COVID-19 containment and coordination strategies in Nigeria and lessons from four other African countries

COVID-19 pandemic will forever remain a major disruption of global activities and lifestyles. However, conversations have rapidly shifted from the dreadedness of the pandemic to the actions and inactions of systems in combating its spread and ameliorating its devastating effects. The pandemic appears to have affected different locations differently, of which there are clinical, public health, economic and social explanations to such dynamics. While it looks as though Africa has one of the least occurrences of fatalities arising from COVID-19, it is never in doubt that the continent has had its fair share of the effects of the pandemic, and some have indeed been extreme. Therefore, to encourage better health emergency responses, it is needful to reflect. The continent needs to look inward to understand its strengths, weaknesses, limitations, and prospects, for the purpose of improving its public health space and better positioned to challenge health emergencies, going forward.

Inspired by the African Health Observatory – Platform on Health Systems and Policies (AHOP), COVID-19 containment and coordination strategies across five African countries, including Nigeria, were evaluated. As quoted from an AHOP document: “[…] Threats of new variants loom and low vaccination coverage raises questions on the future of the response to COVID-19. Prevention remains the key strategy in most sub-Saharan countries. Below, five National Centres (NCs) from the African Health Observatory Platform on Health Systems and Policies (AHOP), based in Ethiopia, Kenya, Nigeria, Rwanda and Senegal, reflect on lessons to be learnt from their coordination and containment responses in the initial phases. They construct timelines to highlight the policies and challenges associated with introducing a range of public health containment measures and discuss the extent to which these measures continue to be valuable given the ever-changing nature of the pandemic.”

To read the report on COVID-19 coordination strategies across the five African countries, kindly click here to download

And to read the report on COVID-19 containment strategies across the five African countries as well, kindly click here to download

You can consider publishing a blog with HPRG. See image below for details.

Understanding the complementary relationships and roles of Integrated African Health Observatory (iAHO) and African Health Observatory Platform (AHOP)

The Ministerial Conference on Research for Health in the African Region, held in Algiers from 23 to 26 June 2008, adopted the Algiers Declaration renewing the commitment of Member States to strengthen national health research, information systems and knowledge management systems to improve health in the African Region. The Algiers Declaration offers a framework to narrow the knowledge gap and thereby improve knowledge generation and the use of knowledge to inform policies, strategies, and actions.

The World Health Organization (WHO) started work on health observatories in the African region in 2010 when it established the African Health Observatory (AHO).1 This followed the 2009 recommendation of the Regional Committee for Africa (AFR/RC59/5).2 In November 2012, during the sixty-second session of the Regional Committee for Africa (RC62) held in Luanda, health ministers of the African Region agreed to establish national health observatories in their respective countries and adopted the resolution entitled “The African Health Observatory: an opportunity to strengthen health information systems through national health observatories.” With the support of the AHO, several countries are developing their national health observatories (NHOs) to strengthen their national health information systems and promote the use of data for better action.

AHO is the regional observatory based and managed by WHO/AFRO. It brings together all the key information (Data – Analytics – Knowledge) on the WHO African region and on the 47 member states. It is a one-stop shop for standardized and validated information at both national and international levels with clear information on data sources. The NHOs are national declinations of the AHO and strengthen the national health information system. They thus contribute to reducing fragmentation and making key information available in a one-stop shop at national and sub-national levels. The institutional anchorage varies from country to country, but in the region, there are three groups: (i) integrated as a structure in the Information System/Planning Directorate of the Ministry of Health, (ii) integrated as a unit attached to the General Secretariat or the Minister’s Office, or (iii) integrated as a fully-fledged structure attached to the Prime Ministry.

Click here to download the full document

AHOP Writing Style

Researchers working across National Centres of AHOP are to write in a particular style that is consistent with the African Health Observatory Platform (AHOP) and World Health Organisation (WHO). The AHOP’s abridged version of the full WHO editorial style manual, which draws on the abridged style guides used by WHO Africa Regional Office (AFRO) and the European Observatory on Health Systems & Policies can be downloaded below. The style guide aims to ensure correctness, consistency, impartiality, and credibility across AHOP outputs, both electronic and print, and offers guidance on avoiding the most common stylistic errors. Please, note that this guide is a living document and will be adapted as further decisions are made on AHOP style across the various outputs. It is intended to be used alongside the full WHO Style Guide. Both Guides are expected to guide persons who write across the AHOP project.

Click here to download abridged AHOP Writing Style Guide

Click here to download the broader WHO Writing Style Guide

 

 

Scientists from the Health Policy Research Group, University of Nigeria rank highly on the globe – AD Scientific Index 2021

In a recent ranking of scientists on the globe, scholars from the Health Policy Research Group took top spots. Professors Obinna Onwujekwe and Benjamin Uzochukwu who are both academics at the University of Nigeria and founders of the renowned Health Policy Research Group clinched 1st and 3rd positions respectively, as top scientists in the University of Nigeria with over 3000 academic staff. The ranking is done by AD Scientific Index.
Prof Obinna Onwujekwe
At country-level, Obinna Onwujekwe ranks 3rd, 171 in the African region, and 39940 on the globe. Whereas, Benjamin Uzochukwu popularly known as BSC ranks 8th in Nigeria, 271 in the African region, and 54284 on the globe. Obinna and Benjamin are each with over 300 research items on ResearchGate, and combined citations of almost 34,000 as calculated by Google Scholar.
Prof Benjamin Uzochukwu
Interestingly, AD Scientific Index has moved beyond citations’ counts to focusing on the actual impact of scientific outputs which can be sourced by designing algorithms around i10 index, h-index and citation scores. You can read more on AD Scientific Index here. It is, therefore, right to say that the duo are impactful scientists, putting the University of Nigeria and the African Scientific Community on the map of global excellence.
Overall, 10 scientists from the University of Nigeria are within the top-100 in the country, and 6 made it to Africa’s top-1000. Their names include Chinua Achebe, Peter Akah, Nnabuk Okon, Joe Mbagwu, James Ogbonna, Martin Eze, Fabian Ezema, and Anthony Attama. You can find more here.
Interacting with Professors Obinna and Benjamin, it is evident that they do not intend to retire from their craft anytime soon. They have extended their wealth of knowledge to younger academics and researchers across the globe, and are indeed worthy models and mentors in the academic community. The Health Policy Research Group which is their brainchild is a no-brainer when it comes to research excellence. It is today, powered by the proteges of the Professors, some of whom are now Professors. Indeed, hearty congratulations to Professors Obinna and Benjamin on this deserving feat.

COVID-19 and crowding out of essential healthcare services: HPRG presents @ 37th Scientific Conference of the Association of Public Health Physicians of Nigeria

The Association of Public Health Physicians of Nigeria (APHPN) held its annual scientific conference at Abuja, Nigeria. The conference featured over 55 selected abstracts from a large pool of submissions. HPRG, under the African Health Observatory Platform (AHOP) presented a synthesis of findings from secondary sources on “crowding out of essential healthcare services amidst COVID-19”. The presentation was made by some members from the AHOP Nigeria Centre. They include Chinyere Okeke, Uche Ezenwaka, Chinelo Obi, Benjamin Uzochukwu, and Obinna Onwujekwe.
 
The well-researched presentation highlighted the huge burden of COVID-19 on the Nigerian health system, which overwhelmed health resources, with severe impacts on essential healthcare services (EHS). There were mentions of preventable health complications and mortalities that resulted from a somewhat overstretch of health resources. The scholars argued the need for a study of this kind to document the “why” of crowding out of healthcare services during disease outbreaks, and the responses that are expected. The implication of this study to the strengthening of health systems building blocks such as service delivery and governance cannot be overstated.

 

Click here to download the full presentation

 
Acknowledgement: African Health Observatory Platform (AHOP)

“Everyone!! wants to read a blog but your scholar-colleagues want to read your journal paper”: Research communication for wider reach

Prince Agwu & Obinna Onwujekwe

It is common to find editors of journals ask scholars to make their research papers appeal to a wider readership. By this, they imply that scholars should move away from a narrow lens, which could be their disciplines, communities or countries as target readers and users of their research findings. When these papers are finally published with a wider readership in mind, they might end up just with co-academics who are doing related studies or students researching around the subject. Hence, they circulate just within the academic walls, and at best, might fetch scholars some Google or Scopus citations and/or reads from ResearchGate. So, is that the reason we should publish our research?

If undergoing strenuous activities from research conceptualization to data collection, analysis and presentation, and at last, publishing in a peer-reviewed journal after tons of revision, would end up just with colleagues or researching students, then scholars might just agree to take off the “problem solving” description attached to the meaning of research. We know most persons within the league of the above-mentioned groups might not have the wherewithal to readily move our studies into practice. Thus, there is an urgent need to spread the “reach” of our studies and expand their ends to attract practicable impacts that should be the highest fulfilment for scholars. And if we must start this conversation, we should begin by asking ourselves this question – who reads our research?

Blogs or Publications??

We should be frank enough to accept that many of our students will happily read a news editorial than our publications just because they would not want to be fixed in an academic hotbed which our publications reflect. A handful will prefer to read novels than our 15-paged publications, for the obvious reason that they seem to have a dislike for the stress academics puts them through which we know is typical of publications. Besides, we might have noticed that the many in-text citations that dot our publications are scary to these groups of non-academics but sits just fine with academics.

Have you ever tried to pass a publication to a politician, a public office holder, or an important community actor? Have you tried to gauge their reactions, especially in climes like Africa where reading is “death” to many? Yet these public office holders and community actors would happily read a simple writeup published in a daily or a Facebook post or one of these shared writeups on WhatsApp. And we know that most of these public office holders and community actors are important stakeholders in the practical utilization of the knowledge from our studies. When they are well involved, they can help push knowledge from our studies into physical realities. Therefore, appealing to these groups of persons should be a vital part of our research, and in this article, we share the sentiments that blogs can do the job.

Quick stats!!

In 2018 and 2020, we published two articles in The Conversation a famous blog outlet, while the larger study was published in Health Policy and Planning a popular health policy and systems research journal. We discovered that as of April 2021, each of our articles in the blog outlet got over 6200 reads and counting, while the journal article got below 4500 page views and not up to 1000 downloads, even that it was published before the second blog article. See images below:

Statistics of readership from The Conversation
Statistics of views from Health Policy and Planning

Are scholars bothered?

In a study, scholars agreed to declare an academic emergency in the world of scholarship. They said, scholars must come together to discuss among themselves the need for seamless research communication, condensing research outputs into easy-to-read formats. These professionals shared the sentiment that their studies are often for a clique of co-academic, even when they know that non-academic groups and policymakers would immensely benefit from the wealth of knowledge and evidence their researches offer. They cited that the journalist would easily reach the hearts of communities and policymakers than the academic because of the seamless and easy-to-read way they adopt in the communication of knowledge. Interestingly, they had a consensus to evolve their research communication by introducing formats with which the public can easily relate, and they include blogs, infographics, cartooning, animation, filming, etc. Unfortunately, most academics are not inclined to these outlets.

Doing blogs is never less professional!!

Scholars are known for jargons, and you can find many of them in their published studies. We know how jargons stall the passage of information. So, a health scientist might be interested in econometrics, then he or she stumbles on a paper in that regard but gets discouraged to read further because the concepts are too high and difficult to relate with. This is where the power of a blog is made manifest. It is a rule of thumb that blog writers should have a college fresher in mind. The jargons and the high-handed knowledge must be condensed to what the college fresher can read and grasp.

Would scholars not be pleased if the big concepts are made so understandable to all? Please, we do not attempt to neglect the importance of keeping the writing professional and appealing to peers on that level but we feel that there is more to just the academic community. You can try to issue an editorial from a daily and a journal publication to your teenage son or daughter, and judge which will appeal more to them. Stretching the readership of our publications beyond our academic colleagues to the non-academic groups is an evolving responsibility for scholars. And blogs aim to marry these ends, which in turn will benefit the expansion and practicability of our research.

We cannot deny that there is a rapid change in the academic industry with a focus on research communication. We have seen big agencies sponsoring blog outlets and academic institutions building blogs into their various academic communities. Amidst these changes, many are yet to embrace this evolution. A core reason is that these blogs might not count as a part of their promotion criteria or that blogs do not reveal them in their professional regalia, because of how common and down-to-earth the blog writer is forced to sound.

Getting promoted is a good sight and revelling in your professional regalia through the appropriate use of jargons and concepts could account for a quality scholar. But should it be all about ourselves? Should we not think of our research impacts transcending beyond the academic walls? Are we comfortable being known, respected and hailed just among co-scholars? Are we concerned about those who need “quick-reads” and not our “too serious” academic papers? Also, are we fair and just knowing that our academic publications could be closed-access and so much money needed to gain access?

We conclude!!

Have you ever wondered what it would look like if your students come to class to celebrate your piece published in a blog that they found on Twitter? Or a village-head expressing gratitude for your article he or she read on a daily? Or a policymaker talking about how your blog was a quick go-to while in a meeting where important decisions were reached? And importantly, that our condensed research outputs in blog formats increase accessibility for those without the money to pay “subscription fees” to quality studies? We believe it will make more sense to you to share a blog link to the WhatsApp group of your community chiefs than to share an academic publication there, and you can tell the reason if truthful to yourself. It is important that academics come to know that the academic community is not just the target end for research, and there is more to the “reach”. And in that “more” lies the ultimate!

Obinna Onwujekwe is a Professor of Health Economics, Systems and Policies at the University of Nigeria Enugu Campus. He is the Chief Editor of the African Journal of Health Economics, and the Coordinator of the Health Policy Research Group, University of Nigeria. He also coordinates the African Health Observatory Platform (AHOP) for Health Systems, Nigeria Center.

Prince Agwu is an academic at the Department of Social Work, University of Nigeria and a research associate at the Health Policy Research Group, University of Nigeria. He holds a Commonwealth PhD Position at the University of Dundee, Scotland, and he is the Communication Lead for the African Health Observatory Platform (AHOP) for Health Systems, Nigeria Center.

See our call for blog articles:

Strengthening Health Systems and Policy Research in Nigeria: African Health Observatory Platform [AHOP] Nigeria Centre meets with Partners

The Nigeria National Centre of AHOP (Health Policy Research Group, University of Nigeria) held a two-day inaugural with their three National AHOP Partners- The Nigerian Institute of Medical Research (NIMR), Veritas University Abuja and the Association of Public Health Physicians of Nigeria (APHPN), from 02-03 December 2020. The AHOP concept, goals and objectives were shared with the partners. The partners also shared their previous and on-going experiences of generating Health Policy and Systems Research (HPSR) evidence and getting research into Policy and Practice (GRIPP). This was followed by a brainstorming session, to propose tasks in the next steps to generate evidence with a focus on Universal Health Coverage. Partners committed to, in the first instance, developing a clear institutional framework for engaging with AHOP over the project period and beyond, identifying current strengths, weaknesses, and ideas for further capacity building. The Nigeria NC is happy to have been able to eventually hold this meeting, which was originally scheduled for April, 2020 but cancelled due to the COVID-19 pandemic restrictions.

Present at the meeting were:

Obinna Onwujekwe – Health Policy Research Group, University of Nigeria

Benjamin Uzochukwu – Health Policy Research Group, University of Nigeria

Enyi Etiaba – Health Policy Research Group, University of Nigeria

Chinyere Mbachu – Health Policy Research Group, University of Nigeria

Chinyere Okeke – Health Policy Research Group, University of Nigeria

Chikezie Ifeanyi – Veritas University, Abuja, Nigeria

Olushola Oluwatosin – Veritas University, Abuja, Nigeria

Adewale Ojogbede – NIMR

Babatunde Adewale – NIMR

Ajuba Miriam – APHPN

Ugwusina Nwachukwu Chinedu – APHPN

Ossai Edmund – APHPN

It is expected that the partners will work together with the HPRG-UNN to scale up the collection and synthesis of data and information on health policy and system for evidence-based strengthening of Nigeria’s health system. Overall, the aim is to move data and information from the point of rhetoric to policies, strategies, and practices.

Press Release from the African Health Observatory Platform on Health Systems and Policy (AHOP): Knowledge brokering platform launched to support health systems in the African region

Presented on 23/11/2020

The World Health Organization (WHO) and partners launched an online platform today to promote the exchange of evidence and experience across countries in the African region. By working to foster evidence-informed decision-making in an endeavor to re-engineer health service delivery, the initiative is expected to drive countries’ health system resilience efforts.

The African Health Observatory Platform on Health Systems and Policy (AHOP) aims to facilitate cross-country learning and accelerate the uptake of high-quality evidence and experiences reflecting the complexity and diversity of the region. This knowledge translation effort will ultimately help strengthen national and regional health system design and performance.

“This is a significant step. So much data and research in Africa is produced, but not always shared,” said Dr Humphrey Karamagi, the Team Leader of Data, Analytics and Knowledge Management at WHO Regional Office for Africa. The experience-sharing occurring between countries on all types of health conditions could be used to deliver services that people are actually asking for.”

Leading public health research institutions in Ethiopia, Kenya, Nigeria, Rwanda and Senegal are generating knowledge through the collection, analysis and synthesis of evidence for use by decision-makers at national and regional levels. Through frequent policy-maker input and engagement, AHOP seeks to respond to policy needs with timely support and reliable evidence tailored and packaged in ways that are useful and usable for policy-makers.

Outputs range from country-specific profiles covering health systems and their performance, to policy briefs on topical issues requiring evidence to guide decision-making. It is expected that the number of national centres will rapidly expand to bring more countries and institutions on board.

A consortium of technical partners, including the London School of Economics and Political Science and the European Observatory on Health Systems and Policies, support the national centres in producing locally-led analyses. The WHO Regional Office for Africa ensures regional relevance of the different analyses.

AHOP complements the larger WHO integrated African Health Observatory (iAHO), currently the most comprehensive, freely available online repository for data, analytics and knowledge on health for decision-makers, researchers, stakeholders and citizens in the region.

“By adding the knowledge component, we want to provide a one-stop shop that will bridge the gap between research and decision-makers to accelerate the progress towards access to affordable and quality health services,” Dr Karamagi said.

This joint initiative is supported by grants from the Bill & Melinda Gates Foundation.

(END)

The new AHOP platform can be accessed with the link https://af-aho-ahop.azurewebsites.net.

Join us for the webinar on Monday 23 November @ 15:00 to 17:00 (Brazzaville time)

To register for this webinar use the zoom link below: https://who.zoom.us/webinar/register/WN_aZ_LnMjwQN22N-kHIjYSZg

password 2a#6^sGh.

Media contacts:

WHO AFRO:

Collins Boakye-Agyemang

Communications Officer

boakyeagyemangc@who.int

Tel: + 242 06 614 24 01

LSE:

Charles Ebikeme

Policy Officer

C.Ebikeme@lse.ac.uk

Tel: +447305415904

European Observatory on Health Systems and Policies:

Maebh Ni Fhalluin

Communications Officer

nim@who.int

Quotes:

London School of Economics

“We welcome the opportunity to work with the programme partners to foster national, regional and global knowledge exchange and dialogue on health systems.”

Elias Mossialos, LSE Head of the Department of Health Policy

European Observatory on Health Systems and Policies

“As Chair of the European Observatory on Health Systems and Policies, and on behalf of the partners, I am delighted that we have been able to work with colleagues in the WHO Regional Office for Africa, at LSE and from the Bill and Melinda Gates Foundation on this important initiative. We hope that by sharing our experiences of how to make evidence work for policy makers we can strengthen AHOP’s knowledge brokering and in turn, learn from them how to strengthen our own practice.”

Liisa-Maria Voipio-Pulkki, Chair of the Steering Committee of the European Observatory on Health Systems and Policies

Click the link to download the Press Release – AHOP_launch_PR_final_EN

Call for Expressions of Interest (Updated): Implementation research to strengthen data systems for immunization coverage and equity (IR Accelerator) Initiative

This is a call for expression of interest (EOI) from implementer-led research teams who wish to undertake implementation research that will contribute to strengthening data and information systems for immunization coverage and equity in Nigeria.

We are seeking to fund up to eight (8) implementation research projects that will contribute to improving our understanding of the challenges and solutions for improving immunization data and information systems in Nigeria. Hence, the research projects will provide evidence on the real world factors that impact/influence the quality of immunization data, and potential strategies for addressing implementation bottlenecks and accelerating immunization coverage and equity.

Background

Nigeria has the highest number of unimmunized children in the world, estimated at 4.3 million in 2018. The coverage of DPT3/Penta 3 fell from 52% in 2014 (SMART) to 33% in 2016 (MICS/NICS). Hence, millions of infants are vulnerable to serious health and nutrition threats because they miss out on basic vaccines. In order to better understand how to reach these children and their families, locally relevant evidence is needed.

Implementation research (IR) can help us generate locally relevant evidence and useful information to better understand and address key challenges faced by the National Programme on Immunization (NPI) in Nigeria1.

The Implementation Research (IR) Accelerator Initiative is part of a collaboration between the Alliance for Health Policy and Systems Research (the Alliance), UNICEF and Gavi (the Vaccine Alliance) which has a twofold objective to promote: i) the generation of high quality, relevant and usable implementation research on data and information systems for immunization; and ii) the application and use of the evidence to address implementation bottlenecks and accelerate impact on coverage and equity.

The Health Policy Research Group (HPRG), College of Medicine, University of Nigeria Nsukka (Enugu-Campus), is the Technical Support Centre (Mentor Institution) for the Alliance in stewarding the Implementation research initiative that was informed by research priorities proposed by a broad range of Nigerian stakeholders.

Read the full call here – Updated Call for EOIs on Implementation Research in Immunization Data Systems _ Nov 26

Mobilisation and deployment of resources for the COVID-19 response in Nigeria: a view with transparency, accountability and anti-corruption lenses

By Obinna Onwujekwe & Prince Agwu

In a previous article of ours, we raised concerns about weak accountability and corruption possibly getting in the way of Nigeria’s response to COVID-19. We cited the report of Transparency International on how corruption affected West Africa’s response to the Ebola epidemic, hoping that the lessons learnt will inform the responses to future pandemics in Nigeria.

There were predictions that the COVID-19 experience will surely not leave Nigeria’s health system in the manner it has always been. Even though the predictions were not clear on if the health system in Nigeria will head in the right or wrong direction. However, the evidence is that the health system is not getting strengthened due to a myriad of factors including poor coordination between the different levels of government, opaque accountability systems, and poorly responsive systems, amongst others.

The accountability mechanisms of these funds are not clear and citizens do not really feel the impact of the resources and there is a seemingly lack of trust in the public sector. This is pertinent because since the pandemic, we have heard on the streets of Nigeria how COVID-19 is a disease for the rich and/or a ploy by the political elites to siphon funds as it is considered customary to them. What we have seen is the outright discard of measures to stem the spread of coronavirus, as the average Nigerian seems to have rather given up on the government, but more concerned about their daily economic survival. We saw how this played out during lockdown, with Nigerians conniving with the Police to defy government directives to stay at home and even threatened to protest continued lockdown after an initial extension.

Now, easing the lockdown has seen a surge in coronavirus cases and deaths, difficulty to contact-trace, few citizens tested, and life seems to have returned to normal, yet Nigerians are largely unbothered. The question is, do we blame Nigerians for taking such position of survival and carelessness at the same time? Elizabeth Donelly of the Chatham House importantly and emphatically said that citizens’ trust is key if the Nigerian government must tackle COVID-19. But with emerging revelations of corruption and weak accountability, the question about trust is answered by the current defiant actions of citizens which seem to compromise responses to containing the virus, as well as the rage and piling of court cases spearheaded by Civil Society Organisations (CSOs) against the government within this time.

For a start, the primary healthcare (PHC) system seems to have been hardly involved in the fight against COVID-19. The scare of the virus has rather inspired low patronage, with concerns for Universal Health Coverage. This is in contrast to the active roles of the primary healthcare in Rwanda, Cuba and Thailand. What rather happened in Nigeria was a massive slash of the Basic Healthcare Provision Fund expected to revamp primary healthcare, which is direly needed during a pandemic as this one, as against a smaller cut in the appropriation meant to renovate the National Assembly Complex.

At a time when countries are making conscious efforts to spend in health, and particularly, human resources for health, health workers in Nigeria have severally indulged or threatened to indulge industrial actions within this time, protesting against neglect and failed promises. Yet at the same time, a single commission in the country shared over N3bn as COVID-19 relief funds among its staff, and federal-level legislators reportedly took delivery of 400 exotic cars at a price of over $20,000 for each.

Since the onset of the pandemic, the Federal and State governments of Nigeria have received cash and kind donations from both private and public donors, of which the cash component alone exceeds NGN230 billion[1]. At the same time, the FGoN’s 2020 health budget was increased by more than 13% from the previous year’s budget[2].  Additional resources that were mobilized include $12 million donated by the Global Alliance for Vaccines and Immunization (GAVI) for health worker training, commodities supplies, surveillance, communication and coordination, etc[3]; some of the over NGN 30 billion raised by the Coalition Against COVID-19 (CACOVID)[4]; and 100 million grant from the World Bank to each state.

Of keen interest to Nigerians, are donations made to the government in the fight against COVID-19. At some point, citizens were worried about making such donations to a government they do not trust, rather than channelling directly to the poor and less privileged who are littered all over the country. In later events after the country moved into a post-lockdown, citizens were seen breaking into warehouses to cart away donated palliatives (food items) mainly from the private sector. The citizens expressed shock and disappointment at the  much quantity of items that were allegedly hoarded by the leaders, even as they have been faced with harsh economic impacts from Covid-19 all the while.


[1] https://civichive.org/covidtracka/donations/

[2] https://yourbudgit.com/wp-content/uploads/2020/03/2020-Budget-Analysis.pdf

[3] https://www.gavi.org/sites/default/files/covid/Gavi-COVID-19-Situation-Report-15-20200811.pdf

[4] https://www.cacovid.org/pdf/list_of_contributors_to_the_cacovid_relief_fund_as_at_30_June_2020.pdf

The news of distrust, corruption and weak accountability have been rife in Nigeria within this time. From the distribution of N20,000 cash to some 2.6m poor Nigerians in 10 days, and the feeding of pupils in lockdown with N500m, all seem to have raised serious concerns about accountability, thus, seeming to confirm the fears of Nigerians. Heightened distrust about spending from the Humanitarian Ministry forced the National Assembly to call the Ministry to explain the figures they have in the public domain, including the steps they took to identify poor Nigerians who benefitted from the palliatives. Despite interventions from the National Assembly and public concerns, little or nothing is done to effectively open up activities of the Ministry to public scrutiny.

A cesspool of corruption in Nigeria is procurement. It reflects the saying by Patricia Garcia “with more money comes more corruption”. One might want to believe that Patricia made the statement with Nigeria in mind. COVID-19 brought about the need to procure certain items in bulk, particularly facemasks, hand sanitizers, disinfectants, among other personal protective equipment. At the onset of the pandemic, most of these items were in short supply, and the compulsory need for them led to increased spending in that direction. Expectedly, a hub for corruption seems to have emerged.

The Open Treasury Portal which government built to feed Nigerians information concerning COVID-19 funds appears to be a work-in-progress, as some important pages do not open. It as well does not give any detail concerning procurement, rather it provides information on bank transactions which amount to insufficient.  There is also the CovidFundTracka which only spells out what is donated to the country but not what is spent. Although there is a guideline for COVID-19 procurement as published by the Bureau of Public Procurement, the document seems more rhetoric than action.

Consequently, Civil Society Organisations (CSOs) try to ask questions and monitor government spending, of which the revelations of possible corruption have been quite revealing. The Ministry of Health is implicated in the purchase of facemasks for about N20,000 ($52) per one and awarding of supply contracts without evidence of competition and bidding. The Federal Road Safety Commission was equally said to have purchased a bottle of 500ml of hand sanitizer for N5,600 ($14) as against the most expensive cost price of N3,000 ($7). Many public agencies  in both within and outside the health sector have all been implicated in the possible poor procurement practices in the fight against COVID-19.

If there is a time Nigerians expect transparency and accountability from the various government Ministries, Departments and Agancies that are involved in the COVID-19 response, it is now. The pandemic places moral responsibilities on governments to get concerned with the affairs of citizens and not further create conditions that will escalate distrust. Nigerian government across all levels should see to it that they win back the trust of citizens by an application of the “rule of law”, and not “rule by law” which has largely been the case. A lot depends on the trust of citizens in their government during disease outbreaks, particularly concerning community engagement, resilience and effective response. These are areas where Nigeria keeps lacking. No doubt that trust is key to reviving these cardinal areas in disease response. It is hoped that Nigeria learns and at least puts forward a sincere, transparent and corruption-free approach in addressing the pandemic onward.

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Obinna Onwujekwe is a Professor of Health Economics, Systems and Policies in the University of Nigeria Enugu Campus. He is the Chief Editor of the African Journal of Health Economics, and the Coordinator of the Health Policy Research Group, University of Nigeria. He coordinates the African Health Observatory Platform (AHOP) for Health Systems, Nigerian Center.

Prince Agwu is an academic in the Department of Social Work, University of Nigeria and a research associate in the Health Policy Research Group, University of Nigeria.