This manuscript describes the process and impact of strengthening the WHO Regional Office for Africa (WHO AFRO)’s COVID-19 vaccination information system. This system plays a critical role in tracking vaccination coverage, guiding resource allocation and supporting vaccination campaign roll-out for countries in the African region. Recognising existing data management issues, including complex reporting prone to human error, compromised data quality and underutilisation of collected data, WHO AFRO introduced significant system improvements during the COVID-19 pandemic. These improvements include shifting from an Excel-based to an online Azure-based data collection system, automating data processing and validation, and expansion of collected data. These changes have led to improvements in data quality and quantity including a decrease in data non-validity, missingness, and record duplication, and expansion of data collection forms to include a greater number of data fields, offering a more comprehensive understanding of vaccination efforts. Finally, the creation of accessible information products—including an interactive public dashboard, a weekly data pack and a public monthly bulletin—has improved data use and reach to relevant partners. These resources provide crucial insights into the region’s vaccination progress at national and subnational levels, thereby enabling data-driven decision-making to improve programme performance. Overall, the strengthening of the WHO AFRO COVID-19 vaccination information system can serve as a model for similar efforts in other WHO regions and contexts. The impact of system strengthening on data quality demonstrated here underscores the vital role of robust data collection, capacity building and management systems in achieving high-quality data on vaccine distribution and coverage. Continued investment in information systems is essential for effective and equitable public health efforts.

Most countries in Africa deployed digital solutions to monitor progress in rolling out COVID-19 vaccines. A rapid assessment of existing data systems for COVID-19 vaccines in the African region was conducted between May and July 2022, in 23 countries. Data were collected through interviews with key informants, identified among senior staff within Ministries of Health, using a semi-structured electronic questionnaire. At vaccination sites, individual data were collected in paper-based registers in five countries (21.7%), in an electronic registry in two countries (8.7%), and in the remaining 16 countries (69.6%) using a combination of paper-based and electronic registries. Of the 18 countries using client-based digital registries, 11 (61%) deployed the District Health Information System 2 Tracker, and seven (39%), a locally developed platform. The mean percentage of individual data transcribed in the electronic registries was 61% +/- 36% standard deviation. Unreliable Internet coverage (100% of countries), non-payment of data clerks' incentives (89%), and lack of electronic devices (89%) were the main reasons for the suboptimal functioning of digital systems quoted by key informants. It is critical for investments made and experience acquired in deploying electronic platforms for COVID-19 vaccines to be leveraged to strengthen routine immunization data management.

This study summarizes progress made in rolling out COVID-19 vaccinations in the African region in 2022, and analyzes factors associated with vaccination coverage. Data on vaccine uptake reported to the World Health Organization (WHO) Regional Office for Africa by Member States between January 2021 and December 2022, as well as publicly available health and socio-economic data, were used. A negative binomial regression was performed to analyze factors associated with vaccination coverage in 2022. As of the end of 2022, 308.1 million people had completed the primary vaccination series, representing 26.4% of the region’s population, compared to 6.3% at the end of 2021. The percentage of health workers with complete primary series was 40.9%. Having carried out at least one high volume mass vaccination campaign in 2022 was associated with high vaccination coverage (β = 0.91, p < 0.0001), while higher WHO funding spent per person vaccinated in 2022 was correlated with lower vaccination coverage (β = −0.26, p < 0.03). All countries should expand efforts to integrate COVID-19 vaccinations into routine immunization and primary health care, and increase investment in vaccine demand generation during the transition period that follows the acute phase of the pandemic.

Background The ongoing COVID-19 pandemic in Africa is an urgent public health crisis. Estimated models projected over 150,000 deaths and 4,600,000 hospitalizations in the first year of the disease in the absence of adequate interventions. Therefore, electronic contact tracing and surveillance have critical roles in decreasing COVID-19 transmission; yet, if not conducted properly, these methods can rapidly become a bottleneck for synchronized data collection, case detection, and case management. While the continent is currently reporting relatively low COVID-19 cases, digitized contact tracing mechanisms and surveillance reporting are necessary for standardizing real-time reporting of new chains of infection in order to quickly reverse growing trends and halt the pandemic. Objective This paper aims to describe a COVID-19 contact tracing smartphone app that includes health facility surveillance with a real-time visualization platform. The app was developed by the AFRO (African Regional Office) GIS (geographic information system) Center, in collaboration with the World Health Organization (WHO) emergency preparedness and response team. The app was developed through the expertise and experience gained from numerous digital apps that had been developed for polio surveillance and immunization via the WHO’s polio program in the African region. Methods We repurposed the GIS infrastructures of the polio program and the database structure that relies on mobile data collection that is built on the Open Data Kit. We harnessed the technology for visualization of real-time COVID-19 data using dynamic dashboards built on Power BI, ArcGIS Online, and Tableau. The contact tracing app was developed with the pragmatic considerations of COVID-19 peculiarities. The app underwent testing by field surveillance colleagues to meet the requirements of linking contacts to cases and monitoring chains of transmission. The health facility surveillance app was developed from the knowledge and assessment of models of surveillance at the health facility level for other diseases of public health importance. The Integrated Supportive Supervision app was added as an appendage to the pre-existing paper-based surveillance form. These two mobile apps collected information on cases and contact tracing, alongside alert information on COVID-19 reports at the health facility level; the information was linked to visualization platforms in order to enable actionable insights. Results The contact tracing app and platform were piloted between April and June 2020; they were then put to use in Zimbabwe, Benin, Cameroon, Uganda, Nigeria, and South Sudan, and their use has generated some palpable successes with respect to COVID-19 surveillance. However, the COVID-19 health facility–based surveillance app has been used more extensively, as it has been used in 27 countries in the region. Conclusions In light of the above information, this paper was written to give an overview of the app and visualization platform development, app and platform deployment, ease of replicability, and preliminary outcome evaluation of their use in the field. From a regional perspective, integration of contact tracing and surveillance data into one platform provides the AFRO with a more accurate method of monitoring countries’ efforts in their response to COVID-19, while guiding public health decisions and the assessment of risk of COVID-19.

The mobile phone global positioning system (GPS) is used to reconnaissance a mobile phone user's location, e.g., at work, home, shops, etc. Such information can be used to feed data gathering expeditions, the actual position of the interviewer/surveyor using the mobile phone inert settings of location mode via GPS, WIFI, and Mobile networks. Mobile devices are becoming progressively erudite and now integrate diverse and robust sensors. The new generation of smartphones is multi-laden with sensors, including GPS sensors. The study describes and evaluates a data-gathering process used by the World Health Organization (WHO–Nigeria, EPI Program) that uses phone-based in-built GPS sensors to identify the position of users while they undergo supportive supervision. This form of spatial data is collected intrinsically using the Open Data Kit (ODK) GPS interface, which interlaces with the mobile phone GPS sensor to fetch the geo-coordinates during the process. It represents a step in building a methodology of matching places on the map with the geo-coordinates received from the mobile phones to investigate deviation patterns by devices and location mode. The empirical results can help us to understand the variation in geospatial data collation across devices and highlight critical criteria for choosing mobile phones for mobile surveys and data campaigns. This study reviewed the existing data gathered inadvertently from 10 brands of smartphones over 1 year of using the mobile data collection with over 80,000 field visits to predict the deviation pattern for spatial data acquisition via mobile phones by different brands.

Background : Tracking every child for polio eradication in the African region has been an ambitious objective in respose to the recommendations of the Global Polio Eradication Initiative (GPEI) to enhance information gathering in areas with sub-optimal and challenging performance. Achieving this objective require real-time information on active surveillance. Acute Flaccid Paralysis (AFP) case searches were captured on mobile phones to monitor polio eradication programme through a digitalised platform developed by the Polio Geographic Information System Centre at WHO Regional Office for Africa. The system generated a huge dataset and influenced the development of several information products that was critical for managing the polio programme within the African region which was acknowledged by Africa Regional Certification Commission (ARCC) as a key support to acheivng eradication of wild polio virus which was celebrated in August 2020. Objective: To document and assess the impact of interactive visualisation infographic platforms to guide decision-making in achieving polio eradication in the African continent Method: The study reviewed retrospective prototype data from a web-based interactive visualization platform sourced from real-time active case searches (ACS) conducted in the African region from June 2017-2020 using android mobile phones. The study participants used the platform via smart screens and touch wall projections for decision making and gap analyses. The study evaluated the tool using the informal user experience evaluation method combined with an automated relay monitor on the active surveillance web-based applications, which cached every visit to the geographic entity. The method employed required platform users to interrelate with ACS and AFP surveillance data via visual displays for their programmatic interventions and accountability. The study also captured their feedbacks through a structured interview and automatically-cached pages. Results: Communicating field level indicators in real-time and interactively to decision-makers is a powerful and veritable tool to solve geographical representation of surveillance gaps at the lowest level of reporting, and reach a wider diversity of audience. These interactive visualisations also solve the problem of complexity in interpretation, which can lead to an impaired understanding of surveillance blind spots, information misinterpretation, which occurs when users of the surveillance data ignore or do not know why, where, and how the data has been produced, or where and how it can be used. Conclusion: The digitalization of disease surveillance, particularly, ACS for Poliomyelitis permits decision-makers to conduct a strategic evaluation of surveillance situations and gaps via interactive visualisations. In this context, these interactive visualisations provide polio programme in Africa wih a platform to visualise interactive imageries of geographical evidence of active surveillance at focal sites using interactive charts, maps and dashboards for all polio surveillance processes. Other considerations, such as cost, ease of use, learnability, and efficiency of those tools were comparatively better than the traditional system.

The polio Eradication Initiative (PEI) is one of the most important public health interventions in Africa. Quality data is necessary to monitor activities and key performance indicators and access year by year progress made. This process has been possible with a solid polio health information system that has been consolidated over the years. This study describes the whole process to have data for decision making. The main components are the data flow, the role of the different levels, data capture and tools, standards and codes, the data cleaning process, the integration of data from various sources, the introduction of innovative technologies, feedback and information products and capacity building. The results show the improvement in the timeliness of reporting data to the next level, the availability of quality data for analysis to monitor key surveillance performance indicators, the output of the data cleaning exercise pointing out data quality gaps, the integration of data from various sources to produce meaningful outputs and feedback for information dissemination. From the review of the process, it is observed an improvement in the quality of polio data resulting from a well-defined information system with standardized tools and Standard Operating Procedures (SOPs) and the introduction of innovative technologies. However, there is room for improvement; for example, multiple data entries from the field to the surveillance unit and the laboratory. Innovative technologies are implemented for the time being in areas hard to reach due to the high cost of the investment. A strong information system has been put in place from the community level to the global level with a link between surveillance, laboratory and immunization coverage data. To maintain standards in Polio Information system, there is need for continuous training of the staff on areas of surveillance, information systems, data analysis and information sharing. The use of innovative technologies on web-based system and mobile devices with validation rules and information check will avoid multiple entries.

Background The Auto-Visual AFP Detection and Reporting (AVADAR) digital health intervention programme is a programme that was introduced to Africa in 2016. The programme adopts the use of the AVADAR SMS – based smartphone application (app) in community-based AFP surveillance activities in order to enhance the detection and reporting of AFP (polio) cases and improve AFP surveillance quality. As at 2020, the AVADAR application is being used in 11 African countries. The need to conduct regular and relevant evaluations of the AVADAR programme is very essential towards improving polio eradication programme performance and effectiveness in Africa. Hence, this study aimed to review and evaluate the quality of the AFP cases reported through the AVADAR intervention and as well evaluate the documentation process of AVADAR alerts and investigations, and the assimilation of AFP cases found via AVADAR into the national databases. Methods This study reviewed and evaluated the quality of AVADAR-involved AFP case reporting and documentation process in 7 of the 11 African countries implementing the AVADAR programme (Cameroon, Chad, the DRC, Liberia, Mali, Niger, and South Sudan). Case validations of all AFP cases reported via AVADAR app, iterations of methods used for peer reviewing AVADAR reporting and documentation, informal interview of community informants (CIs) and health workers (HWs), as well as the development of interactive dashboard to showcase the results of peer reviews, were the approaches used for the review and evaluation process. Results Thirty-nine districts, cutting across the participating 7 African countries were selected for the study. A total of 581 AFP cases were reviewed in the selected districts; of which 496 AFP cases were physically seen with 384 cases confirmed as true AFP cases by the peer reviewers. Thematic findings obtained the interview with CIs and HWs identified key areas (communication, multi-disease reporting, and periodic evaluation) that needs to be improved in the AVADAR surveillance system. Also, the interactive dashboard gave a summary of the peer review outcomes at few glances. Conclusions The findings of the AVADAR AFP peer reviews revealed the app’s efficacy in reporting AFP cases and improving surveillance indicators at district level. However, its documentation at health facility level needs to be re-emphasized and improved via a systematic accountability framework implementation for the actors in the reporting cycle. In order to significantly improve AFP surveillance, we recommend on-going commitment to improve knowledge and collaboration between all AVADAR surveillance reporting teams involved in identifying children presenting with AFP. Keywords: AVADAR, Mobile Health, Peer Review, Acute Flaccid Paralysis, surveillance , Africa

Background: Electronic reporting of integrated disease surveillance and response (eIDSR) was implemented in Adamawa and Yobe states, North-East of Nigeria, as an innovative strategy to improve disease reporting. Its objectives were to improve the timeliness and completeness of IDSR reporting by health facilities, prompt identification of public health events, timely information sharing, and public health action. We evaluated the project to determine whether it met its set objectives. Method: We conducted a cross-sectional study to assess and document the lessons learned from the project. We reviewed the performance of the local government areas (LGAs) on timeliness and completeness of reporting, rumors identification, and reporting on the eIDSR and the traditional paper-based system using a checklist. Respondents were interviewed online on the relevance, efficiency, sustainability, project progress and effectiveness, the effectiveness of management, and potential impact and scalability of the strategy using structured questionnaires. Data were cleaned, analyzed, and presented as proportions using an MS Excel spreadsheet. Responses were also presented as direct quotes. Results: The number of health facilities reporting IDSR increased from 103 to 228 (117%) before and after implementation of the eIDSR respectively. The timeliness of reporting was 43% in the LGA compared to 73% in health facilities implementing eIDSR. The completeness of IDSR reports in the last six months before the evaluation was ≥ 85%. Of the 201 rumors identified and verified, 161 (80%) were from the eIDSR pilot sites. The majority of the stakeholders interviewed believed that eIDSR met its predetermined objectives for public health surveillance. The benefits of eIDSR included timely reporting and response to alerts and disease outbreaks, improved timeliness, and completeness of reporting, and supportive supervision to the operational levels. The strategy helped stakeholders to appreciate their roles in public health surveillance. Conclusion: The eIDSR has increased the number of health facilities reporting IDSR, enabled early identification, reporting, and verification of alerts, improved timeliness and completeness of reports, and supportive supervision of staff at the operational levels. It was well accepted by the stakeholder as a system that made reporting easy with the potential to improve the public health surveillance system in Nigeria.

Introduction: In contemporary corporate scene, one of the most essential and prevalent needs is to satisfy the request of the client in a timely manner. This need has brought about the incorporation of eSupply Chain Management process in business strategy. This is especially prevalent following monumental improvements with incorporating technology into business operations, replacing the previously prevalent and hectic traditional concepts. Considering this, the study explored the various concepts associated with the eSupply Chain Management process, such as its key factors, the various components of the process as well as the various benefits and drawbacks of the process. Lastly, the future scope of the process has also been established in this study to provide recommendations regarding the way in which organisational efficiency can be improved through the incorporation of eSupply Chain Management process rather than the traditional supply chain management process. Methods: A review of case studies and publications on supply chain and eSupply chain management processes, factors, advantages and disadvantages was carefully done to provide a good understanding and comparison of both systems and understand the impact of eSupply chain management on businesses. Results: The effective management of information, material and financial resources flow was seen to be important to both traditional and eSupply chain systems, but more critical to eSupply chain systems. Conclusion: eSupply chain management facilitates the efficiency of other business processes such as procurement and distribution just in time to satisfy customer’s expectations.

BACKGROUND:As we move toward a polio-free world, the challenge for the polio program is to create an unrelenting focus on smaller areas where the virus is still present, where children are being repeatedly missed, where immunity levels are low, and where surveillance is weak. OBJECTIVE:This article aimed to describe a possible solution to address weak surveillance systems and document the outcomes of the deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) project. METHODS:This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation from eight countries in Africa between August 1, 2017, and July 31, 2018. A total of 6954 persons (5390 community informants and 1564 health workers) were trained and equipped with a smartphone on which the AVADAR app was configured to allow community informants to send alerts on suspected acute flaccid paralysis (AFP) and allow health worker to use electronic checklists for investigation of such alerts. The AVADAR and Open Data Kit ONA servers were at the center of the entire process. A dashboard system and coordination teams for monitoring and supervision were put in place at all levels. RESULTS:Overall, 96.44% (24,142/25,032) of potential AFP case alerts were investigated by surveillance personnel, yielding 1414 true AFP cases. This number (n=1414) reported through AVADAR was higher than the 238 AFP cases expected during the study period in the AVADAR districts and the 491 true AFP cases reported by the traditional surveillance system. A total of 203 out of the 1414 true AFP cases reported were from special population settings, such as refugee camps and insecure areas. There was an improvement in reporting in silent health areas in all the countries using the AVADAR system. Finally, there were 23,473 reports for other diseases, such as measles, diarrhea, and cerebrospinal meningitis, using the AVADAR platform. CONCLUSIONS:This article demonstrates the added value of AVADAR to rapidly improve surveillance sensitivity. AVADAR is capable of supporting countries to improve surveillance sensitivity within a short interval before and beyond polio-free certification.

Acute Flaccid Paralysis (AFP) surveillance is the bedrock of polio case detection. The Auto Visual AFP Detection and Reporting (AVADAR) is a digital health intervention designed as a supplemental community surveillance system. This paper describes the design and implementation process that made AVADAR a successful disease surveillance strategy at the community level. This paper outlines the methods for the design and implementation of the AVADAR application. It explains the co-design of the application, the implementation of a helpdesk support structure, the process involved in trouble shooting the application, the benefits of utilizing a closed user group for telecommunication requirements, and the use of a consented video. We also describe how these features combined led to user acceptance testing using black box methodology. A total of 198 community informants across two provinces, four districts and 32 settlements were interviewed about application performance, usability, security, load, stress and functionality testing black box components. The responses showed most community participants giving positive reviews. Data from the Blackbox testing yielded optimum acceptance ratings from over 90% of the users involved in the testing. A total of 22380 AFP Alerts were sent out by community informants and 21589 (95%) were investigated by health workers or WHO AVADAR coordinators. Overall there was 93% assimilation at regional level. About 83% of investigations were done in the vicinity of the alerts in 2018 compared to 77% in 2017. AVADAR implementation model offers a simplistic step by step model that includes community participation as an integral tool for the successful deployment of a mobile based surveillance reporting tool. AVADAR can be a veritable source of project planning data and a mobile application for other interventions that target using community participation to influence health outcomes.

BackgroundSupportive supervision is one of the interventions that fosters program improvement by way of imparting knowledge and skills to health workers. The basic challenge in supportive supervision is the availability of data in real time for timely and effective feedback. Thus, the main objective of this study was to determine the contribution of real-time data collection during supportive supervision for timely feedback and generation of evidence for health intervention planning.MethodsWe analyzed supportive supervision records collected through handheld devices employing the open data kit (ODK) platform from July 2015 to June 2016. Supervision was conducted across the country by 592 World Health Organization (WHO) officers. The availability of real-time data and the distance of health facilities to the community were analyzed.ResultsDuring the study period, 90,396 health facilities were supervised. The average time spent during supervision varied from 1.53 to 3.78h across the six geopolitical zones of the country. The average interval between completion of the supervisory checklist and synchronization with the server varied from 3.9h to 7.5h. The average distance between the health facility and a ward varied from 5 to 24km.ConclusionThe use of handheld devices for supportive supervision provided real-time data from health facilities to state and zonal levels for analysis and feedback. Program officers used the findings to rectify process indicators in time for a better outcome.