A network of community health agents that has helped Nigeria curb polio is taking on a new task: deploying its early detection know-how to raise the alarm on suspected COVID-19 infection as the virus continues to spread.
In recent weeks, COVID-19 has spilled over to regions beyond the capital cities of many African countries, calling for a decentralized approach to help prevent further propagation. The World Health Organization (WHO) has urged countries to bolster emergency responses at the subnational level.
In Nigeria, the work of a 7128-strong network of community health agents on polio and other diseases is now being leveraged. The community workers use Auto-Visual AFP Detection and Reporting – also known as AVADAR – a phone-based application with video clips in several local languages to educate families and help in the timely detection of polio.
Although the application does not have features for other diseases including COVID-19, the community informants have received training on COVID-19 case definition and symptoms to improve their skills in educating families on preventive measures, as well as early detection and reporting of suspected cases of the virus in their communities.
While a separate application for COVID-19 is being developed, the community health workers can make free calls through a closed user group platform to notify district surveillance officers about suspected cases.
“I spend most of my day in the field, going from house to house looking for polio cases and other diseases, but in the past month I have also been using part of my time to sensitize households on the new disease called COVID-19. I have not found any case yet,” says Fatsuma Sani, a community health worker in northeast Nigeria.
Expanding surveillance
The long-running armed violence in northeast Nigeria has devastated basic health service infrastructure. Community health workers like Ms Sani are critical in early disease detection and response.
“The addition of COVID-19 to the activities of the (community health workers) is based on the assessment of their critical contribution to (polio) and other disease detection and reporting in the zone,” said Dr Adamu Ibrahim, the WHO acting coordinator for Nigeria’s North East zone.
