Nigeria’s health system is on a path of growth and keeps evolving. Information about the country’s health system is fragmented, which has occasioned the need for rapid harmonization led by the African Health Observatory Platform (AHOP). The Country Health System and Services Profile (CHSSP) will provide an in-depth description and analysis of Nigeria’s health system and services. It is likewise being conducted in Rwanda, Senegal, Kenya, and Ethiopia, which will provide the basis for comparing the health system and services’ performance across these five countries. The CHSSP is designed to be a key reference document for a wide audience including country-level policy-makers, technical staff, researchers, and development partners. They are intended to provide relevant country-specific and comparative information to support policymaking, analysis, and implementation of approaches related to the re-engineering of health systems and services in the African region.
To commence documenting Nigeria’s CHSSP, the Health Policy Research Group (HPRG), University of Nigeria, which hosts the Nigerian National Centre of AHOP conducted its kickoff meeting to prepare authors for the task ahead. The meeting took place at Hotel Sylvia, Enugu, from 13th – 15th June 2022. Partners with the HPRG on the CHSSP project were in attendance, and they include Veritas University, Association of Public Health Physicians of Nigeria (APHPN), Nigeria Institute of Medical Research (NIMR), Federal Ministry of Health, Nigeria (FMoH), and a representative of the World Health Organisation.
Nigeria’s CHSSP Authors
During the meeting, Dr. Enyi Etiaba who is the Project Manager of AHOP in Nigeria emphasized the overall goals of AHOP in the directions of knowledge synthesis and evidence translation, as she stated that the CHSSP is one of the outputs of the stated goals. She used this opportunity to ensure that all CHSSP authors are aligned with the ideals of AHOP, even as they work on the CHSSP project.
Dr Enyi Etiaba introducing AHOP and CHSSP
Documenting the CHSSP will need a uniform reference manager. The gathering was an opportunity for all authors to run through the endnote reference manager, as the approved reference manager for CHSSP documentation. Facilitated by Dr Chinyere Mbachu, authors successfully downloaded the endnote reference manager, went through step-by-step process of uploading reference materials and sources into it, and could make citations as they write. Authors are expected to make use of the Harvard Referencing Style throughout their writing.
Dr Chinyere Mbachu facilitating a session on Endnote reference manager
In addition to the above, CHSSP authors were introduced to the AHOP writing style by Dr Enyi Etiaba. Important points to note include the use of British style (e.g., use organisation instead of organization), dates should be written without punctuation signs, large figures should be written using spaces as against commas, health care should be written as “health care” and not “healthcare”, hyphenate “evidence-based” when used as an adjective but write without the hyphen when used as a noun, etc. Click here to download AHOP writing style guide.
At about noon time, authors had a virtual meeting with the CHSSP Editors from the London School of Economics (LSE) and WHO-African Region (WHO-AFRO). Concerns drawn from the 11 Chapters of the CHSSP were listed and clarified. The 11 chapters comprise the overall context of Nigeria; organization and governance of the health system; health financing; health workforce; medical products and health technologies; health infrastructure and equipment; service delivery; health information and information systems; performance of the health system (outputs); health services coverage and system outcomes; conclusion and key considerations. The meeting with LSE and WHO-AFRO helped resolved grey areas. It was agreed that authors should keep in touch with the Editors as they write, and lead authors will participate in a monthly meeting with LSE and WHO-AFRO for the duration of the writing stage of the CHSSP project. Also, the overall lead author from the National Centre must go through submissions before they get to the Editors.
Cross-section of CHSSP Authors meeting virtually with LSE and WHO-AFRO
Authors agreed with the Editors on the need to concentrate on national-level data given the timeframe of production and AHOP’s concentration on secondary sources of data. To help the authors, there are some materials in the SharePoint for this project. All authors now have access to the SharePoint. It was also agreed that more time will be allotted to the completion of Chapters 9 and 10 since they are dependent on the completion of the fore chapters. Authors were reminded to concentrate more on the Excel spreadsheet for needed information than the writing template, as some information in the latter may be wrong. Click to download the slides of LSE/WHO-AFRO
According to Professor Obinna Onwujekwe who heads the HPRG and leads the AHOP Nigerian National Centre, the CHSSP when concluded will be both means and end, in the sense that its recommendations will be used for health system strengthening towards the achievement of the health-related SDG targets, especially Universal Health Coverage (UHC) in Nigeria. As a means, it will also serve as evidence-base for the development of the 3rd National Health Sector Development Plan (NSHDP III), a resource for the planned Nigeria Health Sector Reform Programme and the national UHC plan. It will also provide the required information for the development or revision of policies and strategies in the health sector in Nigeria.
Prince Agwu commented on the dissemination of the CHSSP, which will target academia, policymakers, frontline practitioners, communities, media, and civil societies. Strategies for dissemination will keep evolving and will be cross-sectoral.
More on capacity building, CHSSP authors were taken through data sourcing strategies by Prince Agwu and Uche Ezenwaka. The use of Boolean Operators, introduction to new search engines and databases and the use of keywords were discussed extensively. Uche introduced CHSSP authors to janebiosemantics. On specific data from the Federal Ministry of Health, Martins Otuamah took CHSSP authors through specific databases that will be of help in the documentation process. And finally, on capacity building, Prof BSC Uzochukwu, an HPRG and AHOP National Centre lead took authors through academic writing and production of policy briefs. Authors were exposed to non-linear methods of academic writing and the rationale behind building quality academic arguments. This was one of the high points of the CHSSP meeting.
In all, the National Centre is looking forward to 7th July 2022 for first submissions, and 14th and 15th July 2022 for a second workshop that will focus on writing. “We are hopeful authors will stick to the timeframe, and will produce top-quality chapters, which is the signature of the HPRG. Otherwise, we may be forced to substitute authors if and when needed”, as said by the Nigerian AHOP lead, Prof Obinna Onwujekwe.