Leveraging Geographic Information Systems Technology and Local Insight to Improve Polio Vaccination Coverage in Borno State

Nigeria has made tremendous strides in polio vaccination coverage since Geographic Information Systems (GIS) technology was introduced in 2009 to track vaccination teams. This paper takes the case of Borno state in Northeast Nigeria, where a combination of technology, an environment of trust, collaboration, and cohesiveness between all stakeholders, and contextual insight and cooperation of local partners have played a critical role in increasing coverage and accountability and in the reduction of missed settlements. A single source of data, i.e. the master list of settlements (MLoS) maintained by the State, is used to plan all polio campaigns. During campaigns, daily feedback regarding visitation status was given at the Local Government Area (LGA) level, so missed settlements can be planned for on subsequent days. Post-campaign feedback at the end of campaigns allows for more effective micro-planning of the mop-up or subsequent campaigns. Satellite imagery was used to provide additional insight into hard-to-reach areas. Settlement visitation in accessible areas increased from 80.7% in November 2017 to 98.7% in March 2019 and settlements missed went from 10.9% in November 2017 to 0.9% in March 2019. The results indicate that technology integrated with local insight can make a significant contribution towards identifying the underserved and unreached settlements for immunization activities and providing proof of coverage, and, thereby, towards more impactful health interventions.