Category: Blog

Moshood Isah

On vaccination days in Lagos, reaching every child is never simple. In communities surrounded by water, crowded by informal settlements, and rapidly expanding neighborhoods, frontline health workers often spend days trying to identify where eligible children live.

For more than 17 years, Olubukola Grace Obasa has worked to ensure children in her community do not miss life-saving vaccines. As Chief Nursing Officer at Ijede Primary Healthcare Centre and Ward Focal Person for Oke Oyinbo Ward in Ikorodu, she understands how easily entire settlements can be overlooked during immunization campaigns.

With almost her entire career dedicated to saving lives through immunization interventions, Olubukola not just leads the collection of potent vaccines but also ensures proper immunization of children. Identifying zero-dose communities and planning vaccination campaigns often required days of manual work.

Most importantly, Olubukola tries to make use of all available resources to ensure proper data collection for campaign planning and post-campaign evaluation. Planning for an immunization campaign can be a herculean task for her. In most cases, it takes close to a week of working with community mobilisers, Routine Immunization officers, and other key stakeholders to manually identify locations where eligible children can be found.

One major challenge was working with people unfamiliar with the community. “For instance, someone deployed from another area to support micro-planning may struggle to work effectively because they do not fully understand the local settlements,” Olubukola said. “With manual walkthroughs, some hard-to-reach areas can still be missed, no matter how thorough the process is.”

For Olubukola, the biggest concern was not just the workload, but the possibility of leaving children behind. “With manual walkthroughs, no matter how thorough you try to be, some areas, especially hard-to-reach locations, may still be missed,” she said.

That challenge began to change in November 2025 when eHealth Africa, in partnership with UNICEF, introduced digital micro-planning tools across selected LGAs in Lagos.

Using eHealth Africa’s GIS-enabled planning platform, PlanFeld, health teams were able to map settlements more accurately and identify zero-dose and under-immunized communities that could previously be overlooked during manual planning. The system was piloted in Lagos Mainland, Ikorodu, Kosofe, and Alimosho LGAs, where difficult terrain, dense settlements, and rapidly changing communities often make vaccination planning more challenging.

The new approach was quickly put to the test during the statewide Measles-Rubella (MR) campaign conducted from January 27 to February 5, 2026, targeting children aged 9 months to 14 years.

According to Olubukola, the digital planning process helped teams capture settlements more accurately and improved confidence in the data used for vaccine allocation. “Previously, we relied on estimates. We might expect to vaccinate 20 or 30 children in a location, but with this new system, we now have figures that match what we find on the ground,” she said.

She explained that the system also improved vaccine distribution by helping teams allocate doses more accurately based on population size. “We avoid allocating too few vaccines to densely populated areas or too many to smaller settlements. Overall, it makes the process more efficient and cost-effective,” she added.

Beyond planning, the digital tools also improved field supervision. GIS-enabled trackers allowed supervisors to monitor vaccination teams remotely and confirm that teams remained within their assigned coverage areas. “Previously, it was difficult to know if participants had moved outside their designated areas, but with trackers, this is now visible,” Olubukola said.

Similar experiences were reported in Kosofe LGA, where health workers also relied on digital maps and Daily Implementation Plans generated through PlanFeld to identify missed settlements and improve vaccination coverage.

According to Nurse Shote Emmanuella, Ward Focal Person for Orile-Oworo Primary Healthcare Centre in Kosofe LGA, the maps helped teams review daily progress and revisit locations that could not initially be reached. “If we couldn’t find a settlement because a school was unavailable or inaccessible, we planned to return the next day. The maps helped us track those missed areas and ensure no settlement was skipped,” she said.

In some cases, the maps also revealed communities that health workers did not realize extended beyond their usual coverage assumptions. “In one settlement, I initially thought there were only two or three churches. But the maps showed that the area extended further than we thought. We discovered more churches in places we would have otherwise missed and were able to vaccinate more children there,” Shote said.

For frontline health workers, the digital tools also strengthened accountability during campaign implementation. “When people know they are being tracked, they tend to be more accountable in their work. It encourages them to properly cover all assigned areas,” she added.

For health workers like Olubukola and Shote, digital micro-planning is doing more than improving logistics. It is helping ensure that children in hard-to-reach and underserved communities are not missed during immunization campaigns, regardless of where they live.

– Abubakar Abdulkareem

Despite significant progress in Nigeria’s polio eradication efforts, persistent gaps in immunization coverage continue to enable the circulation of variant poliovirus (cVPV). Evidence from campaign evaluations and Lot Quality Assurance Sampling (LQAS) shows that a proportion of Local Government Areas still fail to meet required coverage thresholds, with missed households, absent children, and non-compliance identified as key drivers of low performance.

These operational and data-related gaps, combined with challenges reaching mobile and hard-to-access populations, continue to leave pockets of unvaccinated children, particularly in high-risk northern states. However, in March 2026, a quiet but powerful shift began in Jigawa State.

Across communities, a new group of dedicated eHealth Africa field consultants deployed by the Disease Prevention, and Monitoring Team under the Geo-Tracking System (GTS) Project took their positions. Their mission is simple, yet urgent: to ensure that no child is missed in the ongoing fight against the circulating variant poliovirus (cVPV). This deployment comes at a critical moment. While progress has been made, the virus continues to find gaps, missed households, hard-to-reach settlements, and underserved communities. Closing these gaps requires more than plans; it requires presence, consistency, and trust on the ground.

The deployment and strategic positioning of the eHA field team,Local Government Consultants, represents a deliberate step toward strengthening public health interventions across all thematic areas in Jigawa states, positioning eHA as strategic partner. By ensuring their continuous presence within communities, this approach reinforces real-time support, deeper engagement, and sustained impact at the last mile for the last child. Before stepping into the field, the consultants gathered for an intensive orientation from 25th to 26th March 2026. Over two days, they didn’t just learn systems, they aligned around purpose. Through hands-on sessions on GTS tracking, microplan digitization (eHA Planfled), MLOS validation, and tools like Vaccine Buddy, they built the skills needed to translate strategy into action.

But beyond the tools, the conversations were grounded in real challenges from the field. Insights from recent national training highlighted persistent issues including teams unfamiliar with assigned areas, missed settlements, gaps in supervision, and inconsistencies in data reporting. These are not just technical gaps; they are the spaces where children are left unreached.Now, with a permanent presence in Jigawa, these consultants are helping to change that story.

Day by day, the eHA local government consultants will walk alongside vaccination teams, supporting microplan implementation, strengthening accountability, and ensuring that data reflects reality. They will help teams see what was previously missed, connect fragmented efforts, and respond quickly when gaps appear. Their work brings visibility to the last mile for the last child, where success is defined by every child reached.

This is what change looks like: not a single moment, but a series of deliberate actions, showing up, paying attention, and improving continuously.

 Through this deployment, eHealth Africa is reinforcing a simple belief: that strong systems, when combined with committed people on the ground, can transform outcomes. And in Jigawa state, that transformation is already underway, one settlement, one household, one child at a time.

By Azeez-Ayodele Fatimah Ayotemitide

Cancer prevention is not only a medical challenge; it is a trust challenge. Across the world, efforts continue to reduce the cancer burden through vaccination, early screening, and other proven public health strategies. Yet prevention remains a major struggle, especially in low- and middle-income countries. In 2022 alone, the world recorded nearly 20 million new cancer cases and 9.7 million deaths, with almost 70% of those deaths occurring in low- and middle-income countries. In Nigeria, cervical cancer remains one of the leading causes of cancer-related deaths among women aged 15 to 44, despite being largely preventable through HPV vaccination and early screening.

Science exists, and vaccines exist. Screening tools exist. So why does the burden persist?

That question sat at the heart of eHealth Africa’s 39th edition of Insights Webinar, Reducing Cancer Burden Through Community Engagement and Behavioural Change. What emerged was not just a conversation about healthcare access or infrastructure, but one about trust, perception, and lived experience. Prevention is rarely about access alone; it is also about belief.

When communities have limited confidence in the health system, preventive services such as vaccination or screening can feel distant, uncertain, or unnecessary. That hesitation can delay engagement, making early detection far more difficult. In many communities, the point where uncertainty meets information is also the point where trust either begins or breaks.

The webinar highlighted an important reality within Nigeria’s health system. In principle, primary healthcare centres should be the first point of contact for preventive services like vaccination and screening. But as Dr. Shalom Nanle Dam explained, “what often exists is ‘an inverted pyramid,’ where the fewest patients are seen at primary healthcare centres and the most at tertiary institutions.” It is a powerful reminder that infrastructure alone is not enough. Behaviour follows belief, and belief is shaped by community experience.

One of the clearest lessons from the webinar was that successful cancer prevention begins long before hospital visits. It begins in communities. Muhammad Ribadu Jibrin highlighted the importance of “community entry” as a deliberate strategy, engaging traditional leaders and local influencers before vaccination teams arrive. These trusted voices help shape acceptance long before formal health messaging begins.

The message was clear: “Community engagement is not a communication add-on; it is the intervention itself.” That same principle was evident in eHealth Africa’s HPV intensification campaign in Kano and Bauchi. As Salahudeen Ado Sambo shared, the campaign used a co-creation approach that brought caregivers, parents, state partners, and adolescent girls into the design process early. Questions surfaced before rollout, messages were pre-tested, and myths were addressed before they could spread. This shifted vaccination from something done to communities into something built with them.

Technology also emerged as an important enabler. While trust is fundamentally human work, sustaining it at scale requires strong systems. Speakers highlighted how geospatial data and real-time dashboards can help identify underserved areas, strengthen follow-up, and improve responsiveness. As Salahudeen Ado Sambo put it, “data is the eye of the programme.”

Perhaps the most powerful line from the webinar came from Dr. Shalom Nanle Dam: “Information is medicine.” Cancer prevention does not fail because solutions are unavailable. It struggles because prevention requires alignment—between policies and people, and between health systems and community realities.

As eHealth Africa continues to convene these monthly Insights Webinars, each conversation builds toward a larger goal: the Insight Learning Forum (ILF). The webinar is more than a monthly dialogue; it is part of a growing pathway where insights can be deepened, challenged, and translated into collective action. Prevention begins long before diagnosis. It begins with trust.

Moshood Isah

There is no doubt that significant effort goes into expanding vaccination reach, especially to the last mile and by extension, Universal Health Coverage (UHC). One critical aspect of this process is definitely the supply chain process that ensures the right vaccines reach the last mile when needed and in the most potent conditions.  

Vaccines are highly sensitive to temperature variations, including heat, light, and even excessive cold. This makes its delivery especially to underserved remote communities utmostly critical to the general immunization process. Over the last decade, eHealth Africa, with support from Sokoto State Government, Gates Foundation, and Dangote foundation has facilitated the delivery of over 10 million vaccines and dry goods across over 351 Primary Healthcare facilities in the 23 Local Government Areas of Sokoto State. 

In a bid to replicate the impact in Sokoto state across other locations, eHealth Africa recently conducted a comprehensive high-impact capacity building for Direct Vaccine Delivery and Cold Chain officers in Bauchi state. These sessions revealed that delivering vaccines to underserved communities goes beyond moving vaccines from one place to another. Cold Chain officers and delivery officers were exposed to the deployment of digital tools for better accountability and ensuring that, indeed, all vaccines that got to PHCs are safe for consumption.

The Program Manager, Disease Prevention and Monitoring, Abubakar Shehu, explained that the capacity-building session conducted by ehealth Africa in partnership with the state government and the Ministry of Health was inspired by the need to bridge existing vaccine delivery gaps in the state. 

Abubakar Shehu said the session is critical not only for ensuring safe vaccine delivery but also for strengthening accountability and potency monitoring. He said, “As a leader in the immunization space with more than a decade of experience, eHealth Africa is exposing partners to important digital tools such as the Logistics Management Information System (LoMIS) and temperature monitoring devices to ensure vaccines reach the last mile and remain accessible to the children who need them most.”

. This, according to him, will go a long way in not just boosting vaccine delivery but bringing more eligible children into the immunization net. 

Leading the capacity building session, eHealth Africa’s Sokoto Vaccine Direct Delivery Coordinator, Ahmadu Bello, revealed that some of the gaps identified are the absence of proper temperature monitoring during vaccine transit. He said, “Vaccines are picked up from the cold store and delivered to facilities, but what happens between the cold store and the facility is not recorded. This lack of accountability could endanger the vaccines. ”

He also pointed out inconsistencies in monthly delivery schedules. “We also observed an inconsistency in monthly delivery schedules. If delivery begins in the first week, it must remain consistent; otherwise, stock-outs may occur. To address this, we encourage coordination between the central cold store, the national level, and the Primary Healthcare facilities  to ensure timely distribution”, he added 

Another critical aspect of vaccine delivery that significantly impacts not only immunization services but overall community health is reverse logistics. Bello emphasized that it is not enough to routinely distribute vaccines to PHCs without carefully assessing actual demand. “Some locations require more medical supplies than others, so it is important to prioritize facilities experiencing higher demand rather than allowing vaccines to sit on shelves elsewhere and eventually expire,” he noted.

He also stressed that the proper disposal of used vials and other dry waste remains essential to prevent harm to health workers and community members. “These are key lessons participants have taken away and will cascade to the colleagues they work with,” he added.

If anything, the sessions have changed the perception of Vaccine delivery officers to understand how their role is directly linked to saving lives and expanding vaccination reach. Relishing the potential impact of the capacity building,  state team lead for Vaccine delivery, Abubakar muhammad said, “Now we understand timely delivery reduces wastage and stock-outs. We also learned the importance of deploying temperature trackers”.

Muhammed  reiterated that the capacity building is a major springboard for improved immunization services in Bauchi state, saying, “With this new knowledge gained, we will deliver vaccines on time and make sure each facility receives vaccines with potency and in good condition.”  

In a similar vein, Pharmacist Muhammad Kabir Salisu, Assistant State Logistics Officer, revealed that his team learned how to maintain vaccine potency from national entry to facility delivery, saying they were introduced to tracking applications and temperature monitoring systems.

He emphasized the need for every personnel in the supply chain to take responsibility for protecting children from vaccine-preventable diseases. He stated, “If you are a health professional and a hospital is built in your community, you should understand it is not meant only for your community. If essential medicines are not delivered properly and a life is lost, that responsibility rests with you.”

He added, “The same applies to immunization. If you do not deliver safe vaccines to the last mile, you are failing the people. That is the message to my entire team.”

Through sustained investment in digital innovation, capacity strengthening, and last-mile delivery systems, eHealth Africa continues to bridge critical gaps in vaccine access and accountability. By combining technology, field expertise, and strong government collaboration, the organization is strengthening supply chains, improving vaccine potency monitoring, and enhancing delivery consistency across states. As these efforts deepen and expand, more communities are gaining reliable access to safe vaccines, reinforcing stronger immunization systems and healthier futures for children.