Restoring Health To The Agenda In Nigeria – Report From A Conference

On a cold morning last Saturday, over 200 professionals with a commitment to improving the health of Nigerians met at the Gustave Tuck lecture theatre of University College London. The one-day conference, “Nigeria – Partnership for Health” with the key theme “Restoring Health to the National Agenda” drew participants from across the United Kingdom, the United States of America, Germany and Nigeria to meet, debate and chart a way forward in confronting the many challenges that face the Nigerian health system. The event organized by the Nigerian Public Health Network, MANSAG (the umbrella organization for Nigerian doctors working in the UK), the Institute for Global Health at University College London, the Tropical Health and Education Trust and Africa Recruit was the culmination of many months of diligent planning.

As early as 8 in the morning, delegates began to arrive- with 150 delegates registered, the first sign of how the day would go was when more than 200 delegates turned up. From Nigerian doctors, nurses, pharmacists and other health workers in the United Kingdom to representatives of voluntary sector organizations working in Nigeria to academics, to Nigerian medical and public health students, the cloisters of University College London were filled to capacity.

Dr. Nasidi speaking

The morning kicked off with a presentation from Dr Abdulsalami Nasidi, Director of Public Health at the Federal Ministry of Health who outlined a dismal picture of Nigeria’s current performance on many health indicators. He also shared vignettes from his personal experience working in public health in Nigeria over the years. Professor Phyllis Kanki of the Harvard School of Public Health spoke next on the opportunities and challenges of working in Nigeria, based largely on the work of the Harvard backed AIDS Prevention Initiative Nigeria which she has led over the last 8 years and for which she will receive an honorary doctorate from the University of Ibadan shortly. She was followed by Dr David McCoy Senior Associate at the Centre for International Health and Development in University College London who spoke on the role Nigeria could and should be playing in the international health scene. He made a strong point in not prescribing a solution but leaving this to the ingenuity of the hundreds of highly skilled Nigerians working at the highest levels in the health sectors of most Western economies. Moving and poignant was the verdict on the presentation from three eminence grises- Professor Eldryd Parry, Professor Umaru Shehu and Professor Adetokunbo Lucas all renowned health professionals with years of experience behind them in improving health in Nigeria. They shared their experiences of what progress had initially been made in the Nigerian public health sector from the 1960s when they started their careers to the present day when many of the initial gains have been lost. Their sadness was transparently deep, their sorrow profound as they reminisced on the time spent on reports and advisory committees on the Nigerian health sector, mostly wasted. Their presentations were a stark reminder of what was at stake and helped to highlight why the health of the Nigerian population is in the dire state that it is in today.

Some hope for the future was expressed through the presentations of emergent leaders in the health sector such as Mrs. Fola Laoye of Hygeia, one of Nigeria’s leading private sector healthcare organizations. She spoke eloquently of the innovative approach to healthcare financing that the organization is pioneering, empowering communities to vote with their feet on which health service provider to use. Dr. Seyi Oyesola, a UK based consultant anaesthetist described the exciting new Delta State Teaching Hospital project which he was going back home to lead: an example of one man walking the walk. Following the keynote speeches, the delegates then went into 4 break-out sessions, having first been primed by the ebullient Dr Lola Dare, who urged the delegates to focus on solutions instead of rehashing the problems and challenges. The four breakout sessions focused on building research collaborations, addressing the health workforce issues, building partnerships and linkages with institutions internationally and the role of the private sector. The sessions which were facilitated by members of the Nigerian Public Health Network supported by resource persons with experience in the area were so lively that they had to be extended beyond the time allocated to enable the rich conversations to be captured. Delegates shared their experiences and put forward practical tangible solutions that often provoked heated debates. There was no mistaking the passion and engagement and the experienced facilitators played an important role in ensuring that the groups maintained focus. From the community programmes that Hygeia are developing, to the innovative child health programme in a village in Enugu State pioneered by Dr Edith Okolo, focusing on giving mothers the skills to help and support each other to ensure improved child health, there were stories aplenty to inspire and to suggest that many were putting their words into action. Considering the significant number of Nigerians working within the NHS and the new incentives to strengthen global health links, it was felt that more could be done in building links and partnerships between their institutions in the UK and in Nigeria and delegates were challenged to go back and explore how they could set up links between their organizations in the UK and similar organizations in Nigeria.

Following the break out sessions, the groups fed back and Dr Dare then challenged many of the key partners to say what they would do differently as a result of having been at the conference and listening to the contributions. Dr Nasidi of the Ministry of Health asked delegates to challenge him with specific issues and that he would respond. He shared his contact details with the audience to facilitate communication and bravely agreed to work with the Partnership for as long as he was in a position to do so.

Fiona Duby of the Department for International Development attending in her personal capacity as a friend of Nigeria spoke of the need to engage constructively with partners and to seek examples of areas where other developing countries have been successful, mentioning initiatives from Ghana as an example. Toks Sangowawa spoke on behalf of the UK Faculty of Public Health and promised to continue the work already begun through working with the Nigerian Public Health Network and the recent memorandum of understanding signed between the Faculty and the West African College of Physicians. He stressed that the Faculty would be willing to support Nigeria in standard setting and training, areas in which they have a wealth of experience. Professor Stanley Okolo of MANSAG committed to continue giving Nigerian doctors the organizational framework to deliver on their activities as it relates to Nigeria.

The final contribution in this section came from Chikwe Ihekweazu of the Nigerian Public Health Network who enjoined all the delegates to ensure that the momentum gained from the conference was not lost. He asked that they continue to engage with the emerging Partnership for Nigerian Health to act as a vehicle for advocacy, accountability and partnership for improving Nigerian health. He promised that the learning from the day would be captured in a document that would be shared with whoever is appointed Minister of Health for Nigeria in the next few weeks and would then be developed into a plan for action. He asked delegates to sign on to the conference website by emailing NIGERIA HEALTH in order to be kept up to date with future developments and to spread the word among their networks.

Delegates expressed appreciation for the forum and there were demands that it become a regular affair and that a similar forum in Nigeria be explored to facilitate the sharing of the learning.

The conference proceedings which had been chaired by Stanley Okolo, Jimi Coker and Titi Banjoko ended with a cocktail reception during which there were opportunities to continue networking. Leaving the venue I was struck by the many amazing incidents of the day, from the Nigerian nurse who had initially decided that she could not stay because the hall was overcrowded but whom I still saw engaged in hearty conversation with a group of young Nigerian public health students late in the day, to Muhammed who wrote us from Sokoto State in Northern Nigeria, to say that he would be attending and we initially dismissed as a joke. Linda who had only signed up for a couple of hours but ended up staying the whole day, coordinating the registration desk. Nkem who stepped off a plane and immediately went to work producing name cards for the delegates; the many Nigerians from the United States who came specifically for the conference, one of them having only heard of it days before; Professor Lucas who arrived in London at 5 am and was at the venue by 8 30, ready for his presentation; The members of the Nigerian Public Health Network and their friends, many of them senior professionals, who stayed up till midnight the previous day making sure that all was in place and who were ever ready on the day to step in to help and assist with whatever was needed, no matter how seemingly small or menial to keep the day going. Seeing the passion and dedication was moving.

Professors Shehu and Lucas

The energy in the room was exhilarating. It showed the energy and passion that many Nigerians and friends of Nigeria have, raring to be released to support the country’s renaissance. The health sector is crucial in the nation’s development. Nigerian health professionals and all with an interest in Nigerian health owe the millions of ordinary Nigerians that cannot afford to fly abroad for basic health care their best effort. We have taken the first infant steps in removing the cloak of mediocrity that has clouded our activities. By coming to this conference and committing to play our roles in holding ourselves and our government accountable, we believe that this could presage a new dawn for the Nigerian health sector. The challenges ahead are great and it is only the dawn, and now the long march begins to a new future.