Community Sentinel Surveillance

Communities are and remain critical to effective response to disease outbreaks. Engaging communities and members builds their knowledge base, trust and bolsters their confidence in overall response and in achieving sustainable response mechanism, including surveillance and their response capabilities. It provides readily available and on-ground resources for reporting on outbreaks and intervention, easy mobilization and awareness creation, countering damaging misinformation, fear and misunderstanding about disease because of their extensive local knowledge and deep-rooted community trust, facilitates kit distribution, strengthen intervention team from their collaborative working partnership during outbreaks and interventions. They have access to accurate information about what is happening to community members individually and collectively, and have a way to getting reliable information and providing answers to questions to and communities, and from them.

Ease of disease outbreak and rife spread remain a hallmark of developing society. This is compounded by poor response towards curtailing and reducing impact among such population. This is the basic reason why, in the advent of any outbreak of epidemic, communities, especially in developing countries are easily ravaged. This is the usual experience in developing country, Nigeria inclusive, where most population are rural-based often with poor health responsive system and management capacity.

Community involvement and ‘bottom-up’ approach, in responding to epidemic outbreak, remains weak in Nigeria resulting in ravaging epidemic outbreaks. Rural communities, where over 70% of Nigerian population resides, are often vulnerable are mostly affected, made worse by poor health response system prevailing therein. 

Kogi State, one of Nigeria' s states, and proposed implementation setting, has a total population of 3,314,043 spread across its 21 Local Government Areas, 90% of which resides in rural community, served by PHC (the community-level health service provision commonly available to the population) with poor disease responding capacity.

Community Sentinel Surveillance, CSS, community-based, will aim to aid effective Kogi State response to epidemic outbreaks. CSS will ensure community surveillance and response, ensuring timely detection of outbreaks in communities and their immediate response 

The approach will build community knowledge base, trust and bolsters their confidence in overall response, achieve sustainable surveillance and response mechanism, and capabilities. Readily available and on-ground response resources, easy mobilization and awareness creation, countering damaging misinformation, fear and misunderstanding about disease will be assured as a result their (CSS) extensive local knowledge and deep-rooted community trust. It will also facilitate kit distribution, strengthen intervention team from their collaborative working partnership. This is achievable as the CSS, being component of the communities, will have access to accurate information about what is happening to community members individually and collectively, and have a way to get reliable information and providing answers to questions.

CSS operation will be strengthened with communication linkage between CSS and PHC facility (communities' immediate portal of entry into health system), operating within the LGA (each CSS operation precinct), for easy transmission of community-based surveillance information and reporting, and for immediate health system response to observed community disease outbreaks

This will be beneficial to the vast majority of the state’s total population of 3,314,043 spread across its 21 Local Government Areas, 90% of which resides in rural community, served by PHC (the community-level health service provision that directly serves the population) and which currently possesses poor disease responding capacity. Characteristically, health system at this level is inherently plagued by poor capacity in responding to disease outbreaks and emergency response. This is made worse by inequality and inequity in population access to responsive health services. The population of the state is mostly rural, characteristic of most Nigerian communities, with prevalent economy largely agrarian. In terms of infrastructure, the state is poorly developed and thus largely backward. This is grossly noticeable within the health system. Many of its rural communities suffer from inaccessibility to appropriate responsive health care services, despite its primary health care facilities dotting the state’s landscape. Secondary  and  tertiary  health  care  facilities  are  few  in  the  state, and  people  have  to  travel  long distances, mostly  on  bad  roads  in  order  to  have  access  to  good  health  care  particularly secondary and tertiary care services. Besides the problem of inadequacy of health care facilities, bad   roads   and   high   cost   of   transportation   makes   accessibility to available health care facilities in the state and the   referral   services   available   outside   the   state   highly   difficult.  

The concept of health provision in Nigeria was designed with inculcated community-level and near-population health care provision. However, this has being poorly responsive, with attendant inequality and inequity, negating any population-imparting effect. The outcome is poor responsiveness to disease outbreak. 

Community Sentinel Surveillance, community-based and driven by community-based human resources, strengthened through linkage to PHC system via mobile communication structure, will seek to engender strengthened disease surveillance, early warning systems  through mobile communication to detect, that halt future disease outbreaks. 

Community engagement is a proven efficacious mechanism for effective, impacting and sustainable public health intervention. The approach is a known, and remain critical to effective response to disease outbreaks, promotes a robust epidemic response implementation. It builds community knowledge base, deep-rooted community trust and bolsters their confidence in overall response, ensures sustainable response and capabilities. It provides readily available and on-ground response resources, ensures easy mobilization and awareness creation, countering damaging misinformation, fear and misunderstanding about disease, and provides avenue for reliable information and providing answers to questions. Ownership and sustainable of any intervention are readily outcomes when communities are engaged and involved. 

Communities are and remain critical to effective response public health intervention. This contributed immensely to the 2014 Ebola outbreak response efforts in West African country of Liberia. Engaging community member ensures a number of added value in epidemic response: building their knowledge base on what the emergency is and what can be done, and their response capabilities. Incorporating communities into epidemic response plans builds trust and bolsters community confidence in overall response and in achieving sustainable response mechanism, including surveillance. It also the readily available and existing of on-ground resources, mobilization, and awareness creation, kit distribution, countering damaging misinformation, fear and misunderstanding about disease. Emanating from within the communities and with their extensive local knowledge and deep-rooted community trust, they work alongside and strengthen intervention team. Their ready availability and timely response makes their engagement veritable from onset of any disease outbreak. They have access to accurate information about what is happening to community members individually and collectively, and have a way to get reliable information and providing answers to questions. Key outcome, beyond acceptability, is ownership and sustainability.

Nil for now

No. of communities with CSS actively involved in disease surveillance and reporting

No. of diseases and outbreaks reported and controlled

No. of deaths prevented from disease outbreaks due to timely reporting

A total of ten (10) staff, all are part-time staff.

Centre for Afri-Health Development is a healthcare development organization that seeks to collaborate with governments, research and donor organizations to develop innovative solutions to address healthcare challenges in Nigeria through proven and innovative methods for sustainable impact in health systems and to improve population health outcomes. The Centre is made of highly qualified and experienced professionals, who apply proven and innovative methods and in-depth knowledge of Nigerian setting, to provide support, through a diverse range of services aimed at improving the effectiveness of governments, health and development institutions, for sustainable high quality service to its clients and partners, and to the Nigerian people.

Gender consideration and mainstreaming is a core value of CAHD. In addition is the desire and practice of the Organization in providing health intervention across all social strata. 

To be able to implement concept being advanced through this channel.

Access to potential funding sources for implementation of concepts that improve population health

Potential investors in public health interventions

CAHD is a non-profit organization in Nigeria with potential in contributing to improving the health of, especially under-served and disadvantaged population. CAHD feels the Foundation Prize will aid the organization along this direction fulfilling the Foundation's goal of addressing health security and epidemic challenge.