5 Reasons Digital Innovations are Crucial for the Final Push to end Polio in Nigeria

Judith Owoicho

It is August 2023, in a remote Nigerian village in Northern Nigeria. Children 5 years and below are on a queue waiting to be vaccinated against polio. At Least, 2,509,687 children have already benefited from the 18-day mass vaccination campaign to boost their immunity against Circulating Variant Poliovirus (cVPV2). (World Health Organization [WHO], 2023).

This raises an important question. If Nigeria was declared polio free in 2020, why do we still require polio vaccinations campaigns today? After years of collaborative efforts, significant progress was made in eliminating polio. However, the threat of circulating variant poliovirus (cVPV2) lingers, particularly in remote areas of Northern Nigeria. Efforts are being made to ensure that we see the end of this disease.

As Nigeria continues the journey towards finally eradicating polio, digital innovation has become a vital tool in ensuring the success of the country’s vaccination efforts. One of such innovative solutions is the integration of GIS tracking systems on eHealth Africa’s polio interventions. This revolutionary innovation has transformed how vaccination campaigns are planned, tracked, and executed. 

A Ward focal person ties a box containing the vaccines he has received for the day as he get ready to begin his day’s work Bodinga LGA, Sokoto 13 December, 2023
A Ward focal person picking up tracking devices from the project field officer as they begin their day’s work Bodinga LGA, Sokoto 13 December, 2023
A child receives a FIPV vaccine in Kofan Kade, Mallam Dani’ma Quranic school, Sokoto north LGA Sokoto State. December 10, 2023

Here are five key reasons why digital innovation is the game-changer in Nigeria’s final push to end polio.

1. Every community is reached with accuracy

The foremost challenge in eradicating polio in Nigeria has been reaching remote and conflict-ridden areas where vaccination coverage is inconsistent. With difficult terrains, and insecurity, It is often nearly impossible to ensure that no child is left behind. With eHealth Africa’s GIS technology, teams are able to track and locate settlements in hard-to-reach areas with geo-coordinates of over 70% of settlements that were previously unmapped. This level of precision has allowed vaccination teams to better plan and ensure that no community is overlooked, increasing vaccination coverage rates. In 2023, the geo-coverage rate of vaccination activities tracked rose to 89%, representing a 6% increase over the previous quarter. This data-driven approach has been instrumental in reaching more than 1.4 million children in tracked settlements across the country.

2. Vaccination Campaigns are Monitored Real-time

One useful aspect of digital technology is its ability to provide real-time data and feedback. Vaccination campaigns can now be tracked in real time, allowing for immediate course corrections if any gaps are identified. The GIS technology has made it possible to track vaccination teams as they move from one settlement to another, providing health authorities with the data they need to ensure that every planned area is covered. With this technology during the vaccination campaign in April 2023  12,791 settlements across 56 LGAs in Katsina, Niger, Sokoto, and Zamfara, were reached, achieving an impressive 81% of the planned coverage. This real-time accountability has ensured that vaccine wastage is minimized, resources are optimally allocated, and the campaign’s impact is maximized.

3. Tailored Trainings for Vaccination Teams

Digital innovation not only improves logistical planning and monitoring but also equips health workers with the necessary tools and knowledge to enhance their effectiveness. With the GIS Intervention, eHealth Africa trained 107 individuals across five states—Katsina, Zamfara, Kebbi, Niger, and Sokoto—to effectively use digital tools and geospatial data to improve their vaccination outreach. These training efforts have empowered local teams and equipped health workers with the knowledge needed to adjust strategies on the go, to achieve more successful campaign outcomes.

4. Enhanced Micro Planning for Campaigns

Polio eradication requires meticulous planning, especially in regions where settlements are small, scattered, and often unmapped. Digital health tools have drastically improved micro planning by providing vaccination teams with up-to-date settlement data and templates to develop detailed vaccination plans. The Master List of Settlements (MLoS), regularly updated through digital tracking, serves as a comprehensive guide for teams in the field. This detailed approach has proven instrumental in increasing vaccination coverage in previously underserved areas, as seen in the 89% overall coverage rate achieved during the 2023 campaign, which targeted 4,861 settlements.

5. An Expandable Model for other Public Health Campaigns

The success of eHealth Africa’s GIS technology in Nigeria is proof that digital innovations  can effectively address a wide range of other public health challenges. The systems, data infrastructure, and training models developed for polio eradication are not only efficient but also highly adaptable and can be applied to combat other diseases and public health emergencies.

The successful deployment of GIS technology by eHealth Africa in Nigeria is evidence that digital innovations can help in the solution of many other public health problems. The systems, data infrastructure, and training models developed for the polio eradication program are not only effective but also flexible enough to be used for other diseases and public health threats.

Through continued investment in these technologies, Nigeria is not only positioned to become polio-free but also to build a more robust and resilient healthcare system that will benefit generations to come.

Uniting Against Circulating Variant Poliovirus: Traditional Leaders Lead the Way

by Moshood Isah

A visit to Sokoto State, Nigeria’s historical Caliphate, is always an intriguing experience, despite the often challenging weather. The city’s rich history complements the profound respect held for its traditional and religious institutions, which are similarly revered across Northern Nigeria. These esteemed leaders have consistently played pivotal roles in public health initiatives.

According to the World Health Organisation, the strategic partnership with traditional leaders in Northern Nigeria since 2009 has been instrumental in eradicating the wild poliovirus in the country. Professor Oyewale Tomori, Chairman of the Expert Review Committee on Polio Eradication, emphasized that overlooking these influential community figures would have been a colossal error.

eHealth Africa supporting engagement of Traditional leaders in the fight against Polio

While these institutions were crucial in eliminating wild poliovirus in 2020, the emergence of the Circulating Variant Poliovirus demands a redoubled effort. To combat this new threat, traditional institutions across Northern Nigeria are being strategically deployed. Supported by the Bill and Melinda Gates Foundation (BMGF), eHealth Africa is collaborating with the Sultan Foundation for Peace and Development and other partners to engage these leaders in polio campaign activities.

Haruna Yusuf Aliyu, Senior Program Officer at the Sultan Foundation for Peace and Development, highlighted the significant role of traditional leaders in a sensitization workshop held in Wammako Local Government Area. He revealed that many are spearheading vaccination campaigns directly from their palaces, which has significantly reduced vaccine hesitancy and boosted uptake.

“You can see traditional leaders going house to house, supervising vaccination teams and resolving cases of non-compliance while providing guidance to the teams to make sure that all households are actually identified, enumerated,  then eligible children in those houses are vaccinated”, he said.

Through ongoing sensitization workshops, traditional leaders are equipped with the knowledge and tools to effectively communicate the importance of vaccination to their communities. Despite security challenges in some areas, Yusuf emphasized the organization’s commitment to working closely with community groups and traditional leaders to reach all children with essential vaccines.

eHealth Africa team after a meeting with Sultan Foundation for Peace and Development in Sokoto

Fatimah Howeidy, eHealth Africa’s Project Manager, expressed pride in supporting the Sultan Foundation and other partners to reduce vaccine hesitancy through the involvement of traditional leaders. The initiative has successfully bridged knowledge gaps and dispelled myths surrounding polio vaccination, particularly in underserved communities.

“It’s so inspiring seeing traditional leaders in Sokoto state turn out in their numbers to participate in the polio campaign activities” she said.  We are indeed excited that this intervention remains a  platform to remind traditional leaders of the need to intensify the campaign to eradicate the Circulating Variant Poliovirus (cVPV2)”, she said.  

The Engagement of Traditional Institutions (ETI) project aims to strengthen advocacy by traditional leaders, increase community ownership of polio eradication efforts, and reduce vaccine hesitancy in high-risk Northern states. There are plans to expand the initiative to Southern Nigeria.

ehealth Africa Commits to promoting early detection of Circulating Variant Poliovirus through Lab Support

by Moshood Isah

Nigeria may have been declared a polio free nation but the Circulating variant Poliovirus Type 2 strain transmission still lingers. Nigeria reported 168 cases in 2022. This  has made further interventions crucial particularly  around early detection. The growing cases in a  number of African countries require a focused effort to strengthen polio laboratories that can effectively help the affected countries to quickly confirm cVDPV2 cases and launch outbreak responses, including the introduction of novel OPV2.  

In 2018, the World Health Organisation (WHO) introduced a Global Polio Surveillance Action Plan (GPSAP 2018-2020) to support endemic, outbreak, and high-risk countries in evaluating and increasing the sensitivity of their surveillance systems against Polio. The plan also initiated supplemental strategies that may help in closing gaps in detecting polioviruses, including strategies for immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) while also strengthening coordination across surveillance field teams to foster a more effective programme and document zero cases worldwide. 

The new Global Polio Surveillance Action Plan (GPSAP) for 2022-2024. also focuses on increasing the speed of poliovirus detection, improving surveillance quality at the subnational level, fostering the integration of polio surveillance with surveillance for other epidemic-prone vaccine preventable diseases (VPDs), and mainstreaming gender equality in surveillance activities and programming as a key enabling factor.

To achieve parts of the Global Polio Surveillance Action Plan (GPSAP) 2022-2024, ehealth Africa worked with World Health Organisation (WHO)  supported by the Bill and Melinda Gates Foundation (BMGF) to  renovate and upgrade the   Sequencing Laboratory in the Virology department, University College Hospital (UCH) Ibadan, Oyo State. The laboratory was commissioned by Kazadi Walter, Country Representative and Head of Mission; World Health Organisation to Nigeria. This is part of the effort to improve surveillance, rapid detection and response against the spread of Vaccine Derived Polio Virus and other vaccine preventable diseases.  

Speaking during the official commissioning of the Laboratory, Dr. Kazadi Walter reiterated the commitment of WHO towards eradicating polio virus through the provision of facilities and rendering of technical support to Nigeria’s health care. He stated that WHO in collaboration with the government established the Global Polio Laboratory Network of which 16 are currently in Africa, with two located in Nigeria; Ibadan and Maiduguri. According to Walter, the primary objective is to work with WHO in the African Region (AFRO) to equip the global polio laboratory network labs for robust and rapid sample analysis for polio and to provide support in equipping these labs with sequencing capabilities.

Prof. Kayode Adebowale, the university vice chancellor, commended the initiative saying “this laboratory will not only provide vital information for the eradication of polio but also contribute to our university infrastructure, helping us to fulfill our vision and mission in addressing social needs.” The VC said: “The department has played a crucial role in Nigeria’s polio eradication programmes by contributing significantly to the country’s achievements of being declared wild polio-free in 2021.

Speaking on the role of eHealth Africa in the support for Laboratory Supplies across selected countries in Africa, the Project Manager, Tolulope Oginni said, to ensure optimum utility of the laboratory supplies, eHealth Africa leverages previous and current experience in setting up and managing Emergency Operation Centers to strengthen the staff capacity at the Laboratories in operating the installed equipment.

“These interventions  for  the support for laboratory supply and installation with consumables currently ongoing in at least 12 African countries are expected to improve the labs functionality for faster outbreak detection”, he said. With the support of other stakeholders in the region, this intervention will support labs in the African region that are targeted for expansion of sequencing capacity, support to improve existing sequencing capacity, or labs that require support for virus isolation and identification. This intervention has a huge opportunity to explore collaboration with WHO and other global stakeholders to transform the laboratory infrastructure in Africa into world class facilities which in turn will significantly strengthen their capacity and preparedness for disease outbreaks.