From the grassroots up: Redefining Public Health Surveillance in Nigeria through Community Action Networks

Background: Gaps in community-level surveillance continue to limit early detection of communicable diseases in Nigeria, particularly for zoonotic and emerging infections. Strengthening participatory, One-Health (OH)-oriented surveillance systems is critical for improving outbreak preparedness and response. The objective of this study is to evaluate the operational performance of Community Action Networks (CANs) in strengthening participatory, OH-oriented disease surveillance in Nigeria. Methodology: This was a retrospective program evaluation of the implementation of CAN under the West Africa One Health (WAOH) project. The project was conducted in eight Local Government Areas (LGAs) in five states. Community members (12- 15 per site) were trained in disease recognition, reporting, and risk communication using standardised tools. Surveillance data collected between January 2023 and March 2025 were analysed using descriptive and comparative approaches. Results: Eighty-six CAN members were trained. Between January 2023 and March 2025, 800 health events were reported across eight LGAs. Human health events accounted for 674 (84.2%), environmental events 62 (7.8%), and animal health events were infrequently reported. Reporting increased over time, with higher contributions from rural areas and substantial participation by female members (39, 45.4%). Most reports were channelled through District Surveillance and Notification Officers 559 (69.9%), indicating integration with existing surveillance structures. However, investigation and confirmation rates were higher for human health events compared to animal and environmental events. Conclusion: The CAN model demonstrates operational feasibility and potential to strengthen community-based surveillance and integration into national systems. Addressing gaps in animal and environmental health coordination will be essential for fully realising OH surveillance in Nigeria.