Of all the public sector issues in Nigeria, that of Health has grown quite notorious. The government, resident doctors and other public healthcare personals in several Health institutions have continued to have series of show downs in form of strike actions. Recent strikes by Neuro-psychatric hospital Yaba, Federal Medical Center Owerri, LAUTECH Oshogbo and University College Hospital Ibadan (UCH) collectively sum up to a year and six months, and before that, data shows that recent years have not been without these showdowns which have become the order of the day. Although the government ends up settling, the situation of things seems not to change, because after a while another strike action happens, and then the circular dance of economic shame continues.
When these strikes take place, the participants give remuneration, dilapidated facilities, power, insufficient resources, casualization, broken down equipments, not enough man power amongst others issues as reasons for the showdown. But one wonders why after every settlement, the status quo remains. A recent Nigeria Healthwatch article threw more light on this. That even after the government reaches a compromise with the striking groups, and salaries increased, there is still no change in quality of service delivery, reasons being that the complexity of healthcare and unavailability of relevant data makes accountability, transparency and impact measurement uneasy.
It behooves one to know that the public healthcare professionals in Nigeria are without contract or specification that states clinical expectations, terms of the service to be delivered e.g. number of cases that must be attended to or patients that must be seen. Furthermore it will wow you to know that crucial indicators like work-flow, quality, outcome and patient satisfaction are not in place. There are no set standards in public health delivery, meaning there are no means of evaluating the allocations from the Federal Ministry of Health as well as its quarterly allocation from the National Health Insurance Scheme versus service delivered. Zero value for money assessment, due to little or zero data, thus giving insights as to why the sector is in this mess.
Meanwhile as Africa's biggest economy Nigeria continues to wallop in this despond, the world has left her behind. Economies have begun data revolutions, patients are accessing their healthcare records and are comparing costs versus effectiveness, providers are mining and harnessing performance indicators across institutions, physicians are increasing cost-efficiency, researchers are accessing clinical data. Health institutions performance, choice, accountability, decision-making and other healthy behaviors have increase and improved.
These digital economies have realized the impact that could be made when technology is leveraged to transform data into knowledge and so everyday they create systems driven by technology to spur interconnectivity; where machines and humans are transacting, collaborating, and participating in shared value creation towards opportunities, innovation, growth and development. Back in Nigeria, we know the tale, we are willing to mimic many lifestyles of other economies, but we have refused to depart from our legacy and bureaucratic environments into a more patient-friendly digital system like they have.
In January 2014, the United States Department of Health and Human Services (HHS) and NHS England signed a bi-lateral agreement form then use and sharing of health data, tools and services towards increasing transparency and openness in government. Since then thousands of data sets have been made available for public consumption which in turn has spiraled the emergence of several innovations. Some of these platforms include; A. those that leverage mortality datasets to improve accountability at hospital level thereby identifying hospitals with abnormally high mortality rates, and poor clinical practices, B. those on which health spending and procurement data are published, C. those that leverage crowd sourced information to help patients choose the right care at the right time and make evidence-based, cost-effective treatment decisions aligned to personal preferences and financial constraints, D. those that use food and drug data to maintain a knowledge pool of adverse side effects from drugs, E. those that facilitate innovation in the field of data analysis, data visualization, service design, web and app development enabling innovation using linked health data to say but the least. Little wonder why Nigeria looses millions of dollars to both these economies and more due to 'medical tourism', little wonder how our hospitals are only 'world class' on the pages of newspapers.
This week after battling between work stress, cold, fatigue, and wellness, I ended up in a private hospital, after seeing the doctor and getting diagnosed, I was slammed with a bill which I thought was rather high and then it dawned on me, I had no choice, no other option, there was no way I could compare the cost of the treatment with that of other private hospitals so as to make a better decision. In today's digital era we are able to compare the costs of lots of services and products to see that which aligns with our purse, taste and more before we make purchase due to the emergence of eCommerce and price checking platforms leveraging data, but this development and innovation has fairly extended to our healthcare systems.
It cannot be over stressed that publishing data on general health outcomes can spur competition and innovation between institutions and healthcare professionals. Opening healthcare data to analysts and researches allows for scrutiny, question-asking on resource allocations, improves quality, monitoring of indications and consistency of evaluation. On the patient side it can facilitate preventive healthcare, health outcomes, efficiency, and security. However our eyes may be dazzled with show, or our ears deceived by sound; however prejudice may warp our wills, or bias darken our understanding, the simple voice of nature and of reason says that until Nigeria begins to mimic this habit of 'openness' from other economies, the healthcare system will continue to go the way of a downward spiral.
