COVID-19: HIGHLIGHTS OF NIGERIA’S TIMELY HEALTH CARE SYSTEM RESPONSE.

CATALYSE

Covid 19 and West and Central African Health Systems

Covid 19 et les systèmes de santé d’Afrique de l’Ouest et du Centre

Chioma Onyedinma, Chinyere Okeke, Benjamin Uzochukwu, Obinna Onwujekwe

Date: 26^th April 2021

The current Coronavirus Disease (COVID-19) outbreak is one of the greatest infections of the respiratory tract, affecting so many countries at the same time. The pandemic came suddenly, overwhelming even the well-resourced health systems of high-income countries. Nigeria like most low- and – middle-income countries knew it had an under-resourced and relatively weak health system, making it very vulnerable to the outbreak. The response was to mobilize whatever resources and efforts were possible by government and non-governmental agencies in response to the pandemic to reduce vulnerability and catastrophic effects.

Leadership

Preparations to fight the virus started as soon as there was an alert of the presence of the virus in China. This initial preparation was led by the Nigerian Centre for disease control (NCDC). The Center established a coronavirus preparedness group that activated an incident system for response to any emergency, modelled after the “Polio Infrastructure”, which was key to the success of the 2014 Ebolavirus disease outbreak response. The president then formed the Presidential task force on COVID-19 (PTF) after the first case was detected. The PTF worked closely with the federal ministry of health, NCDC, and other ministries, departments, and agencies to oversee what was being done to control the situation.

How did funds come?

The government responded swiftly by providing the N500 billion COVID-19 crisis intervention fund. This money helped in supporting states for critical healthcare expenses. The Nigeria United Nations (UN) COVID-19 basket fund was designed to serve as a financing and investment platform, and this created an avenue for non-governmental agencies and private individuals to invest in the fight against the pandemic. So many non-governmental agencies individuals made donations to this basket fund, raising more than $64 million and some went further to state what the money was to be used for.

What did we do with funds?

Several guidelines and protocols were developed to enable smooth coordination and provide information for the public. COVID-19 public health emergency operating centres were set up in all 36 states of the federation and FCT. Isolation centres were built in all the 36 states of the federation and we currently have 112 treatment and isolation centres in the country. To facilitate the movement of patients to facilities where they can get help, the National Emergency Medical Services and Ambulance System was established.  Most government-owned tertiary hospitals started free telemedicine response services and phone consultations, to limit the influx of non-COVID-19 patients to the facilities.

Polymerase chain reaction (PCR) laboratories were built and set up across all the states to increase the number of tests done. The federal government bought about 107,000 Cartridges to enable the use of available gene expert machines in the country. Health workers were trained on infection prevention and control (IPC) protocols, sample collection, and how to manage patients effectively. Online courses on IPC made available to the public but targeted at health workers was launched to gain a wider audience.

With regards to technology development and research, ventilators were produced in the country by the military and some higher institutions as well as purchased with designated donated funds. Personal protective equipment like gloves, face masks, and coveralls were produced locally. The federal government gave a grant to the Defence Industries Corporation of Nigeria (DICON) to produce high-quality non-permeable PPE kits. Abia state government empowered tailors in the state to produce PPE’s and two Nigerian firms also partnered to produce PPE’s to meet sudden high demand. A research consortium, constituting the Tertiary Education Trust fund, and other stake holders was formed and given the mandate to carry out research on COVID-19 in Nigeria. The prompt intervention of the federal and state governments and private individuals and organizations has to a great extent, strengthened all pillars of the health systems building blocks through development of policies, regulations, and guidelines, and also building of partnerships and relationships across the health systems.

About the authors

Dr Chioma Onyedinma is a Researcher at the Health Policy Research Group of the University of Nigeria Nsukka and a Senior Resident at the Department of Community medicine University of Nigeria Teaching Hospital Ituku/Ozalla.

Dr Chinyere Okeke is a Researcher with Health Policy Research Group, a Community health physician in the University of Nigeria Teaching Hospital and a Senior Lecturer in the Department of Community Medicine, University of Nigeria, Enugu Campus. She is a member of West African Network of Emerging Leaders in Health Policy and Systems Research (WANEL) and Health Systems Global (HSG).

Benjamin S. Chudi UZOCHUKWU is a Public Health and Community Medicine Physician at the University of Nigeria Teaching Hospital Enugu and Professor of Public Health, Health Policy and Systems, University of Nigeria, Nsukka where he was the founding director of the Institute of Public Health. He is the deputy director, Health Policy Research Group University of Nigeria Enugu campus.

With over 25 years’ experience in Public Health and over 200 publications in peer reviewed journals, he has acted as a policy

adviser and consultant to Nigeria’s Federal Ministry of Health, ECOWAS, West Africa Health Organization (WAHO), and African CDC in various areas of health systems. He has also been involved in the development of State and National strategic health development plans as well as several national policy documents. He is a leading member in Health Policy and Systems Research in Africa and Nigeria and his area of work includes implementation research, healthcare financing, getting research evidence into policy and practice, realist evaluation of health programmes, leadership and Management and Health Technology Assessment.

He is an executive member of the Association of Schools of Public Health in Africa, and currently the Chairman Faculty of Community Health of the West African College of Physicians, Director, Grants and Research, West African College of Physicians and Member, Ministerial Expert Advisory Committee on COVID-19 Health Sector Response in Nigeria.

He is a Fellow of National Academy of Science (FAS) and the Academy of Medicine Specialists of Nigeria (FAMedS)

Obinna Onwujekwe is a Professor of Health Economics and Policy, and the Director of the Directorate for Research in University of Nigeria, Nsukka. He established the Department of Health Administration and Management in the University. He is the founder and Director of the Health Policy Research Group, which is a renowned and reputable research organization. Obinna has led the development of health policies in Nigeria, including the National Health Policy (2016) and the National Health Financing Policy (2016). He has served on the scientific and advisory boards of the African and International Health Economics Associations and is the foundation president of the Nigeria Health Economics Association. He currently chairs the health systems research subcommittee of the Ministerial Expert Advisory Committee on COVID-19 Health Sector Response (MEACoC). He is also a Fellow of the Nigerian Academy of Science and Nigerian Academy of Medical Specialities.

ACKNOWLEDGEMENT

Covid 19 and West and Central African Health Systems (CATALYSE) is funded by IDRC Canada Grant # 109479-001