Lifesaving power of data for every child in Nigeria

Keita (Katsina), October 2021 - Zahariyya Hamza, a 31-year-old mother of six, has a new-found purpose in life. Wherever she goes, she gets a hero’s welcome.

“I used to walk with my head down and eyes cast low as I hardly even knew my next-door neighbors,” says Zahariyya who resides in Nigeria’s northern state of Katsina. “But now I hold my head high and feel so much pride when young mothers call out to me as I am passing by and ask me to come over to their homes. Even my two older children now look at me differently,” she adds.

Zahariyya is one of the over 20,000 UNICEF-trained volunteer community mobilizers (VCMs) working within their own neighborhoods in pockets of northern Nigeria that are termed as at high-risk to the spread of the potentially fatal childhood disease caused by the polio virus. She is easily distinguishable by the bright blue hijab or headscarf that all VCMs are encouraged to wear when meeting with community members.

Their mission is to keep Nigeria polio-free. But their role goes far beyond getting newborns and children below the age of five vaccinated against polio. “I don’t just ask mothers and fathers to accept polio drops. I am their friend and companion right from the first trimester of their pregnancies,” she says, adding: “I try to address their fears or misconceptions, encourage them to go for antenatal care and convince them to make sure their children follow the full immunization schedule.”

Though she is now welcomed with open doors. Until some years ago, members of her own community in Katsina state’s Keita local government area (or district) used to chase away health workers who used to come to their homes to vaccinate their children against polio. “It is not easy at first, but over time they see the benefits of our maternal and neonatal and child health services and become change agents themselves, encouraging others,” says Zahariyya who gradually convinced them to trust vaccinations.

Reaching hardest to reach children and families

In addition to winning smiles, VCMs like Zahariyaa are also aided by easy-to-use data collection and reporting tools in which they record the vaccination and antenatal care status of every mother and each child in the households assigned to them.

Given that VCMs are deployed in some of the hardest to reach, often conflict-affected, densely populated urban poor or remote rural areas, getting real time information from such excluded and underserved communities has played a significant role in reaching “missed” children. By rushing vaccines to communities that have high number of unvaccinated children as per analysis of data collected by the VCM network has helped Nigeria ensure higher levels of children’s equitable access to health and routine immunization services.

Over the last five years, Nigeria has achieved a 10 per cent increase in its vaccination coverage of a key indicative vaccine (DTP3) going up from 44 in 2015 to 57 per cent in 2020. This real-time data reporting and close case-by-case follow-up with vaccine-hesitant families and children who missed vaccination has helped VCMs and the overall immunization programme in Nigeria to ensure that no-one is left behind.  

Digitalizing health information systems

The strengthening of information health systems and establishment of digital solutions have been central to this success. Until recently, the programme was using multiple paper-based registries to record maternal and child medical information, which often did not reach decision-makers in time. This manual data collection and analysis resulted in thousands of children missing vaccination campaigns, especially in hard-to-reach, conflict-affected and urban poor areas.

Since 2016, over 2,000 VCM network supervisors have been using Open Data Kit (ODK) to collect detailed information on newborns, mothers and children under the age of five. ODK is as an open source software for collecting, managing and using real-time data in resource-constrained environments.  

In addition, ODK enables the VCM network to track parents who missed routine immunization appointments, conduct house-to-house awareness-raising visits, organize community discussions on immunization and work with community influencers to address the concerns of vaccine-hesitant parents.

Increasing health coverage with digital solutions

“The digitalization efforts have turned out to be a game changer,” says Peter Hawkins, UNICEF Representative in Nigeria, as it has resulted in enormous efficiency gains and considerably strengthened vaccine monitoring, community ownership and oversight and local accountability.

He adds: “These investments have been pivotal to support the Nigerian health authorities to increase the access and quality of their immunization and health coverage rates.”

In the global arena, UNICEF is leading efforts to digitalize governments’ supply chains at all geographical levels (central, regional, district) and improve the ability of countries to track, identify shortages and forecast needs for supplies. These efforts are fundamental to empower health-managers and community mobilizers like Zahariyya do their day-to-day work with much pride.