By HPRG News
Kurt Lewin said, “no research without action, and no action without research”. The reality of this quote lies in the essence of conducting research, which is to change society. Such change could be to inform, influence, or introduce great policies and programmes; or to improve conditions for the poor and vulnerable; or to even inform effective governance. Any which way, a goal for academia is to ensure that research brings real-time and tangible positive changes to the lives of people, and that generated evidence makes sense to policymakers and used for the good of the public.
These precedents motivate the Health Policy Research Group (HPRG), University of Nigeria to engage in building capacities in advocacies and influencing policies and programmes using research evidence. A well-researched study on bridging gaps between policymakers and researchers was published by the HPRG, and they have gone forward to mainstream these insights and approaches into mentorship programmes for organisations. Very recently, HPRG was engaged to build the capacity of the staff of the German Leprosy and Tuberculosis Relief Association/RedAid Nigeria (GLA/RAN) in Enugu on advocacy for policy change using research evidence.
GLA/RAN, Enugu, is currently implementing an innovation grant from the STOP TB Partnership, titled – ‘Catalysing improvements in drug-resistance tuberculosis (DR-TB) care in Nigeria: A sustainable patient-centred approach’. The core aims of the project include reducing pre-treatment loss to follow-up and commencing treatment for newly diagnosed DR-TB cases as fast as possible, by addressing factors that affect the patient-care pathway from efficacy of investigations through initiation of treatment for DR-TB. In addition, a core part of their research aims will be to get generated evidence into policies and practice. To achieve this, the following important resources from HPRG will be needful:
Concept and importance of advocacy for policy change – By Dr Chinyere Okeke (Click here to download presentation)
Understanding the use and role of media and communication for effective advocacy – By Prince Agwu and Chinelo Obi (Click here to download presentation)
Foundational principles and key components of developing advocacy strategies – By Chioma Onyedinma (Click here to download presentation)
Methodologies and tools for effective advocacy – By Prof Chinyere Mbachu (Click here to download presentation)
How to write a policy brief – By Prof BSC Uzochukwu (Click here to download presentation)
Planning, implementing and evaluating advocacy and communication for policy change – By Dr Chinyere Okeke (Click here to download presentation)
Getting research into policy and practice – By Prof BSC Uzochukwu (Click here to download presentation)
By Prince Agwu, Obinna Onwujekwe, Dina Balabanova and the Accountability in Action Research Team
Despite anticorruption thrusts that have always been a part of the manifestos of successive governments in Nigeria, corruption has remained considerably high in the country. With corruption being common in many sectors of Nigeria, the country in the 2021 Corruption Perception Index (CPI), scored 24 of 100, making it the 154th most corrupt country out of 180 countries in the world, and among the 15 most corrupt countries in Africa. Disappointingly, the health sector continues to feature as among the top-5 corrupt sectors in the country.
Image 1: Nigeria’s CPI since 2012 (Source: Trading Economics)
Is corruption in health a lack of morals or a failure of systems?
Thomas Hobbes described life as nasty and brutish, constantly in a state of war, which explains how the nature of man is disapproving of principles and good behaviour. Hobbes further used this philosophy to buttress the importance of social control (rules and institutions that keep to the demands of the rule of law) against the deviant nature of people and make them more compliant with rules. Just as Hobbes, Sigmund Freud argued that societies get better when the superego (comprising ideals, principles, laws, etc.) is enforced to quell the irrational and socially unacceptable personalities of people (ego). In these, and in other traditional scholarship, the innate tendency to be corrupt appears to be part of human nature, but people can be less or not corrupt in systems that are built to be intolerant of corruption. This is why the Anti-corruption Evidence Consortium argues for the need to strengthen vertical (government offices) and horizontal forces (grassroots people), such that systems can become self-enforcing against corruption.
Therefore, corruption may not entirely be the moral failure of individuals, but even more, a failure of institutions that creates incentives for corrupt practices. At times, institutions may fail to the extent that corruption becomes the only way for people to survive and support their families. Thus, instead of just identifying and punishing individuals who break the rules, an anticorruption agenda must seek to make corruption unattractive and difficult to perpetuate, and at the same time, build a system that can be self-enforcing against corruption.
A reminder about Nigeria’s health sector corruption
A recent review on health sector corruption and a nominal group technique with frontline health workers and policymakers in Nigeria revealed the most common forms of health sector corruption, which were absenteeism, informal payments, health financing corruption, employment irregularities, diversion of patients from public to private facilities, theft of consumables, and illicit procurement practices. More focused research approaches using ethnography, interviews, and group discussions have also shown that the Nigerian health sector is truly challenged by corruption, devastatingly affecting Nigeria’s progress toward achieving global health goals and leading to inefficient use of the current low budgetary appropriations and donor funding to the health sector. The poorest and most disadvantaged groups are most at risk as they have few alternatives to obtain adequate quality care. Indeed, corrupt practices change the ethos of the health system and distort priorities and procedures.
Image 2: Corruption ranking in Nigeria (Source: Channels TV)
While the situation often seems helpless, there is hope in the fact that anticorruption can be successful when governance structures are set up and incentivized in ways to gradually curb it, and when grassroots actors finally say, “enough is enough”. Therefore, the question is – how do we stimulate and galvanize the interests and actions of macro governance structures and community actors toward anticorruption in the health sector? Also, how do we ensure that anticorruption approaches do not only work for a period of time but become an integral part of the system and sustainable?
Stakeholders in health sector anticorruption gathered to find solutions
The Health Policy Research Group (HPRG), University of Nigeria and the Bayero University, Kano (BUK), with partnership from the London School of Hygiene and Tropical Medicine (LSHTM) are vigorously pursuing an anticorruption agenda in the health sector of Nigeria through research and the use of evidence from research to inform policies and strategies that will eliminate corruption in the health system. To achieve this goal, the team convened a Policy Forum on Anticorruption in Nigeria tagged “Stop Health Sector Corruption”, attracting various key stakeholders in the Nigerian health system and anticorruption vanguards from several bodies in Nigeria.
Those that were represented included the Independent Corrupt Practices Commission (ICPC), Nigeria Academy of Science (NAS), Health Reform Foundation of Nigeria (HERFON), International Centre for Investigative Reporting (ICIR), Results for Development (R4D), National Health Insurance Scheme (NHIS), Budgit, UNODC, Nigeria Health Watch, Project Pink Blue, Anticorruption Academy of Nigeria, National Primary Health Care Development Agency (NPHCDA), SERVICOM, Nigeria Governors Forum, etc. The stakeholders narrated several personal experiences of health sector corruption and reinforced the urgent importance of addressing this failure.
With several presentations of documented evidence from the research team from UNN and BUK on the realities and dynamics of corruption in Nigeria’s health sector, particularly primary healthcare, the stakeholders confirmed that thoroughness of the research already done by the team, even though they pointed more areas to cover. Strong emphases were made on the managerial components of the health sector, as corruption, unaccountability, and sheer incompetence at that level have allowed for the thriving of corruption and accountability issues at the level of service delivery. The weakness of the Human Resource (HR) component of the public sector, as well as the lack of properly communicated context-specific rules and regulations for the health sector, were considered enablers of corruption.
Image 3: Cross-section of policy forum attendees
Where do we go from here?
The stakeholders who attended the Policy Forum were clear on where to begin to address health sector corruption. Unanimously, they emphasized the need to drive solutions using evidence from research. Implying that more conversations between researchers in corruption studies and policymakers should be encouraged. Also, based on the reported evidence, stakeholders opined that anticorruption will be unsustainable if strategies do not emanate and include actors at the frontline and those that are affected. It is more like tying the ends of macro politics (the big ‘P’) that comprise the managers at the authority level and their political networks in local government and beyond, with those of micro politics (the small ‘p’) comprising community actors and frontline health workers.
It was for instance suggested that a ‘Rule book’ on anti-corruption in health should be developed and deployed across the country, and civil society groups and community leaders should be encouraged and incentivized to play supportive supervision roles across health facilities. An important incentivization as mentioned by the policymakers is to ensure that the top-level managers act on reports tendered to them by community actors and civil groups. Such is needed for confidence building and developing trust across the “big” (P) and “small” (p) pees. Also mentioned included rapid digitalization of systems, educating service users on patients’ rights as enshrined in law using townhall meetings and media, establishing and optimizing human resource management across health facilities, and putting together reward mechanisms for committed health workers, to mention but a few.
Image 4: Cross-section of policy forum attendees
There is hope!
With the coming together of these powerful actors sourced from organisations and circles that are influential within Nigeria’s health system and policy space, a critical mass of people and systems that can drive a sustainable anticorruption agenda in the health sector is feasible. The policy forum attendees have made their commitments to this cause and are optimistic about improved situations within the health sector going forward. Therefore, more strategic and meaningful engagements will continuously hold until anticorruption in the health sector becomes an indispensable part of Nigeria’s health system, and the rule of law rises to becoming self-enforcing by the system.
With the amount of information asymmetry in the health system, where service users are barely aware of expectations, ensuring prominence of the rule of law remains a viable anticorruption strategy. We understand that this may be difficult to achieve in developing climes like Nigeria, where individuals and organisations can be even more powerful than the system. It is for this reason scaling-up and optimizing the awareness and voices of citizens at the grassroots is much needed and an achievable anticorruption agenda. And civil groups and researchers will continue to pursue avenues to hold government actors to account and draw their attention to the pathetic consequences of undermining the rule of law as applied to healthcare. More voices are needed in health sector anticorruption, and the Accountability in Action Research Team is excited at the rapidly growing institutionalization of health sector anticorruption, evidenced by:
The Thematic Working Group on Action on Accountability and Anti-corruption for SDGs (TWG AAA) at Health Systems Global, where Prof Obinna Onwujekwe and Prof Dina Balabanova (are Co-Chairs)
The proposed African Resource Center for Accountability and Anti-corruption in Health, to be based in Nigeria
Forthcoming Global Network for Anti-Corruption, Transparency & Accountability in Health Systems (GNACTA) to be launched by WHO, UNDP and other major development agencies in December 2022.
The Nigerian Policy Forum on Accountability and Anti-corruption in the health system
Associate Prof Eleanor Hutchinson
Dr Tochukwu Orjiakor
Dr Aloysius Odii
Dr Muktar Gadanya
Dr Maikano Madaki
Accountability and Anti-corruption in Health Project Anti-corruption Evidence Consortium (ACE)
By Chidi Nzeadibe, Geraldine Ugwuonah, Obinna Onwujekwe, Bennett Nwanguma, Theresa Ogbuanya, Paul Oranu, Emmanuel Ezeani, Chinonso Igwesi-Chidobe, Chizoba Obianuju Oranu, Paul Adeosun and Felix Egara
Why yet another conference on Covid-19 Pandemic?
COVID-19 pandemic is arguably the most serious global challenge since World War II. The 1st Annual Multidisciplinary International Conference of the University of Nigeria, Nsukka (UNN) which took place from 5th – 7th July 2021 was convened to explore the role of research, science and innovation arising from the institution and elsewhere in surviving and thriving in the post-COVID era. The theme of the maiden conference was A Whole New World: Research, Development and Innovation in the Pandemic Era. In his remark, the Vice-Chancellor of the institution, Professor Charles Arizechukwu Igwe, FAS, noted that the choice of this theme reflected the university’s recognition of the huge impact that COVID-19 continues to have on public health systems, society, food systems, education, and economies which have led to massive transformations in the way we live and work.
Mainstreaming Science and Innovation in Management of Pandemics- The UNN Example
The pandemic has given rise to significant research, development and innovation possibilities across different fields of human endeavour, typically with the varying aims of understanding, overcoming or adapting to the challenges posed by COVID-19. At the University of Nigeria, many researchers have sought to leverage the opportunities inherent in the adversity of the pandemic to come up with research outputs with huge potential to improve lives and livelihoods and for overcoming or adapting to the challenges posed by COVID-19. The UNN International conference brought together researchers, policymakers, development partners, NGOs and research funders both in Nigeria and beyond to explore research, development and innovations in various disciplines within the context of COVID-19. In line with the realities of the pandemic and to utilize innovations in ICT and remote learning and working, presentations at the conference were done virtually through the Zoom app. Other applicable COVID-19 protocols were also observed.
Science for Social Relevance: Views of the Public Health Expert
The conference keynote paper entitled A Whole New World: Research, Development and Innovation in the Post-Pandemic Era was presented by the globally acknowledged expert on Virology and Infectious Diseases, and Chairman of Nigeria’s Ministerial Expert Advisory Committee on COVID-19 (MEACoC), and former President of the Nigerian Academy of Science, Professor Oyewale Tomori, FAS. He described COVID-19 as ‘the evasive, invasive, elusive, invisible one’ that came to expose the underbelly of our decadent healthcare system and the depravity in our society. Harping on the role of Nigerian scientists in the fight against the pandemic, Prof Tomori averred that:
“the scientists in Nigeria should identify with and be seen by the society as part of the society, must be asking the right questions relating to the problems of our society, must focus research activities on the directions of questions asked, and in collaboration with the government must seek relevance in serving and meeting the identified needs of the society”.
Effective Science Communication: dispelling myth, providing context
In a goodwill message, conference partners – The Conversation Africa (TC-Africa) noted that researchers from the UNN have been writing for the website since 2016 in their mission to mainstream the voices of universities and scientists in the media and to support science engagement and science communication activities in Africa. So far, 41 authors from the UNN have published 37 articles (out of which 16 focused on COVID-19 and other health-related topics) which have been read over 200,000 times. With a monthly readership of 2.5 million, participation of TC-Africa is particularly significant to global dissemination of results of research from this conference. TC-Africa recently recognized the University of Nigeria among the Top Universities in Africa, and her researchers for the most published articles and most read article during the 2nd Annual West Africa Science Communication Awards.
Going forward: Translating research outputs to policy and action
Nearly 200 papers from multidisciplinary perspectives were presented in 33 panels and 6 technical sessions. Topical issues discussed and lessons included innovations in health systems and management, agricultural innovations and food security, lifestyle changes and adaptive behaviours, urban planning innovations and informal settlements, sustainable education, remote learning and digital innovation, and water, sanitation and hygiene (WASH).
A major impact of the conference was the massive public awareness it created, dispelling myths that Nigerians are immune to SARS-CoV-2 and that COVID-19 is a hoax, and also providing context on the pandemic through timely publications in print and electronic media. Research funders both in Nigeria and outside the country were urged to key into the research, development and innovations possibilities at this conference and collaborate with the university to support uptake of the outputs of this conference and other related research projects. It is expected that the quantum of ideas, methodologies and actionable policy recommendations from this conference will contribute immeasurably to global effort at dealing with the pandemic and that products of this conference will help to chart a new development course in the post-pandemic era.
Chidi Nzeadibe is Professor of Geography and Chair of the Conference Committee Twitter: @NzeadibeChidi
Obinna Onwujekwe is Professor of health economics, policy and pharmacoeconomics, and, Director of Research, UNN
Geraldine Ugwuonah is Professor of Marketing
Bennett Nwanguma is Professor of Biochemistry and Chair, Senate Ceremonials Committee, UNN
Theresa Ogbuanya is Professor of Industrial Technical Education
Paul Oranu is the Director of ICT, UNN
Emmanuel Ezeani is Professor of Political Science and Director UNN Consult
Chinonso Igwesi-Chidobe is a Senior Lecturer in Medical Rehabilitation
Chizoba Oranu is a Lecturer in Agricultural Economics
Paul Adeosun is a Lecturer in Agricultural Economics
Felix Egara is a Lecturer in Science Education and Conference Committee Secretary.
We acknowledge Dr Charles Orjiakor for the review of this blog.
How to Cite
Nzeadibe, C., Ugwuonah, G., Onwujekwe, O., Nwanguma, B., Ogbuanya, T., Oranu, P., …, Egara, F. (2022). Surviving and thriving in the post-pandemic era: exploring research, science and innovation at the University of Nigeria. https://hprgunn.com/surviving-and-thriving-in-the-post-pandemic-era-exploring-research-science-and-innovation-at-the-university-of-nigeria/
On May 12, 2022 Prof Obinna Onwujekwe gave a public lecture at the induction of fellows into the Nigeria Academy of Science. The lecture was titled, “Nexus of Science and Evidence-based Decision Making Towards a Responsive and Strong Nigerian Health System”. Prof Obinna gave practical examples of getting research into policy and practice, stating that it is an ideal every scientist should aspire to, and it is the key driver of the Health Policy Research Group, University of Nigeria. Emphasis was laid on utilizing non-academic means to communicate research, such as blogs, policy briefs, podcasts, filming, etc., as they attain wider reach and appeal more to policymakers and the wider public than the technically written scientific publications. He went ahead to discuss stakeholders’ identification, engagement, relationship building, and the real-life value that is brought to research by the Outcome Mapping strategy. The public lecture was received well by fellows and other attendees, as they were challenged to ensure that they move quality studies away from the papers and shelves into policies and programmes that will benefit society.