The Lancet Nigeria Commission (2) Investing in health and the future of the nation

2 April, 2022

The Lancet has published a new Commission on health in Nigeria. https://www.thelancet.com/commissions/health-in-nigeria

HIFA is proud to have more than 1600 members in Nigeria and we look forward to your comments.

EXECUTIVE SUMMARY

Nigeria is projected to become one of the most populous countries in the world, and is rightly taking its place on the world stage. The Lancet Nigeria Commission tells the story of the country through a health lens, and details recommendations that will enable the country and its people to fulfil their potential, and seize the opportunity ahead. It has been led by Nigerians for Nigerians. The Commissioners call for the creation of a new social contract that redefines the relationship between citizen and state. They argue that health has, to date, been neglected by successive governments and consequently the citizens of Nigeria, and must be recentred as a vital investment in the population – one that will reap political and economic benefits. Nigeria is poised to define the future of West Africa, the African continent, and the whole world. This Commission lays out how best to realise that ambition.

EDITORIAL| VOLUME 399, ISSUE 10330, P1093, MARCH 19, 2022

Nigeria: rightly taking its place on the world stage

The Lancet

Published: March 15, 2022 DOI: https://doi.org/10.1016/S0140-6736(22)00511-6

'Recent trends in health outcomes, as detailed in the accompanying Article published today, record 20 years of increased healthy life expectancy (although it is still low within the region, at 56 years), reductions in mortality for males and females of all ages, and rises in health expenditure but, overall, health outcomes are still poor. Nigeria has repeatedly failed to realise the health gains promised by multiple political leaders, and this failure is holding the country back...'

'The Commissioners call for the creation of a new social contract that redefines the relationship between citizen and state. They argue that health has, to date, been neglected by successive governments and consequently the citizens of Nigeria, and must be recentred as an essential investment in the population—one that will reap political and economic benefits.'

THE LANCET COMMISSIONS| VOLUME 399, ISSUE 10330, P1155-1200, MARCH 19, 2022

The Lancet Nigeria Commission: investing in health and the future of the nation

Prof Ibrahim Abubakar et al.

Published: March 15, 2022

DOI: https://doi.org/10.1016/S0140-6736(21)02488-0

SELECTED EXTRACTS (for discussion)

'Access to mass media tends to be lower in rural settings than in urban settings resulting in inequitable access to evidence-based health information.'

'There is a strong sense of trust in traditional birth attendants, especially in rural communities, as they are perceived to be more compassionate than formal health workers and provide options such as home delivery, presenting an opportunity to skill up community-based providers who can support normal deliveries and refer pregnant women needing further care.'

'To improve quality of care, it is important to standardise the training of skilled health workers with national guidelines (eg, in undergraduate training institutions, postgraduate specialist colleges, and for continuing education), in the public and private training and service delivery sectors. There are examples of pilot experiences of using WHO training manuals, local training manuals, or adapting international manuals. However, efforts to standardise training and practice will require a national process for developing (and adapting from international examples), accrediting, and disseminating in-service or pre-service training manuals, and incorporating them into nationally approved training curricula.'

'To ensure that health workers can perform their function as educators of the community in matters of health, they themselves first need to learn to communicate effectively and gain community trust.' [??]

Best wishes, Neil

Neil Pakenham-Walsh, Global Coordinator HIFA, www.hifa.org neil@hifa.org