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Polio immunization campaign in Borno State, where four fresh cases of the virus were recently registered / © PNN

Polio eradication in Northern Nigeria: a transnational approach

Anu Parvatiyar, Lucy Chambers, Jennifer Bencivenga and Natalya Nepomnyashcha of the organisation eHealth Africa write on the ongoing transnational efforts to fully eradicate polio in Nigeria, one of the only three countries in the world where the virus still occurs.

For much of the world, fear of the polio virus seems like an anachronism, an old threat conquered by the march of medical progress. In the 1950s, the development of effective polio vaccinations sparked hopes for the eventual eradication of the virus.  By removing the need for a needle and a trained nurse, the Sabin oral vaccine has directly contributed to massive reductions in polio case counts in the last 50 years. For many regions, the goal of polio elimination has been realized. After India was declared polio free in 2014, only three countries were considered endemic for the virus, including Nigeria.

Nigeria has been steadily making progress against polio. In 2012, there were 122 cases of paralysis from wild poliovirus recorded in Nigeria; in 2014, that number was 6. Although no cases were found in 2015, detecting the virus can be challenging since not every person who contracts the virus will exhibit its most recognizable and devastating symptom, irreversible acute flaccid paralysis of the limbs (AFP). For several years, Boko Haram has controlled and terrorized much of the Borno region in Northern Nigeria with kidnappings, bombings, and violence. An estimated 1–2 million people have been displaced, not only from their homes, but also community institutions that provide access to vaccines and healthcare.

Since August 2016, 4 cases of of wild poliovirus have been reported in the Borno region – a significant setback for total polio eradication for the African continent, but one that the state and national teams, as well as international partners, are working closely to address and resolve. The Nigerian government’s polio initiative involves local government commissioned teams that set out to vaccinate all children under 5. These teams work under conditions that complicate the process, including poor transportation infrastructure and migratory pastoral populations.

Since 2012, eHealth Africa (eHA) has worked to support these teams on data collection and geospatial mapping. Our field officers collect information on tablets to provide context to the imagery, including geocoordinates of villages and towns, settlement names, health facility location, and other relevant data. Geolocated vaccination data, collected in near-real-time, is helping us locate vaccination gaps and pockets where the virus still may be circulating. The resulting basemap becomes the guide from which local teams can plan large-scale “campaigns”: four-day events that target up to 40 million children at a time through door-to-door vaccination.

In addition to geospatial data collection to support field operations, eHA works with state and national governments in Nigeria to provide technical solutions that allow government and partners to manage the many layers of data that are needed to successfully find and eradicate the virus. eHA’s software team, based in Kano, Nigeria and Berlin, Germany, work with a variety of stakeholders on the ground to better understand and translate the needs of the polio eradication program into actionable insights. Located in one the most vibrant tech hubs in the world, our Berlin team works closely with the Emergency Operations Center in Abuja, Nigeria to provide national-level decision makers with a dashboard to view country-wide campaign performance. Most recently, the Berlin team has been working with the Kano-based GIS team to produce dedicated, real-time visuals which focus on the current vaccinations in Borno state, the site of the recent outbreak where elimination activities have ramped up.

Thus, working transnationally and alongside local leadership and international partners, we are hoping to steadily eliminate these pockets and fully eradicate polio in Nigeria. 

More about eHealth Africa at: www.ehealthafrica.org

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