What are your healthcare horror stories and how do we fix healthcare in Nigeria?

health-tech

#1

Please share some of your horror stories about healthcare in Nigeria. How can we fix healthcare in Nigeria?

About a year ago, I lost a family friend during childbirth. We don’t know what happened to her. She went into the delivery room and never returned with her baby. All that’s left today is just a memory of her which stares us in the face every time we look at her son.

Did you know that one Nigerian woman dies every 13 minutes (that’s 109 women dying each day) from preventable causes related to pregnancy and childbirth?

At TC Townhall: The State of Health Tech in Nigeria, Dr. Ola Brown proposed five major steps for reforming the healthcare sector including primary healthcare expansion, tertiary healthcare centralization, improving maternal and child health, task shifting and sustainable healthcare financing. Do you agree with her steps? What would you do differently?

Dr Brown concluded by challenging healthcare entrepreneurs to take advantage of advances in technology to leapfrog Nigeria’s healthcare problems. Check out her full speech here. Tell us what you think, let’s discuss on this thread.

TechCabal’s report, The State of Health Tech in Nigeria, identifies the innovative startups who are already working to find technology solutions to Nigeria’s health-related problems. Have you read the report? Get the report here. Do you see your faves? Who did we miss out?

If you want more reading, you can find all the presentations from the health tech townhall here.


#2

Hi guys!
There are a myriad of problems with the healthcare sector in Nigeria (that goes without saying, right). However, the elephant in the room in my opinion is the massive “brain-drain” that has been on going for a while now. It is estimated that about 10 - 12 doctors leave the country EVERY WEEK!!! That’s not counting nurses and other healthcare professionals. The close to 40,000 Nigerian doctors working abroad account for about half or more of all doctors registered with the Medical & Dental Council of Nigeria (MDCN). This is very worrisome for an already “nearly comatose” Healthcare system. But there is hope!

I strongly call on all the courageous Health-tech innovators and entrepreneurs in the country to see this as a huge opportunity for two major reasons. Firstly, I have observed that there is a rise in the numbers of community health extension workers nation-wide (which can be substantiated with data) and they are taking on more and more crucial responsibilities were it matters most- at the grass root community levels. While this is not the ideal, it is the next best thing. Secondly, they need all the tech support they can get, and that’s where we come in.

I very strongly believe that the health-tech start-up community in the country; focused on delivering value in the healthcare ecosystem should look critically at innovative and sustainable solutions that specifically target the front-lines (Community Health workers and their supporting infrastructure).

Dr. Nathaniel G. George
Co-founder Sonvisage Health-tech Innovators


#3

Thanks Dr Nathaniel. Do you mind sharing the data you have about the rise in the number of community health extension workers?

Also, regarding innovative solutions for community health workers, what kind of solutions do you have in mind? Training? What other solutions do you think will be helpful? Please share.


#4

Sure!
The last figure released about 10 years ago was 117,568 CHEWs, CHOs, and JCHEWs combined. While we are awaiting documented evidence of this perceived increase in their numbers, there already is evidence of increase in the technicality of the roles they are playing at the Primary Health levels. I have shared a few links below to highlight some of these areas. (Note that an increase in their numbers does not necessarily mean a bridge in the health workforce gap, if our population is increasing at a faster rate)

Although, their effect is most notably felt at the moment in the area of maternal and child health; I foresee them inevitably becoming prominent in other areas viewed exclusively for doctors and nurses as circumstances and situations dictate in the face of the so called “brain-drain”. They have been stepping up to the plate! Perhaps the Honorable minister had a similar fore-sight when he aired his view on the surplus (L0l)

Anyway, I am not advocating here for CHEWs and CHOs to perform brain surgeries but I would like to see them supported much more in two major ways (a) Policies- that acknowledges their important role and strategically guide their conduct; perhaps a little less conservatively as well as increase the scale and frequency of training, communication and collaboration with Tertiary centers. (b) Technological support as I alluded to previously.

Here are a few areas I think health-tech. innovators and inventors in the country can dive into and have a good soak.
i) Practical diagnostics e.g the manually operated centrifuge for remote communities
ii) Improved communication facilities in rural areas- this will facilitate the much needed tele-medicine and enhance collaboration with doctors in urban areas
iii) Sustainable means of rural-urban transportation e.g the motorcycle ambulance in India
iv) Health education
v) Supply chain and delivery systems
vi) Sustainable energy innovations
vii) Cheaper cold chain systems and the list goes on

Finally, I would really like to stress that if we are sincere and serious about improving healthcare in Nigeria and the sub-region, it has to begin at the grass-root. As such, whatever innovation is being designed, it should center around significantly improving the efficiency of those operating at the most basic levels of the health care structure with an absolute focus on PRACTICALITY and SUSTAINABILITY!!!

Dr. Nat

Advancing partners- resources-chsc-countries-nigeria

Barbara, D., Vandana, T., Stacie S., Emmanuel O., Peter J., & Catherine Carr (2015). Task shifting in maternal and newborn health care: Key components
from policy to implementation. International journal of gynaecology and obstetrics. Research gate publication 279300888

Hayhoe, B., Cowling, T. E., Pillutla, V., Garg, P., Majeed, A., & Harris, M. (2018). Integrating a nationally scaled workforce of community health workers in primary care: a modelling study. Journal of the Royal Society of Medicine , 111 (12), 453–461. doi:10.1177/0141076818803443


#5

Super useful, Dr Nat.

Your comment about empowering health extension workers reminds me of Dr. Ola’s proposal for fixing the problems. She suggested primary healthcare extension and task shifting.

Task shifting in healthcare is one concept I wasn’t familiar with before she mentioned it. Now that I think about it with regards to your comments, it completely makes sense. Now I wonder how much our policymakers are thinking about it as a solution. (If anyone knows, I would like to hear it).

With regards to your suggestions for health tech innovators, interestingly, we’ve seen a few startups implementing some of them. We covered some of them in our report, the State of Health Tech in Nigeria. What is required is a friendly policy framework for the sector and more capital so a number of those solutions can scale.

Thanks for engaging.