GRASP Propels Polio Vaccination by Locating Remote Nigerian Villages

Thanks to nationwide immunization, by 1979 the United States had effectively eliminated polio, a crippling and sometimes fatal disease. However, in much of the world, polio continued to spread. Polio is incurable and contagious, so widespread and thorough vaccination is the only way to eradicate it completely.

In 1988, national governments organized by the World Health Organization (WHO) and other health organizations formed the Global Polio Eradication Initiative (GPEI) to eliminate polio worldwide by providing access to vaccinations. By 2006, polio had been contained to only four nations. However, the disease returned and spread to 39 other countries in the next five years.

In response to the new outbreak, CDC activated the Emergency Operations Center (EOC) in December 2011 to support the final push to eliminate polio. ATSDR’s Geospatial Research, Analysis, and Services Program (GRASP) took the lead in analysis, mapping, technology, consulting, and support for EOC polio eradication efforts using Geographic Information Systems (GIS).

GIS is a collection of science and technology tools that helps scientists and epidemiologists analyze data and make informed decisions based on the relationship between the data and geography. For example, GIS can be used to generate maps showing where a disease is prevalent. Documenting these helps epidemiologists plan vaccination campaigns, keep accurate records, and communicate with participants.

One of the countries targeted by GPEI is Nigeria. Although thorough vaccination could eliminate the disease, Nigerian populations needing immunization can be hard to locate or to reach. They are often in remote locations and they migrate frequently. Difficult terrain and limited transportation can make getting to these populations a challenge.

For the Nigerian polio eradication project, GRASP produced both desktop and online GIS planning and tracking applications. The program used satellite imagery to identify the position of remote Nigerian communities whose populations needed vaccination. GRASP created maps that showed

• polio cases,
• staff deployments,
• road networks,
• population centers,
• migration patterns of nomadic populations, and
• surveillance and vaccination campaign progress

During the immunization campaign in Nigeria, GPEI partners, including staff from the CDC Emergency Operations Center, the CDC Center for Global Health, the National Geospatial-Intelligence Agency, the Bill and Melinda Gates Foundation, the World Health Organization, and USAID traveled to Abuja, Nigeria. There they worked with Nigerian Ministry of Health officials to plan vaccination campaigns, understand target populations, develop detailed routes for vaccination teams, and communicate about their activities. . The partners quickly recognized that for the vaccination campaign to be successful, local health ministry staff needed training in GIS concepts and skills. GRASP was the perfect choice for that task.

GRASP held informal GIS training with CDC staff in Atlanta, Georgia. In April and May 2013, the program trained 16 Nigerian health workers in basic GIS concepts, methods, and tools and how to operate the Nigeria Polio GIS Dashboard, an information system developed by CDC to track progress of polio elimination efforts in that country.

Based on GRASP’s contributions to the polio eradication campaign in Nigeria, GPEI recognized the effective use of GIS as “critical” in ensuring complete vaccination coverage and eradicating polio across the globe. Now, more health organizations have asked for additional and more diverse GRASP GIS support.

ATSDR’s GRASP provided valuable geographic information to the GPEI campaign in Nigeria by locating villages and populations in need of vaccination. This essential information helped GPEI strategize, plan, and validate the campaign. Further, GRASP provided GIS training to Nigerian health ministry staff so that they can continue the outreach. And most important, GRASP played a major role in potentially saving the lives of thousands of Nigerian children.