By Janet Thomas

In early March 2020, just days before Nigeria imposed its first COVID-19 restrictions, a rapid community survey was conducted in Onitsha, one of West Africa’s busiest market cities. Led by Dr. Nchebe-jah Ilaonusi, an international medical graduate and public health researcher, the study asked 140 adults a few basic but vital questions: what do you know about the virus, how do you feel about it, and are you taking recommended precautions?

The answers provided a rare ground-level snapshot at a critical moment. They also went on to shape how Nigeria, beginning in Anambra State designed public health interventions during the pandemic.

Why Onitsha Mattered

Onitsha’s significance was obvious. Its dense markets, daily cross-border movement, and crowded living conditions made it a likely hotspot for viral spread. By administering surveys in English, Igbo, and Nigerian Pidgin, Dr. Ilaonusi and his team reached traders and workers who are often excluded from online or formal polling. This created a more accurate picture of how everyday Nigerians understood the threat.

What the Survey Revealed

The findings painted a mixed picture. While 60.7% of respondents scored in the “high knowledge” range, key behaviours lagged: only 32.1% reported wearing masks, 37.1% said they would self-isolate if symptomatic, and 41.4% said they would call the Nigeria Centre for Disease Control.

Education and occupation emerged as critical factors. Respondents with a bachelor’s degree or higher were seven times more likely to demonstrate strong knowledge compared to those with only primary education. Traders, business owners, and the self-employed; the very backbone of Onitsha’s market economy were significantly less informed than civil servants and health workers.

Equally striking was what people wanted to know. While 60% asked about the cause of COVID-19 and over 55% about treatment options, far fewer sought practical steps such as how to respond when symptoms appeared. This revealed a crucial “what do I do now?” gap in public communication.

From Research to Policy: Implementation in Anambra and Beyond

What began as a localized survey quickly evolved into a tool for shaping public health responses. Working in close collaboration with Dr. Vincent Okpala, then Commissioner for Health in Anambra State, Dr. Ilaonusi ensured that the findings were translated into practice.

Targeted Market Interventions: Instead of relying solely on radio jingles, the Ministry of Health partnered with market associations and community leaders to run hyper-local campaigns in Igbo and Pidgin, tailored to traders’ realities.

Mask Use and Isolation Messaging: The state piloted mask distribution drives that included simple, repeated instructions on usage. Public hotlines were revised to give step-by-step guidance rather than general alerts.

Economic Sensitivity: Recognizing that traders were unwilling to self-isolate without support, the findings fed into palliative measures that provided stipends and food supplies, making compliance possible without devastating livelihoods.

Replication and Scale-Up: Beyond Anambra, elements of the study influenced Nigeria’s wider health communication guidelines. Its methodology also became a reference point for other states and urban centers conducting rapid knowledge-attitude-practice (KAP) surveys.

A Researcher Bridging Science and Policy

Dr. Ilaonusi’s role in shaping Nigeria’s COVID-19 response highlights his ability to bridge academic research with practical governance. His profile goes beyond public health: he is currently an Adjunct Assistant Professor at the City University of New York, College of Staten Island (CUNY CSI), where he teaches Biology, Anatomy, and Physiology while mentoring STEP students in surgical pathways. He is also pursuing a Master’s degree in Healthcare Management at CUNY CSI.

In addition, he is part of Shen’s Lab, where he advances biotech research on biosensors and spearheads pioneering studies on the effects of Cri-Du-Chat syndrome on speech retardation. This blend of international academic engagement and direct impact on Nigerian health policy underscores his standing as both a researcher and a practitioner.

Lessons for Policymakers in Africa

The Onitsha study continues to offer insights for Africa at large:

1. Target High-Contact Economies: Market traders and transport workers must be at the center of outreach.

2. Translate Knowledge into Action: Campaigns should focus less on abstract explanations and more on clear, practical instructions.

3. Pair Compliance with Support: Economic realities must be addressed if behavioural change is to be sustained.

4. Scale Rapid Assessments: Localized, real-time surveys should become a regular feature of outbreak preparedness.

Conclusion

Though the survey involved only 140 participants, its influence was outsized. By identifying gaps in knowledge and practice, and by shaping concrete policies in Anambra that later fed into Nigeria’s national COVID-19 response, Dr. Ilaonusi demonstrated the power of localized research to transform public health strategy.

The lesson for Nigeria and Africa is clear: ground-level data, when paired with responsive governance, can strengthen pandemic preparedness and ensure that public health policies are not only well-designed but also rooted in the realities of the people they are meant to serve.