Author: Nikhil Patil, March 9 2015 - Non-compliance to polio immunization is a major challenge to effectively reaching 100% coverage of the vaccine across Nigeria and eliminate polio transmission. One solution to address non-compliance has been the introduction of health camps, mobile outreach services that provide basic health services, including simple diagnostics & medication, to low-income communities across Northern Nigeria in 2014. eHealth Systems Africa has been responsible for logistics and management of health camps, in collaboration with local stakeholders, to serve populations across Northern Nigeria. By expanding health services beyond provision of OPV [oral polio vaccine], health camps improve the health of mothers and other family members and ensure that entire families are healthy.
The first five years of a child’s life is indeed very important. eHealth Systems Africa, in collaboration with the Kano State Government and other local & international partners, are currently increasing access to health care during monthly Polio immunization campaigns across Kano State, Nigeria through the use of health camps.
The fight to eradicate Polio in Nigeria is still ongoing, and children within the ages of 0 – 59 months are at high-risk. Additionally, non-compliance has been a re-occurring issue and an effort to overcome this challenge gave rise to the implementation of health camps in conjunction with the monthly Polio immunization campaigns. Since September 2013, the Nigerian National Polio Emergency Operation Centre (EOC) has guided the strategy of “health camps,” targeting high-risk states in northern Nigeria. One of the main reasons for non-compliance was the lack of access to basic health services during non-immunization campaign periods; health camps were introduced as a measure to provide a wider range of basic health services, especially in hard to reach communities.
The aim of health camps is to establish a system that will touch the life of every member of the community, especially children who are the most vulnerable, and to tackle conditions causing the highest morbidity. The health camp, organized from the grassroots, integrates both preventative and curative services using an approach that the members of the community would accept. Health camps consist of 3 stations: the first station where children under 5 can receive oral polio vaccine, a second station where children can receive routine immunization, and a third station for both mothers and children (and other family members) to get diagnosed for simple ailments and receive medication.
Apart from providing vaccines and medicines for the children, the efforts of these organizations have also provided parents in these low-income communities access to medications and have attracted some health personnel to hard-to-reach areas where there are no health facilities. These camps are held at accessible locations in the community during each “Immunization Plus Days” (IPD) and provides basic health care services in addition to offering oral polio vaccine (OPV).
In the attempt to eradicate polio in Nigeria, Kano State has experienced a tremendous improvement over the past few months, raising hopes that the country is on the verge of defeating the disease. Polio cases have drastically reduced from 53 cases in 2013 to just 6 cases so far from January 2014 till date. The non-compliance rates have also decreased and the number of wards with =10% missed children, a reduction from nineteen wards in January 2014 to seven wards in March 2014 (which was the month when health camps were introduced), and further reduced to five wards in June 2014.
The first phase of the health camp operation kicked off on 1st March to 4th march 2014, within all the wards of the 44 LGA’s in Kano state as a pilot test, and it was a successful start. Medications were distributed to all the LGA’s headquarters and were further distributed to all the health camp wards of each LGA on the day of the campaign, which lasted for 4 days. Almost 118,400 persons were given medications for various ailments.
Here are some of the comments from the beneficiaries:
One woman said “Health camps are the only place mothers like me can get drugs to treat malaria, skin infections and diarrhea.”
Another mother said she took her children to be immunized “because I heard that they will be protected against diseases”. The woman, who declined to give her name, added, “I want my children to be well and strong.”
Another pregnant woman who was about 24 years old and had already lost four (4) consecutive pregnancies, said she had never seen a doctor in her whole life but due the presence of the health camp in her community a doctor and other health workers were present and her current pregnancy was saved.
eHealth Africa’s main responsibility is packing and delivering health camp boxes, all-in-one kits that contain medications and other necessary tools to provide health services such as gloves and band aids. The medications provided include, but not limited to: albendazole, septrin, multi-vitamins, paracetamol, and oral rehydration solution. These medicines were administered to mostly women and children suffering from worm infections, scabies, anemia, vitamin deficiencies, gastric pain, diarrhea, pain or fevers, and malaria, all of which are common ailments in these communities.
eHealth is also responsible in creating and integrating a diagnostic-support tool into the health camp data collection. This tool guided health workers from symptom to appropriate medication. Over the four-day IPD period, 1,680 health camps were serviced in the 484 wards across 44 LGAs. Almost 118,400 people are served with 38% of them under-five years old. The entire cost for medication and service for all four days is less than $2.60 per person.
Due to the overwhelming success of the health camps, eHealth is partnering with the Kano State government and other organizations like UNICEF to do more health camps in subsequent months and it is an ongoing service as funding allows, including expansion to other northern states.
In 2014, eHealth Africa and partners have provided 16,659 health camp boxes to LGAs in Kano state alone till date, and plans to offer more than 9,200 health camps in the 44 LGAs and 484 wards of Kano state, to serve more than 650,000 people. Partners are also supporting hundreds of health camps during polio campaign in other high-risk states including security-compromised areas of Borno and Yobe. Although the health camp was introduced to aid in polio eradication by reducing the non-compliance rate, it has achieved success beyond its purpose, and has improved the health needs of both parents and their children.
How can parents in low income communities ensure their children thrive if they both are not in good health? Health camps provide one solution.
ehealth Systems Africa website
National Primary Healthcare Development Agency Nigeria 2014 Online Bulletin
End Game Strategy For Polio Eradication Initiative in Kano bulletin Aug-Dec. 2014.