Inadequate data management and reporting systems posed a significant challenge to effective Adverse Effects Following Immunization (AEFI) surveillance in Nigeria. The absence of streamlined, electronic tools for tracking AEFI cases hindered timely detection, classification, and response, which in turn affected public confidence in the safety of vaccines. Efficient data management was essential to ensure prompt reporting and investigation of AEFI cases to safeguard public health.
With funding from the Bill and Melinda Gates Foundation (BMGF), Sydani supported the National Primary Health Care Development Agency (NPHCDA) and the National Agency for Food and Drug Administration and Control (NAFDAC) to address gaps in AEFI surveillance and reporting across the 36+1 states Nigeria.
Assessments/MEL/Data Management:
Sydani supported the deployment of advanced electronic data management tools to strengthen AEFI reporting systems at all levels. The Digital Health Information System (DHIS-2) and the Med Safety app were key platforms used to optimize data collection, reporting, and management of AEFI cases. The DHIS-2 system, integrated into healthcare facilities nationwide, served as a centralized digital platform for real-time tracking, reporting, and analysis of AEFI data. Healthcare workers were trained to input detailed AEFI case information directly into DHIS-2, ensuring data consistency, accuracy, and timeliness in reporting.
The Med Safety app, a mobile-based tool, allowed healthcare providers and the public to report suspected AEFI cases, enhancing transparency and accessibility. This tool streamlined the self-reporting of adverse effects, providing the National Agency for Food and Drug Administration and Control (NAFDAC) with immediate access to reported data for faster investigation and response. The app also allowed health workers to track the progress of reported cases and receive updates on AEFI investigations, creating a feedback loop that strengthened trust in the immunization process.
To improve AEFI reporting rates and streamline surveillance efforts, Sydani deployed these e-reporting tools across all health facilities in the 36 states and the Federal Capital Territory (FCT). The e-reporting channels were complemented by a robust monitoring and evaluation (M&E) system to track the usage of the tools, assess reporting timeliness, and evaluate data quality. Regular feedback and oversight were provided to ensure health facilities adhered to the reporting protocols, further embedding these tools into routine immunization practices.
Result:
The deployment of DHIS-2 and the Med Safety app significantly improved the rate and accuracy of AEFI reporting across the country. Over 3,000 AEFI cases were reported electronically through these platforms, providing national authorities with critical data for timely investigation and response. The electronic tools enhanced the surveillance infrastructure, ensuring more comprehensive data collection and analysis, which improved decision-making and increased public trust in the vaccination program.
Capacity Building:
To enhance the capacity of human resources involved in AEFI detection, reporting, and management, Sydani, in collaboration with AFENET, conducted multiple training sessions at various levels of the healthcare system. These sessions were designed to update participants on key concepts, including the basic definitions and classifications of AEFI, case management protocols, and reporting procedures.
Participants were trained on how to use the AEFI-DHIS2 module and the Med Safety app, a mobile application for self-reporting suspected adverse drug reactions to national authorities. The training also covered the AEFI data flow process, from line-listing and documentation to timely investigation and feedback. A Technical Working Group (TWG) was established at the NPHCDA and state levels, responsible for coordinating AEFI-related activities and ensuring the continuity of the training cascade to the ward level.
Result:
Through the capacity-building interventions, over 1,000 healthcare workers were trained on detecting and managing AEFI cases, including the proper use of the DHIS-2 and Med Safety app. The enhanced skills of healthcare workers led to timely and accurate reporting of more than 3,000 AEFI cases across the country. The training also increased the responsiveness of the national AEFI surveillance system, allowing authorities to better investigate and address reported cases. This improvement in AEFI reporting contributed to increased public confidence in vaccines and strengthened Nigeria’s immunization program.
