Health
COVID-19 response in southern Nigeria boosts surveillance of other diseases
In many countries, tackling the COVID-19 pandemic has taken cues from other disease approaches, such as lessons from protecting communities against Ebola. But in Nigeria’s Niger Delta, health workers have found inspiration from guarding against the coronavirus.
They have exploited the rigorous surveillance standard set by the COVID-19 response to keep from losing sight of other priority diseases. Mostly what they have learned is how not to divide their attention.
The unifying surveillance strategy they have enveloped is quickly producing significant and – possibly oddly – uplifting results.
“I recorded my first acute flaccid paralysis case since last year while I was following up on the contact of a confirmed case of COVID-19,” says Sarah Oladimeji, a Diseases and Surveillance Notification Officer in charge of finding cases of preventable and infectious diseases in Oredo Local Government Area of Nigeria’s Edo State.
When COVID-19 crept into the southern Delta region in April, health workers had to learn to overcome their worries and hunkered down to the needed work. The odds seemed stacked against the six states that make up the South-South zone: Akwa Ibom, Bayelsa, Cross River, Delta, Edo and Rivers. COVID-19 cases increased daily while community attitudes towards the virus grew lax. Health workers scrambled to manage the time and resources available to respond to both COVID-19 and other endemic-prone diseases.
One solution government teams and health workers hit upon: bring the aggressive COVID-19 surveillance into the systems used to monitor priority diseases.
Across the Niger Delta, the World Health Organization (WHO) and its partners retrained 3874 surveillance officers who had been mobilized to detect COVID-19 cases in hospitals and communities to also look for acute flaccid paralysis (AFP), polio, meningitis, cholera, neonatal tetanus, yellow fever, measles and more.
After the Government decentralized the COVID-19 response in April, some states began also training religious and community leaders – who are often important decision-makers, influencers and informants – to help find and report suspected COVID-19 and other priority diseases in their communities.
Now, four months into the region’s COVID-19 outbreak, health workers are seeing spectacular efficiency. Detected cases of AFP, for example, increased substantially (doubling and even tripling in one state) between the end of March and end of July as the harmonized surveillance ramped up.
Protecting immunization gains
Keeping eyes on both COVID-19 and other diseases, most of which are vaccine-preventable, is an important but challenging task in the Niger Delta where immunization coverage had been low for years. Located along the Niger River and the Gulf of Guinea, the Niger Delta, or South-South zone, comprises a system of coastal communities that rely on farming and fishing. Waterway systems here are often inadequate and moving around is difficult. In the past, residents in the deepest riverine communities, far from a mainland, had little luck accessing a health centre. Many were discouraged by the distance from taking their children for vaccinations, which led the region to its poor immunization coverage and thus heightened risk of disease outbreaks.
Since 2016, community engagement, better access to health care and increased surveillance have led to rising numbers of vaccinated children. Health workers now attend patients in on-sea treatment centres or travel into the deep-river communities by canoe to provide services.
Navigating the creek communities may be hard but health workers accept that medical care has no boundaries, says Dr Edmund Ogbe, WHO Coordinator for Bayelsa State. Public health commitment and resourcefulness seem to be ingrained characteristics of this region.
Increased detection of measles and yellow fever
To protect their gains in immunization coverage and keep from neglecting other worrisome diseases in these times of COVID-19, the integrated surveillance is making a difference. In March, Bayelsa State recorded nine cases of AFP. But 16 new cases were investigated over the next four months – a 180% increase.
With COVID-19 case findings now meshed with the systems used to detect and report priority diseases, more cases of measles and yellow fever are emerging, too. The reported numbers of both diseases increased considerably between the end of March and the end of July. In a couple states, case detection nearly doubled.
The next step will be to accelerate case search throughout the region. State governments in the South-South zone, supported by WHO, continue to train more surveillance officers and community informants on combining COVID-19 and preventable-disease surveillance. Involving communities by educating them and appointing them as public health informants will help ensure that the combined surveillance continues to be a success, says Dr Olubowale Ekundare Famiyesin, WHO Zonal Coordinator of the Niger Delta.
Early detection of any disease is the goal for health workers in the Delta. “All resources for surveillance at our disposal will be deployed to improve early infectious disease detection and reporting, including COVID-19,” Dr Famiyesin promises.
Resident doctors at the University of Medical Sciences Teaching Hospital (UNIMEDTH) in Ondo State have initiated a 14-day warning strike, as confirmed by the National Association of Resident Doctors (NARD).
The strike action, led by the association’s President, John Matthew, highlights various grievances, notably the non-payment of seven months’ salaries to new members.
Matthew added that the strike also addresses the non-payment of palliative to House Officers since February, the failure to disburse the February Hazard Allowance despite prior assurances from the state government, and the ongoing shortage of staff due to resignations.
Matthew lamented the drastic decrease in resident doctors, citing a decrease from 150 doctors to a mere 26 in recent months.
In response to the situation, he urged management to prioritise the full payment of arrears owed to members, immediate payment of the February 2024 palliative to house officers, and prompt disbursement of the February hazard allowance.
The association further called for urgent measures to address the critical shortage of clinical manpower within the institution.
The Federal Government has greenlit the allocation of N25 billion to bolster the efforts of the National Primary Healthcare Development Agency (NPHCDA) and the National Health Insurance Authority (NHIA) in advancing healthcare accessibility and quality across Nigeria.
The Coordinating Minister of Health and Social Welfare, Ali Pate, made this known, stressing the steadfast commitment of the current administration towards revamping the healthcare system to achieve Universal Healthcare Coverage (UHC) for all Nigerians.
In a statement by Deworitshe Patricia, a spokesperson for the ministry, Pate emphasised that the government’s strategy for health sector transformation involves the implementation of a Sector Wide Approach (SWAp) and the Health Sector Renewal Investment Programme (NHSRIP).
Addressing the imperative for reforms in Nigeria’s primary healthcare delivery, Pate highlighted the significance of revising the Basic Healthcare Provision Fund (BHCPF) and its associated programmes.
Pate outlined the objectives of the revised guidelines, which include expanding healthcare services for underserved populations, particularly women and children, reducing maternal mortality rates, alleviating out-of-pocket healthcare expenses, and standardizing healthcare quality across primary healthcare facilities nationwide.
“The Ministry, in collaboration with development partners, is dedicated to ensuring equitable access to healthcare services for all Nigerians, with a special focus on vulnerable groups,” stated Pate. “Through initiatives like NHSRIP, we aspire to minimize the need for long-distance travel for medical care, thereby improving the overall health outcomes and well-being of our citizens.”
In a monumental achievement for medical science, a team of Saudi professionals at the King Abdullah Specialist Children’s Hospital has completed the separation surgery of Nigerian conjoined twins, Hassana and Husaina.
The directive for this historic achievement came from the Custodian of the Two Holy Mosques King Salman bin Abdulaziz Al-Saud and His Royal Highness Prince Mohammed bin Salman bin Abdulaziz Al-Saud, Crown Prince and Prime Minister, demonstrating the Kingdom’s commitment to advancing healthcare.
The complex procedure, initiated on Thursday morning, was the result of meticulous planning and execution by a dedicated team of 38 medical experts. This group included consultants, specialists, technicians, and nursing staff, all working in harmony to address shared areas in the lower abdomen, pelvis, lower spine, and lower spinal nerves of the twins.
The surgery, unfolding in nine carefully planned stages, lasted approximately 14 hours. Dr. Abdullah Al Rabeeah, Advisor at the Royal Court, Supervisor General of the King Salman Humanitarian Aid and Relief Center (KSrelief), and head of the medical team, expressed confidence in the success of the procedure, citing a noteworthy 70% success rate.
“This is a momentous occasion that showcases the Kingdom’s commitment to advancing medical science and providing compassionate healthcare globally,” he said.
The successful separation of Hassana and Husaina commemorates the 60th operation conducted by the Saudi programme for separating conjoined twins. Over the past 34 years, this programme has offered care to 135 conjoined twins from 25 countries.
Dr. Al Rabeeah expressed heartfelt gratitude and appreciation to the Saudi leadership for their steadfast support of the programme.
He said, “The successful separation of Hassana and Husaina exemplifies the Kingdom’s dedication to humanitarian causes and its role as a leader in global healthcare.”
The Press Attaché at the Saudi embassy in Abuja, Mohammed Alsahabi, remarked on the accomplishment, stating, “This remarkable feat underscores the strong collaboration between Saudi Arabia and Nigeria in healthcare. We take pride in contributing to the improvement of these twins’ lives and their families.”
The separation of Hassana and Husaina represents not just a medical triumph but also serves as a symbol of hope for numerous individuals confronting similar challenges globally.
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