The first case of COVID-19 was reported in late February in Nigeria with a rapid increase in the following weeks. As the government and organizations funded by USAID and PEPFAR activated a cross-sectoral collaboration in response, the need for ventilators became clear.

In June, 200 ventilators donated by USAID arrived in Nigeria. Shortly thereafter, the FHI 360-led Meeting Targets and Maintaining Epidemic Control (EpiC) project supported the government to assess health care facility needs for ventilators. The assessment, conducted in 88 locations, revealed that although 350 ventilators existed in the country, many were broken or in poor condition.

The donated ventilators were distributed to 88 health facilities across all 36 states and the Federal Capital Territory. Then, 44 “master” trainers – select biomedical engineers and intensive care specialists from 20 facilities – were chosen and trained in use, installation, and preventive maintenance of the ventilators by Medtronics in collaboration with FHI 360 and the Federal Ministry of Health (FMOH). The trainings were conducted in two batches in Lagos and Abuja with participants getting firsthand experience in installation and use. Master trainers are now conducting step-down trainings with health care providers from all facilities that received ventilators.

The University of Portharcout Teaching Hospital is one of the facilities that has benefited from USAID’s ventilator program. This tertiary hospital in southern Nigeria received three ventilators and now has two providers trained to use them. Dr. Job Otokwala, an anesthetist there, described a recent experience with the ventilator: “I had an infant with pulmonary hyperplasia and pneumothorax with agonal breathing that I had to intubate. I had to use the ventilator with the oxygen concentrator to ventilate the baby overnight. The child pulled through and self-extubated next morning and sustained very satisfactory saturation before being discharged. Good product, perfect outcome.”

Previous investments by USAID and PEPFAR in Nigeria have helped position the government for an effective response to the COVID-19 pandemic. For example, through the Global HIV/AIDS Initiative Nigeria (GHAIN) and Strengthening Integrated Delivery of HIV/AIDS Services (SIDHAS), HIV service delivery projects funded by USAID and PEPFAR and led by FHI 360, the Infectious Disease Hospital Yaba in Lagos was renovated and upgraded in order to better respond to the HIV epidemic. In addition, the facility staff received trainings in infection prevention and control. These investments, coupled with the projects’ collaboration with the government of Nigeria on HIV epidemic response, guided the establishment of a COVID-19 isolation and treatment center at the hospital and its selection by the FMOH to receive two donated ventilators and capacitate staff on installation and use.

EpiC will continue to roll out the step-down trainings on use and maintenance of the ventilators with providers across Nigeria. As providers are trained, they are invited to join a community of practice on WhatsApp and use the messaging platform for ongoing mentoring and real-time peer learning. In addition, EpiC will introduce a simple-to-use performance monitoring tracking tool to support the FMOH in monitoring and evaluating the use of the ventilators.