Dream of achieving universal health coverage for all Nigerians is far-fetched, and among the obstacles standing in the way of achieving this goal is the lack of data exchange between healthcare facilities, SODIQ OJUROUNGBE writes
It was a cold night in Igbokofi, in the Yewa North Local Government Area of Ogun State when Mrs. Folakemi Olaniyi’s water broke, signalling labour.
She was in the third trimester of her pregnancy and knew that she had to get to the hospital as soon as possible.
Unfortunately, she was mismanaged at a private hospital, where she was taken by her husband.
Folakemi told our correspondent that she was later taken to Ijoun Primary Health Centre after her baby’s head and hands got stuck in the birth canal but was refused treatment because her medical records were unavailable.
“They couldn’t access the records from her doctor and were unable to quickly get the information they needed at the time to commence treatment. I was in agony both physically and emotionally,” she recounted.
Although the pregnant woman was later moved to Lantoro Hospital in Abeokuta, where a caesarean section was carried out to remove the baby, who was already dead, Olaniyi is yet to get over the loss of her child.
Speaking with our correspondent, Olaniyi maintained that her baby could have survived the rigours of delivery if her medical records were online and easily accessible by the hospital where she was initially rejected.
Olaniyi’s story is not unique because, in Nigeria, the lack of data exchange between hospitals is a major problem that leads to delays in care and tragic outcomes.
No data sharing among hospitals
The lack of data exchange is not just a problem for patients; it also has a significant impact on the overall performance of the healthcare system.
Findings by PUNCH Healthwise showed that without being able to track and analyse data, it is difficult to identify areas that need improvement like waiting time, infection rates, and patient satisfaction.
This also makes it harder to address systemic problems and improve the quality of care.
According to experts, there is a need to be able to track performance and identify areas that need improvement and without a digital system that allows for the sharing of data, this becomes almost impossible
They argued that the lack of data exchange between hospitals has several serious implications for the country’s ability to achieve universal health coverage by the year 2030.
According to them, without being able to share records, it can be difficult to track a patient’s medical history, adding that this could lead to missed diagnoses and unnecessary tests.
They added that it can also make it difficult to coordinate care between different providers, which can lead to delays in treatment and poorer outcomes for patients.
A Professor of Public Health, Adeola Adekunle said lack of data exchange is one of the biggest barriers to providing quality healthcare in Nigeria, adding that it leads to unnecessary tests, delayed treatments, and even death in some cases.
“The problem is exacerbated by the lack of a centralized electronic health records system in the country. As a result, patients often have to carry paper records from one doctor to another, which can be lost or damaged. And even when records are available, they may not be up-to-date or complete. This is a major problem, as delays in care can have serious consequences for patients.
A delay of even a few hours can mean the difference between life and death in some cases,” Adekunle noted.
The don noted that creating a national electronic health records system would allow for the seamless exchange of data between hospitals and other healthcare providers.
Another public health physician at the Federal Medical Centre, Abeokuta, Dr Abayomi Ayoola said the lack of digital data exchange affects the synergy between medical personnel and patients.
He said, “Without data, we are flying blind when it comes to improving the healthcare system.
“It’s not just doctors and nurses that are affected by the lack of data exchange; patients and their families are also impacted negatively. For example, when patients are referred from one facility to another, their records often don’t follow them, which can lead to confusion and frustration.
“The lack of data exchange also has financial implications on the healthcare system. Without a way to track and analyse data, it is difficult to know where resources are being spent and whether they are being used effectively. This can lead to wasted money and resources, which could be better used to improve patient care.”
2030 targets of UHC for all Nigerians
Universal health coverage programme in Nigeria is aimed at ensuring that all citizens have access to quality healthcare, regardless of their ability to pay. The programme is part of the country’s broader efforts to improve healthcare and reduce poverty.
Nigeria launched its National Health Insurance Scheme in 2005 and it was aimed at providing all Nigerians with access to quality, affordable healthcare and to also meet the target of achieving UHC by 2030.
While the insurance scheme promises to transform healthcare in Nigeria, the country still faces significant challenges in the areas of digital identification, digital payment, and data exchange.
Findings by PUNCH Healthwise showed that many people in Nigeria do not have a digital identity, which is crucial for accessing healthcare services.
According to the World Bank, only about 30 per cent of Nigerians have access to the internet, and only about 20 per cent have access to mobile phones.
The WB noted that this digital divide has significant implications for the country’s ability to provide universal health coverage.
According to experts, achieving the 2030 target for UHC in Nigeria is not feasible, unless the country is ready to invest more in digital infrastructure.
A digital expert, Igbagboyemi Oladele said the lack of adequate healthcare infrastructure in Nigeria should be one reason for the government to leverage technology to improve access to healthcare.
By implementing a digitised healthcare system, Oladele said the Nigerian government can make it easier for people to access the care they need.
He explained that this could involve using electronic health records, telemedicine, and other digital tools to reach more people to improve the quality of care.
Oladele explained, “The goal is to create a system that is more efficient, effective, and equitable. With a digitized healthcare system, people in remote areas can access care without having to travel long distances.Related News
“Without proper digital infrastructure, it will be very difficult for the government to achieve its goal of universal health coverage.
“Presently in Nigeria, there is a lack of digital identification, digital payment, and data exchange in Nigeria. This means that people may not be able to access the healthcare they need, and it makes it difficult to track and measure the impact of the government in achieving universal health coverage.
“For example, without digital identification, it can be difficult to verify a person’s identity and eligibility for healthcare services. Without digital payment, people may not be able to pay for the care they need. And without data exchange, it can be hard to get certain information.
“In a country like Nigeria, with its vast size and diversity, the challenges of providing universal health coverage are significant. The digital divide, which includes gaps in access to technology, skills, and internet connectivity, is one of the biggest barriers to achieving this goal.
“In many rural areas, people lack access to even basic mobile phones, let alone the internet. And in areas with internet access, the cost of data can be prohibitively high. This digital divide means that many people need more tools to access healthcare information and services.”
2030 target unrealistic without digital infrastructure
Experts believe that the 2030 UHC target in Nigeria might be unrealistic, except the country invests more in digital infrastructure.
A medical practitioner at the Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Dr Salisu Adeolu, also identified the digital divide as a major obstacle to achieving UHC.
While noting that the digital divide is not the only obstacle to attaining UHC in Nigeria, the physician said other significant challenges relate to infrastructure and funding.
He said the country’s healthcare system is underfunded, with only about 5 per cent of the national budget allocated to health.
According to him, lack of funding makes it difficult to provide quality healthcare services, particularly in rural areas.
“In addition to addressing the digital divide, we need to invest in improving our infrastructure and increasing funding for healthcare.
“Despite these challenges, there are signs of progress. In recent years, the government launched some initiatives to improve healthcare access including the NHIA. In 2019, the government launched the Basic Health Care Provision Fund, which provides funding for primary healthcare services.
“But these initiatives are not enough on their own. They need to be accompanied by improvements in infrastructure, training for healthcare workers, and efforts to address cultural barriers to healthcare.”
“There are several factors affecting digital public infrastructure in Nigeria. One of the biggest challenges is the lack of reliable electricity. Many parts of the country experience frequent power outages, making it difficult to access digital services like the Internet and mobile phones.
“In addition, there is a lack of broadband connectivity, particularly in rural areas. And the cost of internet access is high, making it out of reach for many people.
“These factors make it difficult for people to access health information and connect with healthcare providers. Without reliable access to the internet, it is difficult to take advantage of digital health tools like telemedicine and online health records.”
Also, another health expert, David Ogunsanya said another factor affecting digital public infrastructure is the lack of skilled workers.
He explained that many people in Nigeria lack the requisite skills needed to utilise digital tools and services effectively.
“Lack of skilled workers also impacts the government’s ability to implement digital health initiatives. Many government agencies lack the staff and expertise needed to manage digital programmes effectively. There is a need for more investment in training and capacity building to address this gap.
“In summary, the lack of digital public infrastructure in Nigeria is a significant barrier to achieving universal health coverage. Without reliable electricity, broadband connectivity, and skilled workers, the country will struggle to take advantage of digital health tools and services.
“This will have a negative impact on the health of the population and could prevent the country from reaching its goal of universal health coverage. To address this issue, the government needs to make a significant investment in infrastructure, capacity building, and training.”
Ogunsanyas said there is also a need for a sustainable financing model for healthcare, adding that the government should consider a combination of public and private funding for accessible healthcare.
Currently, most people pay out of pocket for healthcare in Nigeria, which puts a significant financial burden on patients and their families. This has led to a situation where many people can’t afford the healthcare they need, and are forced to rely on traditional healers or herbal remedies.
“Government could provide basic healthcare services for free while allowing the private sector to offer more specialized and expensive treatments. This would help to ensure that everyone has access to healthcare and be able to meet the universal health coverage goal,” he added.
Oladele, however, said the government needs to provide more funds for the health care system, especially for digital initiatives.
He said, “The government currently spends less than one per cent of GDP on healthcare, and only a fraction of that is allocated to digital initiatives. This lack of funding has made it difficult to invest in new technologies and infrastructure. It has also limited the government’s ability to contract with private companies to provide digital services.
“In addition to these factors, there are also concerns about data privacy and security. Many people in Nigeria are concerned about the collection and use of their data, and there is a lack of transparency about how people’s information will be used.
“The lack of trust in the government’s ability to protect personal data has led to low adoption rates for digital health initiatives. Only a small percentage of the population has enrolled in the NHIS, and uptake of digital health tools like telemedicine has been slow.
“This is a missed opportunity as digital tools could improve access to healthcare and lead to better health outcomes.
“To overcome these challenges, the government needs to address the lack of trust by being transparent about how data is collected and used. It also needs to increase funding for digital initiatives and make investments in infrastructure and capacity building.”
Oladele lamented that there is a lack of accurate and reliable data on the health status of the populace and the effectiveness of different healthcare interventions.
He urged the government to invest in strengthening the country’s health information system and to work with the private sector to develop new technologies, such as mobile health applications, to collect and analyze health data.
“With these challenges in mind, the government has a long way to go to achieve UHC. But there are reasons to be optimistic. Recent initiatives, such as the Basic Health Care Provision Fund, are beginning to make a difference. And many dedicated individuals and organisations are working to improve healthcare in Nigeria.
“If these efforts are sustained, and the challenges outlined above are addressed, there is a good chance that Nigeria can achieve UHC by 2030.
“This would be a major achievement and would have a profound impact on the health and well-being of the country’s citizens.”
