The establishment of Health and Demographic Surveillance system (HDSS) in Bauchi State North East Nigeria; baseline findings, challenges and lessons learned

Abstract

BACKGROUND: Bauchi State has a weak civil and vital registration system; hence the need for robust surveillance system. The Bauchi Health and Demographic Surveillance System (HDSS) was established in 2023 with support from Child Health and Mortality Prevention Surveillance (CHAMPS) network. Its purpose is to obtain reliable population data. OBJECTIVES: To establish a baseline demographic and health profile of the target community and to illustrate the feasibility and challenges of developing a high-quality HDSS in a resource-limited setting in Nigeria characterized by high mortality rates. METHODS: An initial household enumeration was conducted in 257 enumeration areas across eight contiguous administrative wards within the Bauchi and Ganjuwa Local Government Areas of Bauchi State. Following community awareness and field re-demarcation, prospective longitudinal follow-up was commenced. RESULTS: A total of 151,672 individuals in 23,476 households were enrolled. The population structure reflects a young population with 53.3% <15 years. The total dependency ratio is 104. Socioeconomic indicators show low formal education attainment and high unemployment (49%). Household conditions reveal substantial reliance on solid cooking fuels (78%) and on-site pit latrines. Implementation challenges included outdated maps, initial community mistrust, and data system instability. CONCLUSION: The Bauchi HDSS successfully established a surveillance framework which identified a young population with significant public health concern. It shows that it is possible to establish demographic surveillance system in a place with high mortality by using targeted strategies like getting the community involved, hiring local staff, re-demarcating the field, and building technical capacity.