Nigeria expands innovation for early detection  and reporting of vaccine-preventable diseases 

Mrs Bilikisu Dansherko Muhammad is one of the community health workers using AVADAR technology to report and improve surveillance for life-threatening diseases in Kuje Local Area Council, in Abuja, the Federal Capital Territory of Nigeria.

“I wanted to be a medical doctor, but could not fulfil the dream due to early marriage,” says. Bilikisu.
Despite a rocky start, Bilikisu did not give up. She returned to school and completed her tertiary education which qualified her to become a community health worker.

Equipped with the AVADAR technology, she is empowered to promptly report suspected life-threatening diseases and to educate other women in her catchment communities with vital health information to keep their families healthy.

Bilikisu goes from door to door, conducting surveillance for acute flaccid paralysis, which is a telltale sign of the infectious childhood disease, polio. If Bilikisu suspects a case, she reports it to the Nigeria Centre for Disease Control and Prevention. She then sensitizes the family and supports contact tracing in the community.

Compared to the traditional surveillance system, AVADAR provides real-time reporting of suspected cases and real-time response to the reports received. AVADAR being a community-driven app helps to gain access to high-risk areas, therefore improving the sensitivity of reporting in those areas.

Leaving her home in Gyana village, to Rubochi, a close by village, Bilikisu first pays a visit to the primary healthcare facility to notify the health workers there of her presence in the community.

“I first get to the health Centre to inquire if there are any suspected cases before going into the community,” she explains.

Accompanied by Mr Sule Jelio Tude, the officer-in-charge of the health facility at Rubochi, Mrs Muhammad goes from house to house asking if there are any sick children within the household.

She also sensitizes household members about polio, measles and other diseases, while educating them on what they should do if they suspect someone has the symptoms of any of these diseases.

Her four years of experience working as a community health worker during polio vaccination campaigns has helped her gain the trust of the community.

“The people know we are community health workers and they trust us. We are part of the community, we speak the same language and have worked with them since the polio days.

This has made it easier to visit households and educate people on routine childhood immunization,” explains Bilikisu.

Surveillance activities are an integral part of the polio eradication strategy that requires health workers to promptly report any sudden symptoms of limb paralysis in children under the age of 15 to ensure proper investigation to rule out the transmission of all types of polioviruses in the country.

Tude says Bilikisu’ s work in the community has increased health knowledge and health-seeking behavior among its residents.

“People now bring their children to the healthcare center as soon as they notice they are ill,” he says. “They also bring their children for routine immunization and comply with the supplementary immunization activities and health interventions that we conduct in the community.” He says.

Bilikisu also uses the AVADAR application to educate women by showing them pictures of children in the application.

“The technology is on our phones. We can use it to take the geolocation of where we are reporting suspected cases,” she says.

“This makes it easier for the investigating officers to pinpoint the exact location of the suspected cases if we are unavailable to follow them to the field.”

With financial support from the Bill and Melinda Gates Foundation, there are 5071 AVADAR health workers and community health workers deployed to 11 states and 62 LGAs to support the surveillance, sensitization and response to acute flaccid paralysis and three other priority diseases ‒Yellow Fever, measles and Cerebrospinal Meningitis. The project also tracks and responds to cases of zero-dose children.

World Health Organization (WHO) supports the government with the coordination of technical assistance and operational support of partners, including national disease surveillance, outbreak responses and routine immunization activities.

“AVADAR is critical for community-based surveillance of any disease outbreak,” says Dr Walter Kazadi Mulombo, WHO Representative in Nigeria. “Community health workers are at the very heart of this response and without their efforts, this digital innovation would simply not work as effectively as it does.”

When not in the field, Biliksu is a seamstress. She says being a community health worker has salvaged her shattered dream of being a medical doctor.

She maintains that many women with whom she interacts are interested in becoming community health workers. “Empowering women in the health sector will go a long way in disease surveillance, prevention and detection,” she says.

Technical contact:
Mr Korir, Charles; Email: korirc@who.int