Using Modeled Evidence in Nigeria’s Health System: understanding the gaps and promoting the value of evidence-based decision making

By Chinyere Mbachu, Prince Agwu, God’stime Eigbiromolen, Ifunanya Agu, Benjamin Uzochukwu and Obinna Onwujekwe
 
Statistics makes it possible to simulate real life behaviors using models, and this is termed ‘modeled evidence. Mathematical models that simulate different potential health scenarios around disease transmission, and/or the impact of policy interventions on health outcomes, can be valuable to decision makers. They can be used to prioritize and choose between complex trade-offs and ensure the best possible results in efficiency, effectiveness and impact of health policies and interventions.
Literature has shown that, although policymakers are aware of the need to make decisions that are based on scientific evidence, they do not regularly put this concept into practice. This is particularly the case with modeled evidence. Recent disease outbreaks and disasters have highlighted the need for a more proactive health system that anticipates and prepares ahead of health emergencies. At the onset of the COVID-19 pandemic, the Nigeria Center for Disease Control (NCDC) relied extensively on evidence from mathematical models to understand the trajectory of the epidemic and to develop an appropriate response strategy.
As the usefulness of modeled evidence gains more traction in the Nigerian health system, it is necessary to learn how policymakers can be supported to use modeled evidence in decision making. This could be achieved by examining the extent to which modeled-evidence is understood, valued and used by decision makers, as well as the factors/mechanisms that enable or constrain the translation of modeled-evidence to decision-making.

 

Figure 1: Translation of Modeled Evidence to Policy: Nigeria’s Ecosystem Canvas
 
The target audience for this policy brief comprises all the stakeholders in the modeling to decision making ecosystem, including modelers, decision makers, and knowledge brokers who facilitate exchange between them.
Click here to download and read the full policy brief.
Acknowledgement: This project was done in partnership with Results4Development and funded by the Bill & Melinda Gates Foundation.
Suggested citation: Chinyere Mbachu, Prince Agwu, God’stime Eigbiromolen, Ifunanya Agu, Benjamin Uzochukwu and Obinna Onwujekwe (2022). Values, gaps and getting evidence generated from modeling into decision making in the Nigerian health system. A Policy Brief from the Translation of Modeled Evidence for Decision Making project in Nigeria.

“The pandemic is not over, as its impact persists in Nigeria’s health system”: Professor Onwujekwe at the Congress of Postgrads’ Medical Fellows

By HPRG News
 
The effects of COVID-19 pandemic continue to bite health systems, particularly those of low-resource regions. Quoting the Organisation for Economic Co-operation and Development, “The COVID-19 pandemic has shown how vulnerabilities in health systems can have profound implications for health, economic progress, trust in governments, and social cohesion”. The question of strengthening health systems has been recurring since the pandemic and has gotten more answers than actions. However, the conversations must not cease, as it is needful to keep discovering and reminding ourselves of those areas in our health system that have been affected by the pandemic, while underscoring practicable solutions. It is in this regard that Professor Obinna Onwujekwe of the Departments of Health Administration & Management/Pharmacology & Therapeutics and the Health Policy Research Group, University of Nigeria delivered a lecture, titled “Impact of COVID-19 pandemic on healthcare delivery in Nigeria” at the 16th Annual Scientific Conference and All Fellows’ Congress of the Postgraduate Medical College Fellows’ Association that held at Eko Hotels & Suites, Victoria Island, Lagos in August 2022.

 

Figure 1: Cross-section of participants
 
Prof Obinna questioned the resilience of Nigeria’s health system for its failure to achieve the health-related MDGs and its slow pace toward the 2030 health-related SDGs targets. He showcased the indicators that reveal low-level access to quality healthcare services in Nigeria and minimal financial risk protection for health service users. He discussed further how the pandemic disrupted the delivery of essential health services like antenatal, post-partum, intrapartum care, family planning, vaccination services as well as treatment of non-communicable diseases, as health facilities were forced to shut down, some even shutting down unofficially. The impacts of this lack of resilience on morbidity and mortality cannot be overstated. For instance, UNICEF projected that an additional 950 Nigerian children might die every day from preventable causes over the next six months as the COVID-19 pandemic disrupted routine services. The figure below shows the steep downward dive in antenatal visits as the pandemic persisted:

 

Figure 2: Antenatal attendance fell drastically in 2020 compared to 2019 (MSDAT, 2020)
 
Click here to gain access to the full content of the lecture.
 
How to cite: Onwujekwe, O. (2022). Impact of COVID-19 pandemic on healthcare delivery in Nigeria. https://hprgunn.com/the-pandemic-is-not-over-as-its-impacts-persist-in-nigerias-healthcare-professor-onwujekwe-at-the-congress-of-postgrads-medical-fellows/