In 2017, the Federal Government of Nigeria (FGN) through the Nigeria Centre for Disease Control (NCDC) conducted the Joint External Evaluation to determine country’s level of preparedness and strength across the 13 core capacities of the International Health Regulations. Since then, the NCDC has been employing diverse strategies to ensure these capacities are strengthened. Part of the efforts of the NCDC was to lead the development of the National Action Plan for Health Security (NAPHS).
The NAPHS is a five-year plan developed to address critical gaps identified following the JEE. This was done in collaboration with relevant Ministries, Departments and Agencies (MDAs) of the FGN, World Health Organisation and other key development partners. With 19 technical areas and over 600 activities, the NCDC has continued to play a coordination role through close monitoring of the implementation of these activities.
Asides implementation of activities in the NAPHS, the FGN has also hugely invested in COVID-19 response activities. With this in mind, it became imperative at this crucial time, to review progress made vis a vis NAPHS implementation status. The NCDC, in conjunction with the afore-mentioned partners, conducted a two-day NAPHS implementation workshop from 9th -10th June, 2021 aimed at supporting technical areas to update their implementation status and score themselves (self-assessment).
The workshop methodology involved power-point presentations, key documents review and group work. Tools from strategic actions recommended by JEE 2017, benchmark as at the midterm JEE, and activity listed in the NAPHS tracker were also utilised. In attendance were focal persons from the 19 technical areas as well as representatives from the WHO and other key partners.
Key outputs from the workshop were:
1. Development of NAPHS monitoring and evaluation plan for the country
2. Updated NAPHS tracker
3. Updated list of technical areas leads
4. Identified and proffered solutions to challenges faced by different technical areas
5. Improved coordination among MDAs
Given the diverse players within and outside the health sector required for the implementation of the NAPHS, this workshop provided a unique opportunity to ensure alignment and improved communication across MDAs. We are pleased with improved scores and more accountability across all technical areas, even though we are still below optimal targets. The critical next step is to convene another workshop for the validation of scores across all technical areas.
We are grateful to our partners for their commitment and support thus far. Given the importance of inter-sectoral coordination, NCDC will continue to play her national coordination role working closely with relevant MDAs in ensuring Nigerians are protected from epidemic-prone diseases and other public health threats.
Notes
1. Information for this disease was retrieved from the Technical Working Group and Situation Reports
2. Case Fatality Rate (CFR) for this disease is reported for confirmed cases only
3. Information for this disease was retrieved from IDSR 002 data
4. CFR for this disease is reported for total cases i.e. suspected + confirmed
5. Information for sentinel influenza was retrieved from the laboratory
Key points
● There were 83 suspected cases, eight were laboratory confirmed and no death was recorded from five LGA in two states (Edo and Ondo)
Actions
To date:
● Conducted 2021 Lassa fever (LF) high burden states preparedness/response engagement meeting
● Dissemination of reviewed case management and safe burial practices guidelines
● Ensured all five LF molecular laboratories in the NCDC network are working at full capacity for timely testing of samples with reduced turnaround time
Planned:
● Finalise LF five-year strategic plan
Key points
● There were four suspected cases of cerebrospinal meningitis (CSM) reported from four LGAs in three states (Borno – 1, Katsina – 2 & Kebbi – 1). One was laboratory confirmed and no death was recorded.
Actions
To date:
● National CSM TWG meets weekly to review reports from states and plan appropriately
● Enhanced surveillance in all states
Planned:
● Continue harmonisation of the national line list and SORMAS data
● Continue to ensure that states reporting cases send their line lists and collect CSM samples
Key points
● There were 19 suspected cases of Yellow Fever (YF) reported from 18 LGAs in 11 states. None were laboratory confirmed and no death was recorded
Actions
To date:
● National YF multi-partner Technical Working Group (TWG) continues to coordinate activities across states.
● Ongoing plans to strengthen orientation of at-risk states on YF surveillance
● Ensured availability of reagents and consumables in all testing laboratories
Planned:
● Continue monitoring and analysis of YF (Yellow fever) data across all states and FCT to guide response
● Continue coordination of prompt transportation samples to the laboratories
Key points
● There were 212 suspected cases of cholera reported from 19 LGAs in five states (Bauchi – 145, Bayelsa – 5, Delta – 6, Kano – 52 & Kebbi – 4). None were laboratory confirmed and one death was recorded
Actions
To date
● National Cholera Multi-Sectoral Technical Working Group (TWG) is monitoring all states and supporting affected states
● Developed the 2021 Annual Cholera Preparedness and Response Work plan
● Cholera jingles being aired in English and local languages across the country
Planned:
● Continue follow up and monitoring of non-reporting states
● Build capacity for sample collection, transportation, and laboratory diagnosis across states
Key points
● There were 575 suspected cases of Measles reported from 82 LGAs in 17 states & FCT. None were laboratory confirmed and four deaths were recorded
Actions
To date
● National Measles TWG is closely monitoring measles surveillance data and providing feedback to relevant agencies and development partners
● Ongoing weekly surveillance and laboratory data harmonisation
Planned:
● Intensify follow up with states to update and transmit line list
● Continue monthly measles surveillance data review
Key points
● There was one suspected case of Monkeypox reported from Yenagoa LGA in Bayelsa State. It was not laboratory confirmed and no death was recorded
Actions
To date
● Enhanced Surveillance ongoing in Rivers, Delta and Bayelsa States
● National Monkeypox Technical Working Group (TWG) is monitoring activities in all states
Planned:
● Enhance surveillance for monkeypox in high burden states
● Continue harmonisation of the national line list and SORMAS data
Key points
● There were 77 suspected cases of AFP reported from 70 LGAs in 20 states and FCT. None were laboratory confirmed and no death was recorded.
Actions
To date:
● National COVID-19 multi-partner Emergency Operations Centre (EOC) continues to coordinate response activities across states
● Continues reconciliation of Ag-RDT data and collaboration with partners on Ag=RDT scale up
● Conducted meeting to finalise protocol for study on COVID-19 mortality and prognostic factors in high burden states
● Communicated to State focal persons on possible 3rd wave preparation and need to liaise with State Epidemiologists
Planned:
● Deploy antigen-based rapid diagnostic test (Ag-RDT) kits and sample collection materials to the selected states
● Intensify genomic surveillance activities
● Conduct WASH (Water, Sanitation and Hygiene) assessment across all health facilities
● Finalise Local Government Area (LGA) / State transmission categorisation
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