NextBillion - An Initiative of the William Davidson Institute at the University of Michigan

Thursday, September 12, 2013

Midway through our interview the power cuts and the room is thrown into darkness. We are at Nigeria’s National Primary Healthcare Development Agency to talk to its chief executive about the issues facing his nation – and sporadic electricity supply is just one.

Dr Ado Jimada Gana Muhammad has arguably the toughest job in Nigerian healthcare.

“This is the frontline,” he says. “If we do not get it [primary healthcare] right the knock-on effects for the whole of the health care system are too large to calculate. And for many Nigerians, this [primary healthcare] is their first interaction with the system – it will be the basis for their entire view of healthcare, and whether or not they want to use it again in future.”

So how does one go about improving the frontline of a healthcare system where almost 1 million under-fives die each year from preventable diseases? It seems to start with Muhammad’s approach. He frequently uses business terms, talks of ’stratagems’ and views healthcare as a product for which one needs to create demand.

“Over the years our quality of care has eroded. You can have everything right, but if the quality of care is not there it erodes confidence. If customers – I call patients ’customers’ – attend a health facility and the level of care is not what he or she expects the confidence is eroded even further.”