Before establishing Vactraca, a company that produces wearable vaccination trackers, Victoria Ndoh had over a decade of experience in product and project management within the international aid sector. She consulted for the World Bank, worked for the United Nations, UNICEF and the UK Department for International Development. In 2015, as part of her visits to health facilities in remote parts of Nigeria, the entrepreneur learned “hundreds of thousands” of infants were not completing their routine immunisation. Ndoh’s goal is to reduce the immunisation gap, and says the main reason for this was vaccination cards getting lost and mothers not remembering which vaccine their children received. She talks to AMAKA about why the current conversation about vaccines is unfair to Africa, and the hurdles and joy of entrepreneurship and innovation.  

Ndoh, 39, was born in Delta State, Nigeria, and moved to the UK, aged 19, to study international relations at London Metropolitan University before completing a master’s degree in sustainability management at Royal Holloway University. She embarked on a six-month internship at the United Nations to gain experience in international aid before starting her first paid job in Nigeria, working for the US-based NGO, Management Sciences for Health.

In 2020, she collaborated with immunisation specialists across Africa and industrial designers in Britain to design the Vactraca necklace, which is given to mothers on their last antenatal hospital appointment and they are asked to bring it on their next visit. The necklace, which has a pendant that contains the mother’s details can be worn as an everyday accessory and each disc represents an infant’s vaccine schedule ­— a hospital or home visit, and records all administered vaccinations. Designed with simplicity, the necklace can be used in remote places and with the help of a pen, a child’s immunisation history can be recorded. It complements the paper trail of a child's healthcare records and helps to improve vaccination record keeping.

The necklace was tested on mothers in Zambia, Nigeria, South Africa and the U.K. According to Vactraca’s website, it was also tested in private and public health facilities in Nigeria, and “99% of mothers” said they would like the necklace, so they can track their children’s vaccination uptake. Meanwhile, “100% of healthcare workers” said the necklace would “help improve record-keeping for routine immunisation” and increase the uptake.

Vactraca aims to work with partners including Gavi, The Vaccine Alliance and the Bill and Melinda Gates Foundation to close the growing immunity gaps through strengthening routine immunisation, and reduce the number of zero-dose children. According to the World Health Organisation (WHO), over 22 million infants missed their first dose of the measles vaccine in 2020, the largest increase in unvaccinated children in 20 years. 

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AMAKA: What triggered the idea of Vactraca, and what were some of the problems you recognised in early childhood healthcare on the continent, which you wanted to create a solution for?

Victoria Ndoh: While I was working at UNICEF’s health division there were many discussions about children skipping their routine immunisation due to lost or defaced vaccination cards. It’s heartbreaking to see they are missing out on vital life-saving vaccinations because of paperwork. 

The problem is not just in Nigeria, it’s across most middle-to-low-income countries in Africa and globally. My goal was to find a solution for a problem that has existed for many years, and I sat on the idea of Vactraca for nearly two years as I tried to figure out how to create an efficient product that solves or narrows the issue. 

Your goal is to reduce infant mortality rates one necklace at a time. Why is this the right solution and approach for healthcare challenges caused by the gap in immunisation in countries like Nigeria and across Africa? 

Having lived in Nigeria and the UK, it allowed me to compare the differences between healthcare systems. The UK uses a digital system to keep track of everything, but this is not the case in Africa. Being born in a certain country should not determine whether a child gets to live. On the continent, even if you were to visit another facility in the city you live in, the system is such that you would have to register there to receive treatment. So, it’s easy to see how this would create an unnecessary paper trail that ends up getting lost. This is why I wanted to empower mothers and create an item that makes them feel beautiful that they would want to keep safe, all the while storing key information that could save their children. This puts the power in their hands and for every necklace a mother wears, we prevent another infant's death. 

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Can you explain how the necklace works and what this looks like for mothers with more than one child?

The pendant on the necklace has multiple discs and each one represents hospital visits from birth to completion at 15 months, specifying which vaccine and dose the child should have. Generally, each necklace will have at least six pendants, but we customise the pendants for different countries, depending on how many vaccines are required. Mothers with more than one child can use the same necklace as each can accommodate up to four children if they are born on the same day. For instance, those with twins, triplets or quadruplets would need just one necklace. This was something that mothers and doctors requested from us, so we built it with them in mind.

How does Vactraca fit into the conversation of Covid vaccines, especially at a time of growing public vaccine hesitancy and distrust? 

I’ve listened to both anti-vaxxers and pro-vaccine people, and while everyone has a right to an opinion, the conversation is not fair. It’s about a choice, which many can’t afford at the consequence of death. A mother in the West can choose to not vaccinate her child, but this is not an option for those in Africa. Different climates have different necessities and there’s a higher risk for a child in Africa to contract polio, become deformed or even die – something we want to prevent.  

What obstacles remain with adopting solutions like Vactraca, and what’s next?

We need more open minds in the industry and better communication with the target audience because innovation is not a one-size fits all. Many come up with a tech-based solution, but this does not work for everyone. I realised during pitching that selling the product to investors could be challenging because while the necklace is innovative it’s tech-free with no batteries or WIFI required, it’s not a software but rather hardware. The majority of mothers we are targeting live in remote places, so innovation looks different to them, and we cater to their needs. You can’t give them a product that needs charging when they don’t have access to electricity. That’s why we simplified it so health workers can use a biro pen and ink mark the vaccine, write the date of completion or date of next visit. We are currently in talks with representatives of international organisations working in the maternal and new-born health sector and looking to partner with them to enter the market in Ethiopia, DRC, and South Sudan. We are targeting refugee mothers in the listed countries and other fragile countries across Africa. Vactraca is planning a large-scale pilot in five Nigerian states in collaboration with JHPIEGO – a non-profit organisation affiliated with Johns Hopkins University. 

Merging innovation and entrepreneurship can come with its own challenges, particularly in areas saturated with competition. What has your journey been like so far as an African and Black female entrepreneur? 

It’s important to acknowledge the help I have received since I started this journey. Having people around you who believe in you and your dream and want to help is key to success. Otherwise, I wouldn’t have the access or opportunity on my own. I pitched to University College London’s (UCL) business incubator to help actualise the product, and this made everything more enjoyable despite the hurdles. Joining an incubator was a blessing, I received many services, including a business adviser, mentor, advice from lawyers and accountants, for free.