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The University of Maryland, Baltimore through the Institute for Human Virology (IHV) has been supporting the HIV/AIDS response in Nigeria since 2004 with support from the US Centers for Disease Control and Prevention (CDC) under PEPFAR. IHV established a local organization in Nigeria early on, incorporating it under the name IHV Nigeria. The University of Maryland, Baltimore has continued its work directly in Nigeria through the Ciheb Nigeria country office, often working in partnership with IHV Nigeria on key initiatives.


Strengthening HIV Field Epidemiology, Infectious Disease Surveillance and Lab Diagnostics (SHIELD). The SHIELD project is a CDC-funded initiative under PEPFAR focused on improving the quality of HIV service delivery across PEPFAR- and Nigerian Federal Ministry of Health–supported projects in Nigeria. Ciheb works with the national health system (above site) to conduct evaluations, improve data management, develop and manage health information systems, and implement continuous quality improvement.

SHIELD’s recent activities included the launch of a more robust, faster, and user-friendly National Data Repository (NDR) (dubbed NDR 3.0). The NDR is a repository of de-identified patient-level data from facilities across the country. HIV client data is collected that allows tracking of the 95-95-95 cascade at the national level.

Improvements to the NDR platform focused on data ingestion performance, an increase in analytics processing speed, the elimination of duplicate patients, and improved data concurrence between facility electronic medical records (EMRs) and the NDR. Ciheb also led the development effort around NigeriaMRS (NMRS), which is a fork of the open source EMR platform OpenMRS, and championed the transition from facilities using legacy EMRs to NMRS 2.0, thus allowing for better EMR standardization across facilities and the centralization of EMR development efforts.

Ciheb also spearheaded the development of portable biometric systems for the collection of patient biometric data, thus paving the way for client de-duplication at both the facility and national levels.

To accelerate the impact of the public health response to the HIV epidemic, the SHIELD project also supported the implementation of the HIV recent infection testing in 19 states and case-based surveillance with upgrades built into the NMRS and the NDR to support these surveillance activities. Furthermore, commodity management modules have also been developed and incorporated into the NMRS and the NDR to track supply versus utilization of antiretrovirals and rapid test kits at the facility level for PEPFAR-supported facilities.

Turnaround time for return of results for viral load testing has been a lingering problem with Nigeria’s treatment program. It often takes one to six months for results from sample collection. To improve this turnaround time as well as foster interoperability between PEPFAR- and Ministry-supported HIS platforms, Ciheb worked with a partner organization developing the laboratory information management system (LIMS) to implement an LIMS-EMR direct data handshake system, whereby patient laboratory requests captured on EMRs are synchronized directly to the LIMS platform and results returned directly to the various EMRs.

Strengthening Epidemic Response and System (SERS). Funded by the CDC through PEPFAR, SERS is a multiyear initiative focused on improving the epidemiology, surveillance, reporting, and information management of diseases of public health concern in Nigeria. It is a vehicle through which Ciheb provides support to the Nigeria Centre for Disease Control in strengthening the surveillance reporting system and implementing the Integrated Disease Surveillance and Response (IDSR) strategy along with other implementing agencies. SERS’ overall goal is to strengthen information systems in Nigeria to improve the country’s ability to achieve international health regulation compliance and global health security targets.

SERS has prioritized the accomplishment of some strategic initiatives targeted towards achieving its set goal. Some of these achievements included the establishment of surveillance reporting using a mobile app (mSERS) for SMS-based weekly reporting across eight states in Nigeria through 144 local government area disease surveillance and notification officers and 40 state surveillance frontline officers.

Other achievements included the update and enhancement of the mSERS reporting system to support the reporting of newly assigned diseases for weekly reporting, refresher training for disease surveillance frontline officers in two states (Niger and Akwa Ibom States), and support for the expanded use of the Surveillance Outbreak Response Management and Analysis System (SORMAS) – an application adapted to Nigeria for case-based surveillance and disease outbreak management. The Ciheb SERS team also worked in collaboration with the NCDC team to build the capacity of more than 260 disease surveillance frontline officers on the use of SORMAS, provided the frontline officers with tablets and internet data for SORMAS implementation, enhanced the functionalities of the NCDC Connect Centre applications and processes to strengthen the country’s response to COVID-19, and built the capacity of over 250 connect centre agents (1st and 2nd line responders) to support NCDC’s response to COVID-19.

In addition, Ciheb also established a follow-up team to support NCDC in monitoring arriving airline passengers for COVID-19 for a period of three months. More than 3,500 persons were monitored over a period of 14 days.

Project ECHO. Ciheb piloted the first “telementoring” healthcare project in Nigeria in 2018 called Project ECHOTM, an initiative developed and promoted by the Project ECHO Institute at the University of New Mexico School of Medicine. ECHO, which stands for Extension for Community Health Outcomes, uses teleconferencing to link specialists with practitioners and create “communities of practice” in underserved areas.

Through Project ECHO, Ciheb has been able to provide technical support to implementing partners with site assessments and deployment of conferencing infrastructure. Ciheb recently coordinated a central immersion training of 140 participants from 25 organizations in Nigeria, with a step-down training of more than 400 participants across six HIV “surge states.” The ECHO sessions have been an avenue to share relevant information, guidance, and strategies to sustain the gains of the PEPFAR antiretroviral treatment program in the midst of the COVID-19 pandemic and travel restrictions, allowing for greater protection of healthcare workers while maintaining patient treatment.

The ECHO platform has also supported PEPFAR regional meetings to discuss the HIV program in the context of COVID-19, thereby creating avenues to share experiences, challenges, successes, and best practices that can be adopted across regions.

Nigeria AIDS Indicator and Impact Survey (NAIIS). Another of Ciheb Nigeria’s initiatives is the NAIIS, which is funded by the CDC under PEPFAR. The NAIIS is part of PEPFAR’s Population-Based HIV Impact Assessment (PHIA) projects, which determine the prevalence of key HIV-related health indicators, including HIV incidence, prevalence, viral load suppression, CD4 distribution, and risk behaviors.

The NAIIS findings, announced in 2019, indicate that Nigeria has made progress in its fight against HIV epidemic, but is still not on track towards the UNAIDS’s 95-95-95 goals. Though the NAIS found a lower national HIV prevalence among Nigerians, only one in every three persons living with HIV reported knowing their status. In 2020, the data was further examined to obtain deeper insights into both HIV epidemiology and other disease entities, in order to inform future studies as well as provide insight into behavioral and biological contexts of HIV across all states in Nigeria. NAIIS data is now hosted on the National Bureau of Statistics’s National Data Archive portal.

Biannual Nigeria Bulletin

Screenshot of the first page of the Ciheb Nigeria newsletter for August 2021

Continuous Quality Improvement

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Implementing CQI programs in Nigeria

News and Impact Stories from Nigeria

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Ciheb Nigeria to Study Adverse Events Following COVID-19 Vaccination

A Cohort Event Monitoring survey to examine and evaluate the safety of individuals following COVID-19 vaccinations in Nigeria has begun in five states of Bauchi, Edo, Enugu, Kaduna, Lagos, and the Federal Capital Territory, Abuja. This observational surveillance program’s purpose is to monitor safety signal detection following the rollout of COVID-19 vaccines in the country.

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Data Demand and Information Use through STATA Training in Nigeria

Ciheb Nigeria, in partnership with the Federal Ministry of Health, recently facilitated a training to promote a culture of data demand among stakeholders to encourage the use of data on the National Data Repository (NDR) to track program outcomes and impact. The training also aimed to build the capacity of the stakeholders to maximize the use of data on the NDR for research.

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Ciheb Holds Workshop for Partners, Stakeholders on NDR Implementation in Nigeria

Ciheb Nigeria, in collaboration with the Federal Ministry of Health, recently facilitated a three-day workshop for implementing partners, key stakeholders, and other parties of interest in the health sector to improve user education, understanding, and efficiency at all levels of the National Data Repository (NDR) implementation.

Interviews by location. Covid-19 sero prevalence survey distribution in Nigeria. A map of Nigeria with the states of Gombe, Nasarawa, and Enugu highlighted in blue.

Dashboards to Support Nigeria COVID-19 Serosurveillance Study

In the fall of 2020, Ciheb conducted the first phase of a COVID-19 population-based serosurveillance study in the Nigerian states of Enugu, Nasarawa, and Gombe. Ciheb created a data collection tool for the serosurveillance study known as the Computer-Assisted Personal Interview (CAPI). 

A field worker wearing protective equipment conducts a nasal swab of a woman sitting down.

Second Phase of COVID-19 Seroprevalence Survey Underway in Nigeria

The second phase of a COVID-19 seroprevalence study in Nigeria has begun in Kano State in Northwest Nigeria and the Federal Capital Territory, Abuja.


A graphic of the electronic registration for the Nigeria COVID-19 vaccine smartphone portal.

Ciheb Supports Vaccine Video Production and Publicity in Nigeria

The National Primary Health Care Development Agency (NPHCDA) in Nigeria has developed two videos to help educate the public and publicize the rollout of the COVID-19 vaccines.


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Remembering Henriatta

With great sadness, we announce the untimely passing of our beloved Nigeria office team member Henriatta Selle Tiri Kamji. Affectionately called “H. Tiri” by all who knew her, she was a humane, loving colleague who demonstrated a profound dedication to her work and earned the respect and admiration of many.


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Award Expands COVID-19 Seroprevalence Investigations in Nigeria

Ciheb was awarded $900,000 from the U.S. Centers for Disease Control and Prevention to expand a COVID-19 seroprevalence study in Nigeria.


Two people process lab samples.

COVID-19 Survey Releases Preliminary Estimates of Seroprevalence in Nigeria

Ciheb has completed the first phase of a new COVID-19 population-based serosurveillance study in the Nigerian states of Enugu, Nasarawa, and Gombe. 

A choropleth map showing the prevalence of H-I-V in Nigeria. It is green overall with darker spots in the south and southeast areas.

Involving Nigerian Health Facilities with National HIV Case-Based Surveillance

Ciheb in Nigeria introduced case-based surveillance and its implementation in the country to more than 130 health facilities and about 800 participants.

A small screenshot of several users logged into an ECHO meeting.

Seven-Nation ECHO Telementoring Project to Support COVID-19 Response in West Africa

Ciheb in Nigeria is helping support a multi-nation telementoring project that will better equip healthcare workers to respond to increasing COVID-19 demands in remote locations. 

A graphic with a red ribbon over a Nigerian flag and many numbers.

UMB Recognized for NDR Contributions in Nigeria

As part of World AIDS Day 2020 events, Ciheb Nigeria co-hosted a workshop focused on Nigeria’s progress toward HIV/AIDS epidemic control. The US Ambassador to Nigeria, Mary Beth Leonard, recognized UMB's efforts in her comments. 

New Toolkit Aids COVID-19 Response in Nigeria

Ciheb Nigeria has helped develop a toolkit to assist the Government of Nigeria on activating COVID-19 emergency operation centers at the sub-national or state level.

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Full NAIIS Report Now Available

On September 25, 2020, Ciheb Nigeria and representatives of the US Government formally presented the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS) Report to the Government of Nigeria.

COVID-19 Survey Launches in Nigeria

A new Ciheb-supported study is underway to assess the prevalence of COVID-19 in Nigeria. More than 200 staff are being deployed across the three Nigerian states of Enugu, Nassarawa, and Gombe to complete this ambitious survey in less than two-months’ time.

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COVID-19 Response in Nigeria

Ciheb is playing a key role in the coordinated global effort to address the COVID-19 pandemic in low-resource countries on the African continent. Read about our efforts in Nigeria.


Awards Support COVID-19 Response in Four Countries

Ciheb was awarded four grants from the U.S. Centers for Disease Control and Prevention to support COVID-19 response activities in Botswana, Nigeria, Malawi, and Mozambique.   


COVID-19 Surveillance in Africa

The Africa Centres for Disease Control and Prevention has been working to support African Union Member States to rapidly detect and respond to COVID-19.


Strengthening the COVID-19 Response in Nigeria

For five years, Ciheb has been helping strengthen Nigeria's disease surveillance and response capacity and has recently ramped up efforts in response to COVID-19.


Amplifying the ECHO Effect in Nigeria for High-Quality HIV Care

Ciheb has continued to implement the ECHO ModelTM at sites in Nigeria since its pilot project. Recently, in December 2019, Ciheb helped extend the reach of ECHO by hosting a three-day immersion training session in Abuja.


NAIIS Results Inspire Hope Featured Image

NAIIS Results Inspire Hope

The Nigeria HIV/AIDS Indicator and Impact Survey was one of the largest population-based HIV/AIDS household surveys ever conducted. NAIIS directly measured HIV prevalence and viral load suppression across Nigeria.


Research Examines Media Communication During a Disease Outbreak

During a disease outbreak, responders have multiple competing demands that require their attention. An analysis of the monkeypox outbreak in Nigeria demonstrates that communicating with the media should be among the top priorities. 




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