Progress in the face of cuts: a qualitative Nigerian case study of maintaining progress towards universal health coverage after losing donor assistance
By: Uche Shalom Obi, Osondu Ogbuoji, Wenhui Mao, Minahil Shahid, Obinna Onwujekwe, Gavin Yamey
In the coming years, about a dozen middle-income countries are excepted to transition out of development assistance for health (DAH) based on their economic growth. This anticipated loss of external funds at a time when there is a need for accelerated progress towards universal health coverage (UHC) is a source of concern. Evaluating country readiness for transition towards country ownership of health programmes is a crucial step in making progress towards UHC. We used in-depth interviews to explore: (1) the preparedness of the Nigerian health system to transition out of DAH, (2) transition policies and strategies that are in place in Nigeria, (3) the road map for the implementation of these policies and (4) challenges and recommendations for making progress on such policies.
A review of corruption and accountability issues in Nigeria’s COVID-19 response: Implications for health systems governance
By: Prince Agwu, Nma Ekenna, Uche Obi, Tochukwu Orjiakor, Aloysius Odii, Enyi Etiaba, Benjamin Uzochukwu, Obinna Onwujekwe
Flexible and urgent health spending during public health emergencies distorts procurement processes and potentially encourages corrupt practices in health systems. This can erode public confidence, resulting to poor compliance to health safety measures during public health crisis. Thus, anticorruption in health, and in pandemic responses is key. COVID-19 related articles (reports from various government bodies and CSOs) on resource mobilization, appropriation, public perceptions towards accountability and anticorruption, were reviewed. Findings were organised under three themes: i) mobilized resources for COVID-19, ii) evidence of corruption or anticorruption in spending them and iii) implications for health systems governance.
A review of Nigeria’s health systems response to COVID-19: lessons for strengthening the health systems for improved service delivery
By: Chinyere Okeke, Chioma Onyedinma, Benjamin Uzochukwu, Obinna Onwujekwe
The COVID-19 pandemic has challenged the health systems of almost all the countries in the world. A strong health system is characterized by its ability to respond to emergencies while remaining resilient in delivering high-quality routine essential services promptly. This is not the case in most low- and middle-income countries, of which Nigeria is one of them, making them very vulnerable to COVID-19 pandemic. Prior to the pandemic, health systems had not received adequate attention. However, with this pandemic, the country’s leadership has made efforts to respond to reduce its spread. These efforts are worth documenting, as they will inform policymakers and other stakeholders in Nigeria to reflect on the ways to adapt and scale up the positive measures identified.
National Responses to COVID-19 in Nigeria: Data and Evidence to Support Health Preparedness and Responses
By: Obinna Onwujekwe and Chinyere Okeke
This presentation explores and compares responses in the two anglophone countries that together make up almost half the population of West Africa, Nigeria and Ghana. Drawing on desk reviews including media reports and policy documents as well as key informant interviews with key national and sub-national health sector decision-makers and implementers in the Covid 19 response timelines of interventions at central and local government level to address the pandemic, and observations as to how and why these interventions worked (or not), intended and unintended effects are presented. A qualitative exploration of whether the timelines of the waves from the epidemiological analysis and of the interventions show any similar patterns or not. Lessons from the analysis for the ongoing management of the present epidemic and any future pandemics are explored.
Health system responses and capacities for COVID-19 in Nigeria: a scoping review
By: Uguru, N., Ojielo, N., Ogu, U., Onah, S., and Ude N
Prior to the index case in 2019, there was no official preparedness plan on the ground of inadequate public awareness of COVID-19 in Nigeria. Health system financing and infrastructural development were at a very low point. This study aimed to find out information and determine the capacity of the Nigerian health system’s responses to COVID-19 in the country. A scoping review of media and official documents and journals, published from 1st December 2019 to 31st December 2020 was done. Other online news sources that have consistently reported health systems’ responses to COVID-19 in Nigeria, were also reviewed. The geographical scope of the articles were national and sub-national. The search was conducted in English and performed in PubMed, Google Scholar and Scopus.
Marketplace aspect of Primary Health Centres in Nigeria and its implication for health care delivery
By: Aloysius Odii, Obinna Onwujekwe, Prince Agwu, Pamela Ogbozor, Tochukwu Orjiakor, Eleanor Hutchinson, Dina Babalanova
Healthcare facilities are routinely regarded as fundamentally an institution or establishments housing local medical services or practices. In that sense, the enduring human interactions and economic transactions in these spaces are often overlooked. Yet, this could pose challenge to healthcare delivery and the overall intent to meet health-related goals. In this study, we narrate how health facilities operate as a marketplace and drew attention to its implication for healthcare delivery. Our description of the marketplace follows an economic anthropological perspective, which sees them as sites for complex social processes, instigators of cultural activity and realms for economic exchange.
Strategic health purchasing progress in sub-Saharan Africa and adjustments needed for health financing systems to become more resilient to pandemics
By: Obinna Onwujekwe, Nathaniel Otoo, Stella U. Matutina, Uchenna Ezenwaka, Augustine Kuwawenaruwa , Joël Arthur Kiendrébéogo
Strategic Purchasing Africa Resource Centre (SPARC) is a hub in sub-Saharan Africa that serves as a go-to source of information, support and capacity building for strategic purchasing to get better value for health spending to advance universal health coverage. Governance challenges which can be gross irregularities such as delays in provider payment, corrupt practices, and weak monitoring and accountability mechanisms, historical budgeting (not evidence-based), provider/purchase split and roles that are not clearly defined etc., affect the efficiency of health insurance schemes in Nigeria.