Tolu Ojo

Technology Booms in Nigeria But E-health Lags: Private sector recommended to harness opportunities

Technology is booming in Nigeria. This was evident as I headed off to Nigeria’s first e-health summit held in Lagos, a city full of contrasts.

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 push for a cashless economy.

Data show that there are more than 102 million phones, 46 million Internet users and 1.2 million personal computers in use in Nigeria. This is in contrast with the health sector, where infrastructure is poor, underfunded, outdated and even unavailable. In Nigeria, there are no structures in place to facilitate e-health solutions in the market in spite of all the opportunities available.

Why is e-health in Nigeria lagging behind other developing nations in spite of the technology boom in the nation and how can the private sector leverage technology to improve health care in Nigeria? These were a couple of the questions participants at Nigeria’s first e-health summit held Sept. 12 attempted to address.

The summit was organized by the health technology firm Aajimatics and its partners, Global Resouces & Projects and Anadach Group. Attendees included members of the private sector (for-profit and nonprofit), government, funding bodies and academia.

While it is evident that there are many e-health products available to the Nigerian market that can be leveraged to create impact, there is no policy guiding implementation of the technologies in the health market.

Some innovative health solutions presented included health smartcards by Aajimatics and mobile product authentication (MPA) technology by Sproxil, which uses mobile phones to verify drug products in conjunction with the National Agency for Food and Drug Administration and Control.

MPA technology would be of great benefit in Nigeria, where fake drugs continue to invade the market, but 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 stakeholder meetings like the summit and to develop strategic plans that can be translated into e-health policies in Nigeria.

Another national health policy that could benefit from private sector partnership highlighted at the summit is the National Health Insurance Scheme (NHIS). More than 13 years after the implementation of the NHIS, less than 3 percent of Nigerians have been covered under the scheme compared to 65 percent 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 health maintenance organization in the emerging managed care sector of Nigeria, explained that private insurance can meet the goal of universal insurance by catering to the much-maligned informal sector, noting that willingness to pay for health is greater than the government’s ability to mobilize resources for health in resource-poor settings.

Other suggested innovations in health insurance include links to financial instruments for poverty alleviation, collaboration with the pharmaceutical industry, using market strategies to meet the actual needs of the consumers and government collaborations with private providers for technical expertise. Stronger links with the public sector would reduce abrupt changes in programs that tend to occur with cabinet changes in the country and would facilitate the process of achieving sustainable universal coverage.

Panelists agreed that fragmentation within the sector needs to be addressed and private sector stakeholders need to create more platforms to share information, discuss and create solutions to address Nigeria’s health challenges. Private sector stakeholders from Hygeia Community Health Plan and the International Finance Corporation (IFC) also agreed that the private sector had to play a crucial role in providing health insurance for the Nigerian population and shared valuable lessons learned from their organizations in the provision of affordable health insurance.

A key lesson shared by Dr. Olumide Okunola of the IFC was that for an idea/invention to be considered innovative in health care, it needs to be scalable, and this can only be achieved by models that add value and meet the needs of the market. This statement could not have resonated better the theme of the summit.

Sharing his experience, Dr. Sam Quarshie, head of ICT at Ghana Health Service, spoke on the need to consider the human factor when pondering new health technologies: “I remember when I went to the MD of a major hospital. He said he was NIIT. I thought he was talking about a technology certifying institute in Ghana. Rather, NIIT stands for Not Interested In Technology.” While the story generated laughs, it was a stern reminder of the importance of user buy-in.

For any innovation to be scaled up, the user must see the benefit and this can only be realized if the needs of the consumer are considered in the development of new health technologies. Private practitioners and members of the Association of General and Private Medical Practitioners of Nigeria (AGPMPN) in attendance agreed and shared incidents where they were presented with health care solutions that were great concepts in theory but provided no real solutions in practice.

The e-health market is very big and solutions are already being used by select providers to improve the health outcomes of a few members of the population. However, for e-health to be considered successful it must be accessible and beneficial to all individuals, just like mobile technology, Internet access and quickteller cashless card technologies.

It appears the greatest challenge to the development of e-health solutions and indeed advancement of the health care sector in Nigeria is the lack of appropriate partnerships and communication that can facilitate the advancement of programs and policies.

The e-health summit helped orchestrate collaboration between private sector stakeholders, the e-health industry and the Nigerian government to create a framework for leveraging technological innovations to improve health care delivery. Future similar events are in the works and I left with a definite sense of excitement at the partnerships formed and the opportunities they present.

Tolu Ojo is a health systems analyst at Solina Health, a consulting firm that serves as the “regional innovation broker” for the Center for Health Market Innovations, where this blog first appeared.

Health Care
healthcare technology, public health, public-private partnerships