In Cameroon’s Extreme Nord province, digital tools make a difference in the fight against polio. When a patient’s sample en route to the national laboratory suddenly veered off course by hundreds of kilometers, a quick check of the Tec4med dashboard set it back on track—ensuring a faster diagnosis. And in the fight against polio, speed matters. The sooner cases are detected, the quicker outbreaks can be contained, preventing further spread.
To strengthen this process, VillageReach and the International Medical Corps (IMC), in partnership with Cameroon’s Ministry of Health (MoH) and the Expanded Programme on Immunization (EPI), focused on improving sample quality using temperature as a key indicator. They also worked to accelerate transport reimbursements for health workers. Their efforts targeted the country’s two most remote regions—Extreme Nord and Nord—where new sample reception sites (PREBs) were set up, complete with cold chain equipment to safeguard samples in transit.
Assessing Initial Challenges
VillageReach’s initial assessment in 2022 revealed that Cameroon consistently met global targets for timeliness, with an average of less than 3 days between the collection of polio samples and their arrival at the national lab in Yaoundé. However, the average temperature of samples received was often out of the recommended range (2-8°C). Additionally, delays in reimbursement of transport costs were disincentivizing health workers from transporting the samples.
Distribution of polio sample collection kits and other supplies. Credit: International Medical Corps, Cameroon
Implementing Targeted Improvements
To address these challenges, we focused on improving the quality of samples and strengthening the governance and coordination of reimbursements for health workers.
Specific actions included:
- Designating transporters for each health facility to be responsible for sample transport in the two most remote provinces: Nord (“North”) and Extreme Nord (“Far North”).
- Ensuring prompt and appropriate reimbursement for polio cases detected and sample transport, with performance-based benefits in these regions.
- Creating two new regional sample reception sites (PREBs) in Kousseri and Maltam (Far North region).
- Purchasing and delivering three freezers with ice packs and sample carriers to Kousseri, Maltam, and Guider PREBs.
- Training health workers at health facilities on sample collection, sample quality, and biosecurity.
- Procuring polio sample collection kits (for both human and environmental samples) and sample carriers for health facilities, along with biohazard spill kits and personal protective equipment (PPE) for PREBs.
- Returning sample carriers from the national lab to the Extreme Nord and Nord provinces via EPI routine vaccine distributions.
- Piloting the use of real-time digital trackers to monitor the quality (and location) of the samples during transport.
- Organizing joint supervision visits with the MoH and quarterly meetings with stakeholders involved in sample transport to address potential bottlenecks.
This illustrative map shows the movement of polio samples from the Far North region of Cameroon to the Institut Pasteur laboratory in the capital Yaoundé
The technical and financial support provided by IMC and VillageReach in the two northern-most provinces was carried out under the umbrella of the Global Polio Eradication Initiative (GPEI) and complemented support provided in the rest of the country by the World Health Organization (WHO) and other partners.
Measuring the Impact
The implementation of these activities led to significant improvements:
- Sample transport: The average time between sample collection at the health facility (or community) level and delivery to the regional level in the two supported regions remained under 1 day, with slight improvements observed during the one-year project period (October 2022 to November 2023)
- Reimbursements: The time to reimburse health workers was reduced from over one month to less than two weeks, building trust and encouraging timely sample transportation.
- Sample quality: A significantly higher percentage of samples were maintained within the recommended temperature range (2-8°C) during transport to the national lab in Yaoundé (see below).
Dr. Yaya Adjams, EPI Coordinator for the Extreme Nord province, noted the impact: “This project represented a great contribution to the transport of samples in the region, especially with the arrival of Tec4med [digital trackers]. In one case, the polio samples veered off-course and bypassed Yaoundé and were found in Douala; we realized this by looking at the Tec4med dashboard and we called for the samples to return to Yaoundé. Since that time, I have been checking the dashboard myself. Moreover, there has been a clear improvement in the time it takes to transport samples from health facilities to the central level thanks to this project.”
Transitioning to Government Leadership
As the project concluded, activities were successfully handed over to Cameroon’s EPI department and the World Health Organization, ensuring continued progress in polio surveillance and sample transportation in the region.
For more information about the Polio Lab Sample Transport program in Cameroon, please contact:
- VillageReach: Mr. Patrice Tshekoya (patrice.tshekoya@villagereach.org) or Louis Tshituka (louis.tshituka@villagereach.org)
- International Medical Corps: Dr. Dorothy Dissake (ddissake@internationalmedicalcorps.org) or Mr. Patrice Wa Tshihinga Ilunga (iwatshihinga@internationalmedicalcorps.org)