Technology is booming in Nigeria. This is evident as I head off to Nigeria’s first E-Health summit, recently held in Lagos. It seems every Nigerian, from the young woman in the corner shop to the bus conductor hustling for passengers, is chatting on a mobile phone. Smart phones make occasional appearances and all the banks display online banking and quickteller signs thanks to the government’s push for a cashless economy.
Data show that in Nigeria there are more than 102 million phones, 46 million internet users and 1.2 million personal computers in use. This is in contrast to the health sector where technology infrastructure is poor, underfunded, outdated, or even unavailable. In spite of the technology boom, why is E-health in Nigeria lagging behind other developing nations? How can the private sector leverage technology to improve health care in Nigeria?
Organized by health technology firm Aajimatics and its partners, Global Health Project and Resources and Andach Group, the E-Health Summit would address these questions. Key players in the Nigerian healthcare sector—including representatives from private healthcare, government, funding bodies, and academia—assembled to explore how to leverage the private sector to address some of the country’s health challenges, under the theme: “Understanding Current E-Health Ecosystem in Nigeria and the Role of the Private Sector in harnessing Potential Opportunities to improve health for all Nigerians.”
Federal policy needed to scale up drug authentication technology
With so many e-health products available in Nigeria, there is no policy guiding implementation of the technologies in the health market. Among the innovative health solutions presented were health smartcards by Aajimatics, as well as mobile product authentication (MPA) technology by Sproxil®, a CHMI profiled program, which uses mobile phones to verify drug products in conjunction with the National Agency For Food, Drug Administration and Control (NAFDAC). MPA technology would be of great benefit in Nigeria where fake drugs continue to invade the market. However, the lack of exact government policy supporting the technology on a national level limits its impact in drug quality control. This highlighted the need for the government to be included in such stakeholder meetings like the E-Health Summit and developing policies that can be translated into strategic plans to establish E-Health policies in Nigeria.
Leveraging private insurance providers to expand health insurance coverage
Another national health policy that could benefit from private sector partnership highlighted at the summit is the National Health Insurance Scheme. More than 13 years after the implementation of the scheme, fewer than 3% of Nigerians have been covered under the scheme, compared to 65% of the population in Ghana over a similar time frame. The public sector alone is failing to deliver on the scheme. Dr. Ladi Awosika of Total Health Trust Ltd, a leading HMO in Nigeria’s emerging managed care sector, explained that private insurance could support the goal of universal insurance scheme by catering to the informal sector. Attendees from Hygeia Community Health Plan and the International Finance Corporation (IFC) agreed that the private sector has to play a role in providing health insurance for the Nigerian population and are pushing the private sector to do two main things. First, create social health insurance plans that would provide social health insurance plans to the informal sector, which constitutes up to 70% of the population and currently has no representation under the National Health Insurance Scheme (NHIS). Second, establish community health insurance plans for low-income communities that involve risk-pooling.
Some innovations in health insurance include linkages to other financial instruments for poverty alleviation, collaboration with the pharmaceutical industry, using market strategies to meet consumer needs, and government collaborations with private providers for technical expertise. Stronger links between providers of health insurance and local governments would facilitate the process of achieving sustainable universal coverage for all Nigerians. Encouraging the government to partner with the pharmaceutical industry can lead to agreements that allow healthcare providers that serve the poor to access medicine supplies at subsidized rates.
Garnering buy in from health leaders “Not Interested In Technology”
Despite their enthusiasm, many innovations face resistance in being implemented because of human factors. Dr. Sam Quarshie, head of ICT at Ghana Health Services, told an anecdote about the director of a major hospital who was not bashful about his lack of interest.
“He said he was NIIT—I thought he was talking about a technology certifying institute. Rather, NIIT stands for Not Interested In Technology,” Dr. Quarshie recounted, generating laughs while stressing the importance of user buy-in. For any innovation to be scaled up, users must see the benefit, and this can only be realised if consumer needs are considered in the development of new health technologies. Private practitioners and members of the Association of General Private Medical Practitioners of Nigeria agreed with Dr. Quarshie, sharing several examples of healthcare solutions that were great concepts in theory, but didn’t work in practice.
A new framework supporting health technology scale up in Nigera
At the E-health summit, private healthcare leaders, the e-health industry and the Nigerian government collaborated to create a framework for leveraging technological innovations to improve healthcare delivery in the country. Future similar events are in the works.
The e-health market is very big and select providers are already using these tools to improve the health outcomes. However, for e-health to be considered successful it must be as accessible and apparently beneficial to all individuals as mobile technology, internet access, and quickteller cashless cards technologies. The greatest risk to the development of e-health solutions and indeed advancement of the healthcare sector in Nigeria may be the lack of appropriate partnerships and communication that can facilitate the advancement of programs and policies to improve the health outcomes of the general public.
However, with all the partnerships fostered at this event, I left excited at the momentum to leverage technology to improve healthcare in Nigeria.