How Nigeria Won the Fight Against Polio.
- Posted By Vitalis_Obidiaghaa | On September-26-2020 15:26:36
- Nigeria is now free of wild Polio. On 21 June, the African Regional Certification Commission, an independent advisory body of the World Health Organization, certified that the country had eradicated the disease.
The victory was hard -fought. For decades, health officials encountered numerous challenges to eradication, despite understanding the roots of the disease and receiving the necessary resources from the international community to fight it. By the end of 2010, it seemed that the country was finally on the verge of winning the battle -that year, there had been only 21 recorded cases in the whole country – but spikes in cases over the next two years (62 in 2011 and 99 in 2012) signalled there was more work to be done.
Health officials were puzzled by the spike; they had reached vaccination rates above 90 percent for children under the age of five, the threshold required to eliminate the disease. Initially, officials suspected that vaccination delivery campaigns struggled because of challenges arising from conflict and negative perceptions of foreign medicine; these suspicions seemed to be supported by the fact that most of the new outbreaks were in the north, where conflict and negative perceptions are more common.
But then, Yau Barau, who in his work with the National Primary Health Care Development Agency (NPCDHA) has been on the frontlines of this battle for over a decade, realized that they needed to think outside the box. Soon, Barau and his colleagues saw that the real root of the problem was that the vaccination teams were using faulty maps.
While driving through Gangara Ward in Katsina State during a vaccination campaign, NPHCDA officials and local teams noticed an inconsistency; the number and location of settlements on the hand drawn maps at the ward headquarters did not match what they were seeing on ground. To get a more systematic understanding, they visited a sample of 25 settlements that appeared on these hand drawn maps, collected names and geo-coordinates and overlaid them with satellite imagery from Google Earth. The maps were indeed faulty; numerous settlements were not correctly located or named and some settlements were missing entirely.
Applying the same methodology to other regions of the country, they found out that the areas in the north where outbreaks were occurring all had faulty maps. In response, experts worked with local communities to develop a comprehensive methodology for generating validated digital maps. Community buy in around methodology ensured trust, which in turn allowed for accurate data collection at the local level.
Local cartographers were trained to collect boundary information for wards, (the smallest administrative division in Nigeria) and names and coordinates for every settlement in each ward. The improvements in the local maps were remarkable. Settlements of up to 1000 people that had previously been unmapped and had not been visited by vaccination teams in many years were now precisely located and named.
With support from the Bill and Melinda Gates Foundation, the NPHCDA mapped 10 Northern States over two years. By incorporating high-resolution satellite imagery, machine learning, and advanced data science methods, these maps were able to include comprehensive delineations of each settlement and spatially precise population estimates (these additions were made possible through a partnership with Oak Ridge National laboratory and World Pop/Flowminder). The enhanced maps could now not only ensure that each settlement was included in vaccination plans, but also enabled significant improvement s in plan efficiency. Equipped with specially precise, accurate data, planners could better allocate vaccine supplies and better design vaccinator travel routes.
“Integrating geospatial data into our vaccination planning process was the number one game changer’’ says Barau. “Seeing the joy and happiness of our vaccinations teams confirming that the hamlets or settlements were at the right place, with the right name, was a turning point in our fight against polio. When communities validated our data and we started using the data for implementation, we felt we were really going somewhere. Teams worked long hours to finish their works, as we knew that we could eradicate the disease if each vaccination team met 100% of their objectives. This approach enabled that.”
Out breaks fell to zero and have stayed there. These innovations did more than help to eradicate polio in northern Nigeria, they led Bill & Melinda Gates Foundation and the United Kingdom’s Department for International Development to create GRID3 so that the mapping interventions could be scaled up to all of Nigeria and extended to the countries.
“The fight again st polio virus in Nigeria and the final declaration of Nigeria as free of wild polio was made possible through the utilization of geospatial technology.” Says Dr Faisal Shuaib, Executive Director and Chief Executive Officer of NPHCDA. “GIS-Based maps from the GRID3 Nigeria data improved the micro-planning process, thereby enhancing the ability of the frontline health care workers to accurately identify settlements and track under five children to be immunized with polio vaccines.’’
Commenting via his twitter handle, the Hon. Minister of State for Health, Dr. Mamora stated that “We need to guard jealously the certification gotten. Staff of the NPHCDA are a rare breed, we wouldn’t have achieved this without your support, to you, I say the reward of hard work is more work.” Achieving this eradication is the best way to celebrate those who paid the supreme price. They are the heroes and heroines of this day.” The Hon. Minister of Health has demonstrated leadership in this fight. We thank President Buhari who promised not to bequeath a polio endemic country to his successor. Thank you God almighty for this day.”