A CRITICAL ANALYSIS OF NIGERIA’S PUBLIC HEALTH SYSTEM AND EVIDENCE

BASED RECOMMENDATIONS FOR IMPROVEMENT

BY

FALEYE FUNMILAYO OLUWAGBOGO

Au22/01/NSC468
SUBMITTED TO
MISS ENIOLA
 INTRODUCTION

The science of preserving and enhancing individual and community health is known
as public health. In order to do this job, healthy lifestyles are encouraged, disease and
injury prevention research is conducted, and infectious disease detection, prevention,
and response are studied (World Health Organization, 2022). Protecting the health of all
populations is the overall goal of public health. These populations might range in size
from that of a single neighborhood to that of a whole continent. Disease prevention,
health promotion, and the evaluation and enhancement of community-wide health are
the fundamental tenets of public health (American Public Health Association, 2022). In
order to create policies that address health disparities, environmental variables, and
social determinants of health, public health professionals collaborate with governments,
healthcare organizations, community groups, and international agencies. They operate
in a variety of areas. Epidemiology (the study of patterns, causes, and consequences of
health-related events), biostatistics, behavioral sciences, health policy and
management, and environmental health are important facets of public health. Public
health seeks to establish circumstances that allow everyone to live better lives through
the application of scientific research, policy development, and community participation
(World Health Organization, 2022).

Aims And Objectives That Aim At Critically Analyzing Nigeria’s Public Health
System

Some potential aims and objectives for critically analyzing Nigeria’s public health
system could include:

1. Assessing the current state of the system and identifying areas for improvement
2. Evaluating the effectiveness of current policies and programs.
3. Identifying gaps in healthcare access and quality.
4. Determining the best practices for delivering healthcare in Nigeria.
 5. Proposing solutions to address the challenges facing the system.
6. Developing a plan for improving the overall quality of healthcare

Significance Of This Study Entails:

The significance of critically analyzing Nigeria’s public health system is that it could lead
to improved healthcare for the country’s population. By identifying areas for
improvement and developing solutions, it’s possible to improve the quality of healthcare,
increase access to care, and save lives. The analysis could also inform policy decisions
and guide future investments in the healthcare system. Ultimately, the goal is to ensure
that everyone in Nigeria has access to high-quality, affordable healthcare. That’s a big
task, but one that is definitely worth the effort.

“A Critical Analysis Of The Public Health System In Nigeria”

Uneven distribution of medical services is a result of Nigeria's public health system's
challenges, which include a dearth of medical experts, particularly in rural areas. A
sizeable section of the population has limited access to healthcare as a result of this
imbalance. There are serious issues facing Nigeria's public health system that call for
urgent attention (Ogwuche, Ume, & Okafor, 2019). Effective service delivery is
hampered by a lack of resources, a lackluster infrastructure, and a scarcity of medical
specialists (Okon, Okorie, & Nnadi, 2020). Furthermore, health inequities are made
worse by regional variations in healthcare access. To improve the general resilience
and effectiveness of Nigeria's public health system, addressing these challenges calls
for coordinated efforts in resource allocation, infrastructure development, and health
personnel training (Ogunbanjo, Adebanjo, & Sofolahan, 2018).To address these
challenges, evidence-based recommendations include:

1. Increased Funding: Give the health sector more priority and financing so that it
can upgrade facilities, buy vital equipment, and guarantee that prescription
drugs are available.
2 Workforce Development: Invest in training and deploying healthcare
professionals, especially in underserved rural areas, to bridge the gap in service
delivery.
3 Community Health Education: Implement comprehensive community health
education programs to raise awareness about preventive measures, hygiene
practices, and early detection of diseases

4 Technology Integration: Leverage technology for data management,

surveillance, and communication. This includes electronic health records,
telemedicine, and mobile health initiatives to enhance healthcare delivery and
monitoring.

5 Disease Surveillance and Response: Strengthen disease surveillance systems

to enable early detection and rapid response to outbreaks. This involves
improved coordination among health agencies and timely dissemination of
information.

6 Public-Private Partnerships: Foster collaborations between the public and

private sectors to enhance resource mobilization, infrastructure development,
and service provision.

7 Preventive Healthcare: Emphasize preventive healthcare measures to reduce

the burden of diseases. This includes vaccination campaigns, health screenings,
and health promotion activities.
8 Inadequate infrastructure and equipment, including a lack of functioning health
facilities, poor sanitation, and a lack of medical supplies
9 Low health literacy, including a lack of understanding of basic health concepts.

10 High rates of infectious diseases, including HIV/AIDS, tuberculosis, and malaria

11 Lack of a unified public health system, with several different ministries and
agencies involved in public health
12 Poor monitoring and evaluation of public health programs

13 Weak coordination and collaboration between different public health stakeholders

EVIDENCE BASED RECOMMENDATION FOR IMPROVING THE PUBLIC HEALTH
SYSTEM IN NIGERIA

Evidence-based strategies for improving Nigeria’s public health system can draw
inspiration from successful models in other countries. Some proven approaches
include:

1. Primary Healthcare Emphasis (Inspired by Cuba): Prioritize primary

healthcare with a focus on preventive measures, community engagement, and a
strong network of community health workers. Cuba’s healthcare system, with its
emphasis on preventive care, has shown positive outcomes. Cuba’s healthcare
system is often cited as a model for primary healthcare, and there are several
key factors that contribute to its success. One of the most important factors is the
focus on preventive care. Rather than waiting for people to become sick and then
treating them, Cuba’s system focuses on keeping people healthy in the first
place. This includes things like regular checkup health education, and community
engagement (Perez, 2016). Another key factor is the strong network of
community health workers. These workers are based in the communities they
serve and are responsible for things like providing basic healthcare services,
collecting data, and promoting health education(Perez, 2016).

2. Telemedicine Integration (Inspired by South Korea): Leverage telemedicine

to enhance healthcare access, particularly in remote areas. South Korea’s use of
telemedicine has demonstrated success in providing timely medical consultations
and reducing geographical barriers.. One key aspect of this system is the
widespread use of broadband internet, which allows for high-quality video
conferencing between patients and doctors. This is particularly useful in rural
areas, where access to doctors can be limited. Another key aspect is the use of
electronic health records, which allow for the easy sharing of patient information
between doctors and other healthcare providers(oyewo,2021).
3. National Health Insurance (Inspired by Germany): Implement a
comprehensive national health insurance system to ensure universal coverage.
Germany’s model combines public and private sectors to provide high-quality
healthcare services for all citizens. One key aspect of this system is the
requirement that all residents have health insurance(Lehmann, 2020). This
ensures that everyone has access to healthcare, regardless of their income or
employment status. Another key aspect is the strong role of the government in
regulating the system. This includes setting standards for what services are
covered and ensuring that all residents have access to those services (Lehmann,
2020).

4. Community Health Workers (Inspired by Brazil): Invest in training and

deploying community health workers to improve healthcare access, especially in
rural and underserved areas. Brazil’s Family Health Strategy employs community
health workers effectively. Brazil has a very robust system of community health
workers, known as “agents de saúde.” These workers are typically from the same
community they serve, and they provide a range of services, including health
education, preventive care, and referrals to healthcare facilities. The system is
notable for its success in reducing infant mortality and improving overall health in
poor and remote communities(van den Heever, 2010).
5. Disease Surveillance (Inspired by the United States CDC): Strengthen
disease surveillance and response mechanisms. The Centers for Disease
Control and Prevention (CDC) in the United States provides a model for effective
tracking, monitoring, and responding to disease outbreaks. The CDC has a
number of programs that support disease surveillance, including the National
Notifiable Diseases Surveillance System (NNDSS) and the Emerging Infections
Program (EIP). These programs use a variety of methods, including electronic
reporting and data analysis, to track diseases and identify potential
outbreaks(Centers for Disease Control and Prevention, 2022).
6. Health Information Systems (Inspired by Estonia): Implement robust health
information systems for efficient data management and decision-making.
 Estonia’s e-health system is an example of successful integration of digital health
records. This system includes a unique identification number for each citizen,
which is used to access their health records and other information. This system
has allowed Estonia to improve the quality and efficiency of healthcare, and it
has been used to track the spread of diseases and implement public health
interventions (Sikkut, Kivirand, & Ottie 2019)
7. Public-Private Partnerships (Inspired by Singapore): Foster collaboration
between the public and private sectors to enhance healthcare delivery.
Singapore’s model incorporates private providers while maintaining a strong
public healthcare framework. Singapore’s public-private partnership (PPP) model
for healthcare has been highly successful in providing high-quality, affordable
healthcare to its citizens. In this model, the government provides subsidies and
regulations, while private healthcare providers offer services at a competitive
cost. This system has resulted in high levels of patient satisfaction and quality of
care, and it has also helped to keep healthcare costs under control(Terhorst,
2013).

8. Health Education Campaigns (Inspired by Australia): Conduct targeted health

education campaigns to promote preventive behaviours. Australia’s public health
campaigns have been effective in raising awareness and encouraging positive
health practices. The campaign uses a range of media, including television,
radio, and social media, to deliver health messages on topics such as physical
activity, nutrition, and smoking cessation. The campaign has been successful in
increasing knowledge and awareness of health issues, and it has also been
credited with reducing rates of obesity and smoking (Lee, Braunack-Mayer, &
Baume, 2008).
These evidence-based strategies, adapted to Nigeria’s context, can contribute to
building a more resilient, accessible, and efficient public health system. Implementation
should consider local nuances, infrastructure, and the unique healthcare needs of the
Nigerian population.
 Conclusion

Enhancing Nigeria’s public health system requires a multifaceted approach, drawing

inspiration from successful strategies implemented in various countries. By prioritizing
primary healthcare, integrating telemedicine, establishing a comprehensive national
health insurance system, deploying community health workers, strengthening disease
surveillance, adopting robust health information systems, fostering public-private
partnerships, and conducting targeted health education campaigns, Nigeria can build a
more resilient and accessible healthcare framework. However, successful
implementation necessitates adaptation to Nigeria’s unique context, careful
consideration of local factors, and sustained commitment to improving health outcomes
for its diverse population.
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