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How to leapfrog health systems in Nigeria  

For many decades, Nigerians have lived with a lack of basic health services and poor infrastructure at basic health care centres and general hospitals, leading to needless deaths. This trend can be reversed by leapfrogging the country’s health systems.

Leapfrogging means using new technology, operating model or pattern of behaviour to accelerate the development of a system (be it an organisation, industry or an entire economy) by helping it skip over development stages that had previously been unavoidable.

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It no longer news that Nigeria’s health sector struggles with unsatisfied demand for basic health services, weak health systems, limited public funding, poor infrastructure, insecurity, rising incidence of disease burden, low human resources capacity, elevated rates of infant and maternal mortality.

Experts say technological innovations, alternative operating and financing models and new legal frameworks have potential benefits in improving access to health care services especially for those in hard-to-reach areas.

Technology can improve safety and quality of healthcare services and products, improve knowledge and access to health information for health workers and communities leading to better productivity of the health workforce,

These experts say that digital technologies can improve efficiency and reduce the cost of health services delivery, facilitate the rapid transmission of public health information in real-time for timely decision making and enhance the capacity for monitoring the performance of programmes and the health system as a whole.

Three types of innovation are critical to successful leapfrogging: new technologies, new operating models, and new behaviour patterns.

How does it work to deliver healthcare to the public?

According to the World Economic Forum project supported by the Boston Consulting Group (BCG), in developed economies, techniques and structures that had been created to meet previous developmental challenges have tended to remain embedded in health systems, even after circumstances have changed or superior methods have become available.

Leapfrogging in health systems requires certain enabling conditions. These include a minimum level of physical infrastructure, for example, basic sanitation and electricity supply and a minimum level of workforce sophistication.

An environment or a mindset that encourages and rewards leapfrogging is also necessary. Key aspects of such an environment are: a policy framework creating a favourable environment for innovation, both within and outside the health system; the ability to adapt to new trends and evolving patterns of medical needs; and flexibility in the design and implementation of health policies to suit different contexts and cultures

The other dimension of leapfrogging opportunities, represented on the horizontal axis, is made up of three innovation types – technology, operating model change and behaviour change – describing the kind of innovation that can induce leapfrogging within the seven categories.

“Technology” encompasses new health-related activities and products. For emerging economies, the most powerful technological innovations are often those that are simpler, more affordable and more durable than existing solutions.

“Operating model” refers to any modification in the organizational set-up and process design of health-related activities. This includes, for example, changes to the roles, workflow, and incentives of health workers at a given service delivery point.

“Behaviour change” refers to the evolution of the preferences and conduct of individuals (patients or health workers) and organisations (payers) acting within the health system. It could include the adoption of different lifestyles by individuals or changes in the way physicians interpret their roles within the health system

 How can leapfrogging strengthen Nigeria’s health sector?

There are numerous examples of emerging markets using this leapfrogging strategy in areas unrelated to health care. The classic example is mobile financial services.

In Nigeria, for instance, most people have extremely limited access to healthcare owing to Out- of pocket payment and absence of large coverage of health insurance. And yet, millions of people in Nigeria today use mobile phones. More and more aspects of health care are becoming information-based and are therefore able to be digitised.

The more that digital information becomes critical to care, the more digital technologies have the potential to transform how care is organized and delivered—and the more emerging-market health systems have the potential to leapfrog previous approaches and models.

In this digital era, using digital technology to ensure access to quality healthcare is no longer an option; Ola Orekunrin-Brown, chief executive officer (CEO), Flying Doctors Nigeria observed that an innovative approach to healthcare in Nigeria, using telemedicine, remote support for para-clinical healthcare staff and institution of robust systems to manage patient journeys is also what we need.

“In addition to this, embarking on protocolisation of common and easily preventable disease management guidelines, task shifting and efficient referral systems will transform healthcare in Nigeria by improving accessibility and reducing cost,” she said.

Similarly, Adeyinka Adeniran, chief executive officer (CEO) Medflit, a leading health information technology platform said that telemedicine will enable people to access healthcare readily at an affordable rate lesser than the cost of hospital visits. In addition, telemedicine provides an added advantage in its ability to cater to the needs of patients anywhere and at any given time.

“With the use of telemedicine, patients do not need to travel along distance to receive medical care; the prompt delivery of healthcare services would ultimately save lives,” he said.

 To illustrate the leapfrogging opportunity, it plotted health care expenditure per capita against health-adjusted life expectancy.

Andrew Nevin, advisory partner, and chief economist, PricewaterhouseCoopers (PwC) said Nigeria’s life expectancy is relatively low at 54.3 when compared to other listed countries such as China at 84.7. This figure is linked to indicators such as; poverty and pollution which has reduced the nation’s life expectancy to 47 years.

“Life expectancy at birth is one of the most frequently used health status indicators. Gains in life expectancy at birth can be attributed to a number of factors, including rising living standards, improved lifestyle and better education and better health facilities,” he said.

 

ANTHONIA OBOKOH

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