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[afro-nets] RFI: How to establish a working HMIS in northern Nigeria (9)
- From: "Toyin Togun" <email@example.com>
- Date: Mon, 27 Nov 2006 16:30:15 +0000 (GMT)
RFI: How to establish a working HMIS in northern Nigeria (9)
Thanks to Emmanuel Otolorin for that rather honestly "graphic" picture of the state of the health system in Nigeria; he ended it on a note of optimism that "The journey of a thousand miles begins with just a step." On a lighter side, I'll add that for a system so 'crippled', even that "just a step" might be very difficult and take forever.
However, the four major challenges facing health systems in Nigeria especially, but in almost all developing countries include:
1) Health workforce crisis;
2) Insufficient financial resources for investment in health;
3) Leadership challenges toward the formulation and implementation of pro-equity health policies;
4) Lack of adequate and timely evidence (this will include operational research capacity, HMIS, etc)
All these challenges 'synergistically' contributed to the 'deplorable' state of the health system; and any attempt to address the health system will require a programmatic approach with strategic, focused and integrated interventions aimed, at least, at all of the four major 'challenges' listed and others that could be contextual. In addition, such an integrated package of interventions must initially develop or include a HMIS that is contextual, given the current constraints of the health system in Nigeria rather than being fashioned after what exists in developed countries; with potential for improvements as the 'situation' (i.e the condition and perfomances of the health system) improves, if I may also share Otolorin's optimism.
'Individually' addressing issues such as HMIS in Nigeria, most likely will not achieve the desired objectives; will not be cost-effective; and neither will it be sustainable because of the influence of the 'other' factors which are actively at play.
Dr. Toyin Togun, MD, MPH
London, United Kingdom.