TOYIN ADEBAYO , ABUJA

UNICEF and the World Health Organization (WHO) has warned of an alarming decline in global vaccine coverage due to a COVID-19 pandemic that is disrupting the delivery and uptake of immunization services around the world.

UNICEF has said, Nigeria is facing a critical moment of choice, wherein children can either be protected from a host of preventable diseases or face an uncertain future and possibly dire health prospects.

UNICEF’s Representative in Nigeria, Peter Hawkins said, “This is a critical moment for Nigeria’s children. We can either seize it – or condemn millions of children to preventable illness or even death.”

“We have a long way to go to ensure greater protection for children against disease – and vaccination rates, including against the highly contagious and deadly measles virus, are in danger of lapsing,” said Peter Hawkins. “Let’s seize this moment to reimagine how we bring vaccinations to children, leveraging on existing community structures for COVID-19 prevention, to improve vaccination rates too – and ensure a brighter and healthier future for Nigeria’s children.”

The global vaccination coverage rate with the third dose of the vaccine against diphtheria, tetanus and pertussis (DTP3) has plateaued at 85 per cent since 2010. In Nigeria, numbers show that routine immunizations in the first 6 months of 2020 have dropped compared to the same period in 2019 – indicating a deterioration in important routine vaccination coverage, due to COVID-19.

“No Nigerian child should die from a preventable disease that can be easily prevented with an affordable vaccine that is readily available within our borders. Let us not let COVID-19 distract us from the work we still need to do to ensure that EVERY Nigerian children receives their full routine immunizations,” said Hawkins.

 Global disruptions due to the COVID-19 pandemic are threatening to reverse hard-won progress in immunization rates worldwide, according to new data by WHO and UNICEF. 

At stake is critical progress made over the last decades in reaching more children and adolescents with a wider range of vaccines, including in Nigeria. However, despite this progress, Nigeria still contributes 30 percent of the global number of unimmunized children between the ages of 0 and 5.
 

Similarly, Dr Faisal Shuaib, Executive Director of Nigeria’s National Primary Health Care Development Agency (NPHCDA) added that, “We are in a strong position here in Nigeria – we have a full stock of routine immunization vaccines and can use the strong community outreach programmes across the country, not only to prevent the spread of COVID-19, but to also ensure children receive vaccinations for diseases we can easily prevent. We must seize this moment to be creative and act wisely.”

Due to the COVID-19 pandemic, at least 30 measles vaccination campaigns around the world were or are at risk of being cancelled, which could result in further outbreaks in 2020 and beyond.

UNICEF Executive Director Henrietta Fore said, “We already knew the challenge of vaccinating every child was daunting, and now we know that COVID-19 has made a challenging situation even worse.”

“We must halt a further deterioration in vaccine coverage and reinforce vaccination services before children’s lives are threatened by other outbreaks. We cannot trade one health crisis for another.” 

Given stagnating global coverage levels, the likelihood that a child born today will be fully vaccinated with all the globally recommended vaccines by the time she will be 5 years is less than 20 per cent.

The analysis shows that in 2019, nearly 14 million children did not receive any of the life-saving vaccines such as measles, diphtheria, tetanus or pertussis. Two-thirds of these children are concentrated in ten countries: Nigeria, India, Democratic Republic of the Congo, Pakistan, Philippines, Ethiopia, Brazil, Indonesia, Angola and Mexico. 

Countries that had recorded significant progress, such as Ethiopia and Pakistan, are now at risk of backsliding if immunization services are not restored as soon as feasible.

“We must reimagine immunization in Nigeria and build back better, despite the pandemic,” said Peter Hawkins.

“We can do this by building the confidence of caregivers in accessing immunization services, reaching out to people where they are to ensure they understand the importance of these vaccinations for their children’s lives, and protecting healthcare workers so that they can deliver these services safely and effectively.”

TOYIN ADEBAYO ,ABUJA

The Director General, Nigeria Centre for Disease Control (NCDC) , Dr Chikwe Ihekweazu hinted that there are possibilities that Covid-19 is airborne, meaning it can be transmitted through the air.

He gave this hint while briefing newsmen at the Presidential Task Force on Covid-19 briefing on Monday in Abuja, saying, this could be attributed to new evidence.

The NCDC Boss stated that, the disease which was initially believed to be transmittable only through droplets that emanate from the nose and the mouth and fall to the ground, but strong evidence has shown that it could be airborne.

According to him ; “Over the past few weeks, increasing evidence has emerged that in addition to droplet infections; we cannot rule out that airborne transmission is also possible as a mode of transmission of COVID-19.

“Understanding the modes of transmission of any new virus is very critical for defining response strategies. For COVID-19, from the very beginning, our understanding based on other coronaviruses that spread was primarily through droplets.

“Droplets are excretions from the respiratory tracts that can’t stay on in the air; they ultimately fall to the ground after a few minutes.

He continued; “We have studied transmission, studied clusters of these infections, we saw increasing evidence from clusters of infections where droplet transmission did not seem to be enough to explain the clusters that we are seeing.

“Diseases that are commonly understood to be spread by what we call airborne infection are things like measles and influenza; that can be suspended in the air and transmit over longer distances.”

The NCDC boss noted that the World Health Organisation (WHO) has also updated its guidelines with the same position on the mode of COVID-19 transmission.

The NCDC boss, however, called on Nigerians to act in a precautionary way and assume that the virus could be transmitted through the air.

He added that, they have studied transmission, studied clusters of these infections, we saw increasing evidence from clusters of infections where droplet transmission did not seem to be enough to explain the clusters that we are seeing.

“Diseases that are commonly understood to be spread by what we call airborne infection are things like measles and influenza; that can be suspended in the air and transmit over longer distances.”

The NCDC boss noted that the World Health Organisation (WHO) has also updated its guidelines with the same position on the mode of COVID-19 transmission.

He, therefore, called on Nigerians to act in all precautionary way and assume that the virus could be transmitted through the air.

Ihekweazu also advised against indoor activities and stressed the need to re-emphasise safety protocols against COVID-19.

TOYIN ADEBAYO, ABUJA

The College of Nursing and Midwifery, Maiduguri in Borno state, has secured full accreditation from the regulatory body, the Nursing and Midwifery Council of Nigeria.

The accreditation comes 40 years after inception and made possible with recent donation of modern equipment and tools by WHO with funding support from the European Union.

Items donated include laboratory equipment, classroom furniture, library books, practical teaching tools, hospital beds and computers. According to the students and staff of the institution, these equipment and facilities have also made teaching and learning a lot easier and friendly.

Hajia Rukaiya Shettima, the Provost of the College of Nursing and Midwifery, Maiduguri, Borno state said, “I have the opportunity to share two distinct yet complementary experiences of this school, “One, as a student nurse in the then School of Nursing and now as a staff, in fact, the provost of the school, now College of Nursing and Midwifery. 

According to her, although the School of Nursing was established in 1971 by the defunct government of northern Nigeria, I gained admission to study nursing in 1981. As a student nurse in the 1980s, I still recall how we struggled to memorize procedures, role-play steps and imagine practical approaches for activities we hadn’t adequate equipment for practicals. Despite the challenges, studying nursing in this school back in the 1980s was fun and a privilege, yet more arduous.” 

Without the full accreditation of the Borno College of Nursing and Midwifery, Hajiya Rukaiya confirms that the school was limited to a sparse curriculum and few students. “The school hadn’t full accreditation from Nigerian Nursing Council and admitted just a few students due to inadequate facilities and teaching staff. Although we did well for many years in national and international examinations, it took uncommon dedication and commitment to success.”

Accreditation ensures the same standards and criteria across all nursing programmes in Nigeria irrespective of locations while ultimately improving the quality of nursing education and keeps the curriculum up to date on current trends in nursing and healthcare. Without full accreditation, a nursing school is limited to admitting a certain number of students and offering a handful of healthcare programmes.

Hajiya Rukaiya’s experience as a staff and indeed the manager of the College is now different. “Now as a staff of the college since 1991, things have changed a lot,” she added. The quality of training and learning started declining over the years due to obsolete equipment, outdated facilities and exodus of many skilled teachers who left for safety or for greener pastures especially in the last decade associated with the insurgency in north-east Nigeria. It was not until 2016 that the government of Borno state upgraded the school to a College of Nursing and Midwifery. 

“As a College of Nursing and Midwifery, the school still operated with partial accreditation until WHO, with funding support from the European Union, supported the College with requisite laboratory equipment and reagents, information technology tools including computers, modern nursing textbooks and classroom facilities which enabled full accreditation in 2020 after forty years from inception.

“With the full accreditation today, teaching and learning at the College of Nursing and Midwifery in Maiduguri have improved tremendously. In fact, in our last examination, 98% of our students scored 95% in nursing exams. Presently, the college admits as much as three times the number of students admitted hitherto in Basic Nursing programmes, Basic Midwifery, Community Nursing and Community Midwifery. Also, the college curriculum has been expanded to include community midwife and community nursing among others. The college can now award a Higher National Diploma in Nursing and Midwifery. Many thanks to WHO supported by the European Union.”         

Prior to the insurgency, northeastern Nigeria had one of the lowest health development indicators in Nigeria. As the crisis festered for more than a decade, health indices deteriorated.  “More than two-thirds of health facilities became completely or partially destroyed with a dramatic drop in childhood vaccination rates, leaving children at greater risk of preventable life-threatening diseases such as polio, malaria, meningitis and measles,” says Dr. Collins Owili, Emergency Manager, WHO health emergency programmes for north-east Nigeria. 

Over the years, the healthcare workforce in Borno state weakened and declined tremendously. Affected populations remain at high risk of epidemic-prone diseases like cholera, measles, meningitis, and viral fevers such as Lassa fever and yellow fever. Endemic malaria accounts for 50% of mortality and morbidity, a proportion that is higher than all other causes of death combined including cholera, measles and hepatitis E. Also, one in five children is severely malnourished within a context of high malaria prevalence and a weakened healthcare system.

Hence, it became urgent and essential to strengthen the healthcare system, build the capacity of available health staff, strengthen the curriculum of healthcare institutions and provide urgently needed care which has become unavailable or inaccessible to many people in need. 

With funding support from EU, USAID, governments of Canada and Germany and other donors, WHO is responding to the direct impact of the crisis on the populations by providing technical guidance, capacity building of local health workers, setting standard protocols, disease surveillance and response to disease outbreaks. Supporting the College of Nursing and Midwifery, in Maiduguri with training equipment and facilities for improved healthcare teaching and learning will impact on the healthcare delivery system now and in the long term.

…Trains 42 Sample Collectors Across  21 LGAs

TOYIN ADEBAYO, ABUJA

The World Health Organization (WHO) State Anambra State Coordinator, Dr Igboekwu Chukwumuanya has hinted that, “WHO invested both human and financial resources in training 42 samples collectors across  21 LGAs of the state.

He said this has directly contributes to the realization of government’s goal of decentralizing the COVID-19 response to enable states and LGAs take ownership.

While adding that, WHO’s commitment is centered on supporting the government actualize the set targets. 

According to him, the training sample collectors directly contributes to strengthening the laboratory component of the pandemic response is committed to supporting.  Adding that, once fully strengthened, LGAs are expected to become the operational hub of the pandemic response, to guarantee long term sustainability of the response.”

As of 07 July 2020, Nigeria has 37 functional COVID-19 test laboratories located in 36 States and the Federal Capital Territory. The country also recorded 29 286 confirmed cases, discharged 11 828 patients, and 654 deaths from 156 925 tested samples.

Ms Ifediata Adaora, a Medical Laboratory Scientist and one of the beneficiaries of the two-day training on Covid-19 on sample management organized by the World Health Organization (WHO) in collaboration with the Nigeria Center for Disease Control (NCDC) said the capacity building is timely and has empowered them to effectively respond to COVID-19.

Saying, the training will boost the States’ capacity for active case search and sample collection thereby dictating more cases which will help in curbing the pandemic. 

“it was quite an educative training, which left us better informed on facts about the Covid-19 infection, how to prevent infection through proper use of personal protective equipment, sample collection, packaging and transport.

Notwithstanding restrictions put in place by both the state and federal Government, cases of COVID-19 in Anambra state remain on the increase.

Based on the Presidential Task Force’s recommendation of decentralization of the response to the states for sustainability and improved coordination, the Anambra state government has created roving Rapid Response Teams (RRT) who operate as semi Emergency Operation Centers (EOC) at various Local Government Areas (LGAs).

These teams are involved in active case search at the community level to find more patients. To support the active case search, WHO supported Anambra State and trained 42 personnel from 21 LGAs, which included laboratory scientists/technicians and scientific officers to intensify the response and provide the support needed in increasing sample collection across all LGAs.

According to her, the facilitators were trained on how to correctly collect, package, and transport COVID-19 samples in the state.  Before the hands-on training, virtual training on COVID-19 sample management was conducted in April 2020 with a few participants mainly from the State level.

TOYIN ADEBAYO, ABUJA

The World Health Organisation (WHO) has revealed that tackling mental health during isolation is essential to full recovery of Covid-19.

Narrating his ordeal, Dr Korir Charles, a WHO Nigeria staff who recovered from COVID-19 said, “When I tested positive to COVID-19 on April 23 2020, I was evacuated to an isolation facility with minimum contact with other infected persons and none with people from outside. Being in isolation was really one of my lowest points as I began feeling depressed and worried about my situation. 

Fortunately, the psychosocial support provided by the World Health Organization (WHO) Stress Counsellor; Dr David Igbokwe went a long way in helping me cope with the situation.

He reached out to me on a daily basis, prompted me to have a structured daily routine and begin journaling of my experience”.

He further stated, “During isolation, I was also encouraged to reach out to family members and close friends for bonding and social support. I recall a discussion I had with him and he made me count the positive things I have achieved in my working life. This simple strategy made me focus on my strengths in the present as well as have hope for the future. I usually looked forward to receiving calls from him.” 

The COVID-19 pandemic, like other situations of crisis (natural or man-made disasters), is a time of significant stress, notably associated with the uncertainty regarding possible duration and discovery of a cure/vaccine. This ongoing stress cuts across all categories- age, socioeconomic status, gender and is worse for some already vulnerable populations (elderly, poor, with pre-existing physical/mental health problems).

So far, since Nigeria recorded its first case on February 27 2020, the numbers of confirmed cases have risen to 28 711 with 645 deaths while 11 665 have been discharged as of 05 July, 2020. 

A Consulting Psychiatrist in Lagos state, Dr Thomas Ibironke said, “mental and psychosocial illnesses can result from social isolation, loss of pleasures of life (like attending parties, travelling, and conferences) and stress arising from working at the frontlines. Others include unstructured work, handling children while working, job loss amongst others. With lockdowns and movement restrictions in place in many states, levels of loneliness, depression, harmful alcohol and drug use, and self-harm or suicidal behaviour may also be on the increase.

Sh added that, “To have good mental health during the pandemic, people need to focus on what is within their control, take care of their general health including diet, sleep and exercise, reduce listening or watching unreliable news, connect with loved ones remotely and speak out if they are struggling and speak to a licensed professional (counselling, other therapies, medication if needed)” she added.

Speaking further on addressing mental health amid COVID-19 pandemic, Dr Igbokwe mentioned that, “I have attended to quite a number of patients going through phases like anxiety and depression and have been able to help a lot recover and get back on track when things are not as they used to be, it is not surprising to see these effects on people’s mental health.”

He added that,  “to maintain good mental health during this pandemic, it is important to adhere to a few guidelines; don’t stay inactive for extended periods watching TV, don’t spend time thinking or asking when will this end or why is it affecting me, don’t lose hope, faith and self-control. Do have a routine, do exercise, do focus on the positive aspects of the situation, do pay attention to nutrition, do have quality conversations with friends and loved ones.”

Saying, one in four Nigerians – some 50 million people – are suffering from some sort of mental illness, according to the World Health Organization.

WHO continues to be at the forefront of the fight against COVID-19 by providing support to respective response pillars of Emergency Operation Centres and the Presidential Task Force on COVID-19.

TOYIN ADEBAYO, ABUJA

The World Health Organisation (WHO), has revealed that COVID-19 infections in Africa today (Wednesday), surpassed 500 000, and there is concern as a growing number of countries are experiencing a sharp rise in cases.

Saying, it said in less than five months, the virus has claimed 11, 959 lives, overtaking the 11 308 lives lost in the world’s worst Ebola outbreak in West Africa between 2014 and 2016.

WHO added that cases have more than doubled in 22 countries in the region over the past month, saying nearly two-thirds of countries are experiencing community transmission.

It said Algeria, Egypt, Ghana, Nigeria and South Africa account for about 71% of COVID-19 cases, adding that South Africa alone accounts for 43% of the continent’s total cases.

However, the accelerating growth trend is not uniform across the continent, with some countries recording a steady rise in cases, indicating a protracted pandemic.

“Eritrea, Gambia, Mali, Seychelles and Togo are witnessing long doubling times and low growth rates. Seychelles had not experienced a case in nearly two months, but in the past week had dozens of new imported cases, linked to crew members of an international fishing vessel. There are also some signs of progress as 10 countries have experienced a downward trend over the past month. Although Egypt accounts for 15 percent of cumulative cases, it has seen a decline in the past week”, WHO said.

The World Health Organization (WHO) Director for Africa, Dr Matshidiso Moeti said, “With more than a third of countries in Africa doubling their cases over the past month, the threat of COVID-19 overwhelming fragile health systems on the continent is escalating.

“So far the continent has avoided disaster and if countries continue to strengthen key public health measures such as testing, tracing contacts and isolating cases, we can slow down the spread of the virus to a manageable level.”

Eighty-eight per cent of COVID-19 infections are among people aged 60 and below, likely due to Africa’s relatively young population. However, the likelihood of dying from COVID-19 rises with increasing age and the existence of co-morbidities, with the risk of death among patients aged 60 years and above being 10 times higher compared with those below 60.

Also, the WHO Director for the Eastern Mediterranean Dr Ahmed Al-Mandhari, added that, “Communities across the continent have a crucial role to play in controlling the pandemic, especially as countries begin easing lockdowns and opening up their borders”

“As governments continue to implement public health measures, individuals must remain as cautious and vigilant as ever to protect themselves, their families, and their communities. Hand washing, mask use, physical distancing and other preventative measures are key to controlling transmission, saving lives, and ensuring that already overwhelmed health systems are not stretched to breaking point.”

The organization said as COVID-19 continues to spread, thousands of health workers have also fallen ill, saying equipping and protecting health workers is one of the central pillars of the COVID-19 response.

WHO is working to support countries respond to COVID-19 by providing technical guidance, crucial medical equipment and has remotely trained more than 25 000 health workers.

WHO has also organized more than 420 shipments of key equipment, including more than 3000 oxygen concentrators, 23 000 GeneXpert diagnostic testing machines and almost 4 million pieces of personal protective equipment for health care workers.