In a recent incident that happened When 32-year-old Shafa’atu Isyaku noticed that her 4-year-old daughter, Maimuna, could not move her left leg, she took her to a primary health care centre in Kano State, north western Nigeria.
“I was worried because I had seen what polio could do to a child,” Shafa’atu says. “I wanted someone to examine Maimuna and tell me what was happening.”
Health workers assessed Maimuna and reported her symptoms through Nigeria’s disease surveillance network.
Surveillance officers then began an investigation to determine whether her condition could be linked to poliovirus or another cause.
Sudden weakness or paralysis in a child is known as acute flaccid paralysis. It can have several causes and does not necessarily mean that a child has polio. Every suspected case must be reported and investigated quickly so that poliovirus can be ruled out or detected early.
Nigeria was declared free of wild poliovirus when the World Health Organization (WHO) African Region received its certification in August 2020. But circulating variant poliovirus remains a public health threat, particularly in communities where too many children have missed vaccination.
Continued surveillance is needed to detect the virus quickly and guide a timely response.
From 24 August to 9 September 2026, Nigeria conducted an independent review of its surveillance system for polio and other vaccine preventable diseases.
The review covered 13 high priority states, 39 local government areas and 111 health facilities across the country’s six geopolitical zones.
The National Primary Health Care Development Agency and the National Polio Emergency Operations Centre led the review with WHO and partners in the Global Polio Eradication Initiative (GPEI).
Teams met government officials, health workers, traditional leaders, caregivers and community informants. They examined records, visited facilities and followed up reported cases.
The review included communities that may have limited access to health services, such as internally displaced people, migrants, nomadic communities, border populations and people living in conflict affected areas.
WHO provided surveillance expertise, supported field assessments and helped analyse the findings.
WHO also supports government led polio work through data analysis, training, coordination, community engagement and efforts to strengthen disease surveillance.
The evaluation revealed that over 95% of Nigeria’s surveillance network performed strongly across the assessed indicators.
At the same time, critical gaps were identified that may delay timely case detection, notably within secondary and tertiary health facilities, as well as among mobile, migrant and underserved populations. Analysis of reviewed acute flaccid paralysis (AFP) cases by gender indicated a distribution of 45% female and 55% male.
“Nigeria has made important progress in protecting children from polio, but maintaining those gains requires constant vigilance,” says Dr Pavel Ursu, WHO Representative in Nigeria. “This review provides evidence that will help the government target resources where they are needed most, strengthen surveillance in underserved communities and detect health threats earlier.
WHO remains committed to supporting government efforts to ensure that every child, regardless of where they live, is protected from vaccine preventable diseases.”
The review has given health authorities a clearer picture of where action is needed.
Government teams are developing corrective measures, including mapping migrant settlements and pastoral routes, improving population estimates and expanding case searches in places where routine services may miss children.
In conflict affected areas of north east and north west Nigeria, proposed measures include engaging retired health workers in case searches and immunization activities.
Satellite imagery may also help authorities estimate the number and location of people living in remote settlements.
The work supports the government’s National Polio Emergency Action Plan and its wider efforts to strengthen primary health care, immunization, disease preparedness and health security.
It also contributes to the Nigeria Health Sector Renewal Investment Initiative, which aligns government and partner efforts around national priorities, including stronger primary health care and disease preparedness.
It will also support implementation of Nigeria’s Integrated Disease Surveillance and Response framework and the country’s responsibilities under the International Health Regulations (2005).
Community informants and frontline health workers are often the first to notice and report possible cases.
“Many suspected cases are first reported by community members, traditional leaders or local volunteers,” says Dr Babangida, the state disease surveillance and notification officer in Kano State.
“When information reaches us quickly, we can investigate sooner and make sure children receive the support they need.”
For Shafa’atu, the value of the system lies in whether families receive a timely response.
“When your child is unwell, you want someone to listen and act quickly,” she says. “Knowing that health workers are looking out for children in our community gives families reassurance.”
Although polio was ruled out, Maimuna was referred for further medical treatment.
Executive Director of the National Primary Health Care Development Agency, Dr Muyi Aina says the findings provide a basis for targeted action.
“We are committed to acting on these findings and strengthening primary health care services to help protect every child,” Aina says.
Sustained government leadership, community reporting and coordinated partner support will be needed to put the findings into practice.
Parents and caregivers who notice sudden weakness or paralysis in a child should take the child to the nearest health facility immediately.
The external surveillance review was conducted with financial and technical support from GPEI partners.
Continued vaccination, early reporting and sustained investment in surveillance are essential to detect poliovirus quickly, stop transmission and protect every child.