Urban health is indeed becoming topical in global health systems, with rapid urbanization across the developing regions. The urban growth rate in Nigeria is currently over 4%, with more than 50% of Nigerian residents living in urban areas. Of those living in urban areas in Nigeria, about 54% live in slums and are at risk of facing poverty, poor healthcare, low-quality education, and poor nutrition, among other poor living conditions. It is a fact that the number of urban residents will certainly grow in the coming years, implying that countries like Nigeria must be intentional and committed to managing urban population growth, despite insufficient resources.
The Health Policy Research Group, University of Nigeria, and its partners at the Community-led Responsive and Effective Urban Health Systems (CHORUS) have developed a keen interest in urban health systems. They apply scientific approaches to work with urban policymakers, health sector stakeholders, and the urban poor to understand the health concerns facing the urban poor regions and design evidence-informed interventions to address such concerns and engender good health. You can read more about the Nigerian-CHORUS project here.
Early shreds of evidence are already emerging and presented at global stages, raising more consciousness about urban health and the urban poor, and strategies that can help improve situations. First, the Nigerian-CHORUS Team was present at the 18th International Conference on Urban Health (ICUH) from 24th to 27th October 2022 in Valencia, Spain. They were also present at the Health System Global (HSG) Conference in Bogota, Colombia, from 31st October to 4th November 2022. Presentations from the team are compiled and can be seen below. We encourage policymakers, healthcare practitioners, and academics to go through the quality presentations to have more understanding of events and scenarios within Nigeria’s urban health space, as well as the plights of the urban poor.
Away from urban health, there were other presentations on securing cost effective immunization for Nigeria, and issues around accountability and corruption in Nigeria’s health sector.
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Presentation 1
Gender differences in health seeking behaviour and use of informal, private and public providers in two Nigerian cities
By Chinyere Mbachu, Nkoli Ezumah, and Obinna Onwujekwe
The authors presented evidence that show the different roles played by women and men in health seeking behaviours of slum households, as well as what men and women value differently in seeking healthcare. Such insight is needful to design healthcare interventions for the urban poor in ways that can accommodate gender peculiarities.
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How to cite: Mbachu, C., Ezumah, N., & Onwujekwe, O. (2022). Gender differences in health seeking behaviour and use of informal, private and public providers in two Nigerian cities. Presented at the ICUH 2022 Conference from 24th to 27th October. https://hprgunn.com/wp-content/uploads/2022/12/001_Gender_Health-Seeking.pdf
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Presentation 2
Opportunities and threats to linking informal healthcare providers into the formal urban health system in Nigeria
By Health Policy Research Group
In Nigeria, informal healthcare providers (IHPs) account for a significant proportion of health service delivery in underserved urban areas. Although the National Health Policy and Strategic Plan recognize the contributions of IHPs, there are no clear mechanisms to link them into the National health system. In the absence of more consistent and structured linkages between informal and formal providers, the consequence of fragmented and poor quality of care will be borne by service users
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How to cite: Health Policy Research Group (2022). Opportunities and threats to linking informal healthcare providers into the formal urban health system in Nigeria. Presented at the HSG 2022 Conference from 31st October to 4th November. https://hprgunn.com/wp-content/uploads/2022/12/002_Linking-IHP-and-FP.pdf
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Presentation 3
‘Between Devil and Deep blue sea filled with sharks’: Covid 19 and West and Central African Health Policy and Systems and Lessons for Current and Future Epidemics and Pandemics: Nigeria Case study
By Obinna Onwujekwe, Chinyere Okeke, Nkoli Uguru, Chinyere Mbachu, Adanma Ekenna, Nwadiuto Ojielo, Benjamin Uzochukwu
This research explores drivers of national and sub-national health policy and system responses to Covid 19 in West and Central Africa, intended and unintended effects on the most vulnerable, mechanisms fueling these effects and lessons for strengthening ongoing and future health policy and systems for epidemic preparedness and response in resource constrained contexts.
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How to cite: Onwujekwe, O., Okeke, C., Uguru, N., Mbachu, C., Ekenna, A., Ojielo, N., & Uzochukwu, B. (2022). ‘Between Devil and Deep blue sea filled with sharks’: Covid 19 and West and Central African Health Policy and Systems and Lessons for Current and Future Epidemics and Pandemics: Nigeria Case study. Presented at the ICUH 2022 Conference from 24th to 27th October. https://hprgunn.com/wp-content/uploads/2022/12/003_COVID-19_HPS.pdf
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Presentation 4
How does integration affect the cost of immunization campaigns? Findings from Nigeria and Sierra Leone
By Christina Banks, Flavia Moi, Kyle Borces, Laura Boonstoppel, Obinna Onwujekwe, Divine Ndubuisi Obodoechi, Florence Sibeudu, Michael Matthew Amara, Faisal Shuaib, Maimuna Hamisu, Bassey Okposen, Binta Ismail, and Logan Brenzel
The COVID-19 pandemic accentuated the need for efficient strategies for vaccine delivery. Co-delivering multiple antigens through immunization campaigns is likely to take place more frequently over the coming years. However, the impact of integration on campaign costs is not known.
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How to cite: Banks, C., Moi, F., Borces, K., Boonstoppel, L., Onwujekwe, O., Obodoechi, N., … Brenzel, L. (2022). How does integration affect the cost of immunization campaigns? Findings from Nigeria and Sierra Leone. Presented at the HSG 2022 Conference from 31st October to 4th November. https://hprgunn.com/wp-content/uploads/2022/12/004_Immunization-Cost.pdf
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Presentation 5
Resources and strategies to facilitate and motivate linkages between informal service providers and formal health systems in Nigeria’s urban slums: findings from a rapid review
By Chinyere Okeke, Benjamin Uzochukwu, and Obinna Onwujekwe
Nigeria is a large low-and-middle income country with health indicators showing underperformance both in absolute terms and relative to other countries at similar levels of economic development. There is a paucity of formal healthcare providers in most urban slums, thereby helping to develop a market for informal healthcare providers that thrive in such areas. In the absence of more consistent and structured linkages between non-formal and formal providers, the consequence of ‘fragmentation’ of health services and poor quality of care will be borne by service users. Hence, there is a critical need to strengthen and support more institutionalized linkages of the formal with informal health service providers to improve quality and continuity of care.
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How to cite: Okeke, C., Uzochukwu, B., & Onwujekwe, O. (2022). Resources and strategies to facilitate and motivate linkages between informal service providers and formal health systems in Nigeria’s urban slums: findings from a rapid review. Presented at the HSG 2022 Conference from 31st October to 4th November. https://hprgunn.com/wp-content/uploads/2022/12/005_Linkage-IHP-and-FP.pdf
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Presentation 6
Multi stakeholders’ roles and coordination mechanism for a resilient health system in COVID-19 response: Learning from experiences in Nigeria
By Ezenwaka Uche and Obinna Onwujekwe
Collaboration among multiple stakeholders from different sectors requires a coherent coordination mechanism in planning and implementing responses to public health emergencies such as COVID-19 to improve the effectiveness of a health system and health outcomes. The review provides new knowledge on stakeholders involved in the COVID-19 response and how their actions and roles are has been coordinated across different levels of government in Nigeria.
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How to cite: Ezenwaka, U., & Onwujekwe, O. (2022). Multi stakeholders’ roles and coordination mechanism for a resilient health system in COVID-19 response: Learning from experiences in Nigeria. Presented at the HSG 2022 Conference from 31st October to 4th November. https://hprgunn.com/wp-content/uploads/2022/12/006_Resilient-Health-System_COVID.pdf
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Presentation 7
“Just a small payment”: equity of informal payments in Maternal and Child Health Services in Primary Health Centers in Enugu, Nigeria.
By Pamela Ogbozor, Obinna Onwujekwe, Eleanor Hutchinson, Catherine Goodman, Charles Orjiakor, Prince Agwu, Aloysius Odii, and Dina Balabanova
Equitable access to maternal and child healthcare is essential to reduce the MMR in Nigeria, 512 per 100,000 live births. Strategies to increase access will fail if informal payments (IP) are not managed. A key question is whether there are informal exemptions for the poorest groups, which would moderate the equity impact? We explored the Robin Hood hypothesis that informal payments can improve access as health workers charge wealthy patients more and poorer patients less. Also, the nature of IPs and factors that enabled them were explored.
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How to cite: Ogbozor, P., Onwujekwe, O., Hutchinson, E., Goodman, C., Orjiakor, C., Agwu, P., Odii, A., & Balabanova, D. (2022). “Just a small payment”: equity of informal payments in Maternal and Child Health Services in Primary Health Centers in Enugu, Nigeria. Presented at the HSG 2022 Conference from 31st October to 4th November. https://hprgunn.com/wp-content/uploads/2022/12/007_Informal-Payments.pdf
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Presentation 8
Suboptimal and dearth of social care and justice services in Nigeria’s health sector: Evidence from the COVID-19 pandemic response
By Prince Agwu, Aloysius Odii, Charles Orjiakor, Pamela Ogbozor, Eleanor Hutchinson, Martin McKee, Dina Balabanova, Obinna Onwujekwe
Optimizing social protection in healthcare will demand recruiting and employing social care and justice professionals like social workers to deliver quality social care and justice services. While this is obtainable in most developed and some developing countries, social protection in Nigeria’s healthcare has been poor, and the effects have been telling since the outbreak of COVID-19
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How to cite: Agwu, P., Odii, A., Orjiakor, C., Ogbozor, P., Hutchinson, E., McKee, M., Balabanova, D., & Onwujekwe, O. (2022). Suboptimal and dearth of social care and justice services in Nigeria’s health sector: Evidence from the COVID-19 pandemic response. Presented at the HSG 2022 Conference from 31st October to 4th November. https://hprgunn.com/wp-content/uploads/2022/12/008_Social-Care_COVID.pdf
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Presentation 9
The double-edged effect of volunteer labor in primary health care in Nigeria
By Charles Orjiakor, Eleanor Hutchinson, Obinna Onwujekwe, Aloysius Odii, Prince Agwu, Pamela Ogbozor, Dina Balabanova
Health worker shortages are common in low resource settings and compromise access to quality healthcare. Facility managers adopt several means to attempt to optimize service delivery. One way is the engagement of volunteers to assist in facilities, which could likewise enable corruption and unaccountability.
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How to cite: Orjiakor, C., Hutchinson, E., Onwujekwe, O., Odii, A., Agwu, P., Ogbozor, P., & Balabanova, D. (2022). The double-edged effect of volunteer labor in primary health care in Nigeria. Presented at the HSG 2022 Conference from 31st October to 4th November. https://hprgunn.com/wp-content/uploads/2022/12/002_Linking-IHP-and-FP.pdf
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