With the second wave of COVID-19 outbreak in Nigeria, WHO is supporting government to leverage on the existing  Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) system to strengthen community-based surveillance for the disease. In 731 wards across eleven (11) COVID-19 high risk states, WHO is supporting engagement of more than 670 AVADAR informants to conduct house-to-house COVID-19 surveillance and reporting of suspected COVID-19 cases, sensitize and support contact tracing in the communities.

 So far, the informants have provided more than 85 000 households with COVID 19 preventive messages in Kaduna, Kano, Jigawa, Katsina, Sokoto, Zamfara, Kebbi, Bauchi, Taraba, Borno and Yobe states.

“We are trusted by community members because we are integral to the communities where we work,” says Mustapha, a Kano State-based AVADAR informant. “We speak the same language and are known by our communities since the days of AFP surveillance for polio. Thus, engaging the communities, penetrating the households and getting the real facts about suspected COVID-19 cases in high risk wards is easy and achievable” stated Mustapha. 

Early detection and timely reporting of COVID-19 especially from rural and semi-urban communities is crucial to controlling the spread of COVID-19. AVADAR informants are trained on the use of mobile-based data collection to ensure real time reporting of suspected cases from communities. Hence, the AVADAR structure serves as the entry point for early detection and response to the outbreak. In addition, the informants are supporting contact tracing of cases and awareness creation using local languages and appropriate cultural mix of the communities. Therefore, they play key roles in increasing sensitivity of surveillance, tracing of contacts and reporting at the community levels. 

In Kano state, WHO-supported AVADAR informants raised the risk consciousness of more than 23,000 households. While in Sokoto, the informants have empowered more than 25,000 households with COVID-19 non-pharmaceutical intervention strategies.

Speaking on the intervention, WHO Nigeria Representative/Head of Mission, Dr Kazadi Mulombo says that AVADAR is critical for community-based surveillance for any disease outbreaks and indeed handy for COVID-19 surveillance at the community levels. “Leveraging on AVADAR structure for strengthening community-based surveillance for COVID-19 was borne out of the successful experience of the system in detecting suspected cases of Acute Flaccid Paralysis (AFP) for polio surveillance”, says Dr. Mulombo. “This, therefore, justifies why WHO has deployed its AVADAR informants to penetrate communities, identify suspected cases of COVID and provide real-time reports to the appropriate authorities for targeted response.”

Prior to the deployment of AVADAR informants, WHO developed a standard case definition of COVID-19 in an audio format in major languages, strengthened the capacity of AVADAR informants on added responsibilities to support COVID-19 response in compliance to “Do no harm” and “duty of care” principles and equipped them with adequate IEC materials to facilitate sensitization, active case search and contact tracing. 

Nigeria is experiencing a second wave of COVID-19 outbreaks. As of 24 February 2021, Nigeria has confirmed 153,842 cases of COVID-19 including 1,885 deaths. COVID-19 is preventable by social distancing, wearing of face masks and regular hand washing with soap under running water.