equipped working space and fast internet speed in Nigeria for the EOC - a challenge for agencies working in insecure or remote regions.
Microplanning & Geodata Collection
Nigeria’s population is growing fast, with large numbers inhabiting the vast areas throughout the north. Without an understanding of population, terrain, and transportation, large numbers of settlements are missed by polio vaccinators.
eHA’s Geographic Information Systems (GIS) team has already captured 10 TB of Nigeria which has assisted the locally based data collectors to map previously missed settlements, often in insecure regions. The software is loaded onto GIS enabled tablets which allow data collectors to gather crucial demographic information. This is used in microplanning activities by local governments and partners to ensure more children are reached in large scale immunization campaigns in Kano and Bauchi states.
eHA’s innovations mean that during immunization campaigns, the GPS-enabled mobile phones carried by vaccinators track team’s movement, and promptly identify missed settlements. These are revisited and ensure more children are covered. Through eHA’s work, 782 previously undocumented hamlet settlements were identified, which ensures that more settlements will be visited during future vaccination campaigns.
eHA partners with Novel-T to operate a custom Vaccinator Tracking System (VTS) and dashboard that monitors the vaccinators movement, area percentage covered, and missed settlements. Each vaccinator has an Android-based mobile phone equipped with a custom tracking application, which identifies missing areas, and new locations for campaign “mop-up” days.
eHA provides over 12,000 vaccinator teams with phones during our monthly Immunisation Plus Campaigns. Each round, we provide tracking support to 80 local government areas (LGAs) across Northern Nigeria. eHA has developed synergies across districts to make operations more effective and improve the quality of our geodata, meaning more children have access to lifesaving vaccines.
Northern Nigeria has many rural, isolated communities that can be 10km or more from the nearest health facility. A lack of access of basic health services means that these communities can be reservoirs for the polio virus. eHA’s polio program provides GPS-enabled smartphones and maps of hard to reach settlements to WHO and UNICEF’s mobile health teams, who travel to remote communities and supply families with routine vaccines and basic care services year round.
Mobile health teams capture the GPS coordinates for each settlement they vaccinate and upload health register summary data daily to WHO-UNICEF accessible databases. eHA’s involvement in the Hard To Reach initiative has significantly improved the reporting time and number of people reached.
End Game Strategy
Convincing noncompliant parents and local leaders to accept the polio vaccine after an initial refusal is challenging, and needs a deep understanding of the community and its culture. eHA works with the End Game Strategy team in Kano to analyze data from immunization campaigns of all noncompliant settlements and households in the state, so EOC staff then effectively addressnoncompliant hotspots.
Through eHA’s involvement in End Game Strategy, Kano state has seen a steady decline of children who missed a polio vaccine over six months, from 1436 to only 714 children.