Nigeria’s Health Care System: Capitalizing on Communication tools

Drawing Lessons from the COVID-19 Pandemic

Markus Frieauff from Unsplash

At the peak of the pandemic in 2020, together with a colleague, we published an article highlighting the COVID-19 disease’ devastating impact on access to premium healthcare services in Nigeria.

Nigeria’s healthcare system before the pandemic was already a shadow of itself but the advent of the disease further crippled the system. In fact in 2018 for instance, a Lancet study measured the performance of 195 countries’ health care access and quality index and ranked Nigeria a very depressing 142nd. Sadly, the other countries on the lower radar are also in sub-Saharan Africa.

But come to think of it, Nigeria has been commended for handling endemic diseases such as Lassa fever and Ebola in 2016 and 2014 respectively, but still, there is a very long hurdle to cross to achieve premium access to health care for all like high ranking countries such as Iceland, Netherlands, etc.

As pointed out in the article, our health care system is plagued with ‘obsolete medical equipment, unmotivated professionals, lack of adequate tracking systems to monitor disease outbreak, and unequal access to healthcare, especially for the most vulnerable.’

As a communication researcher who believes in the developmental potency of communication tools, I have pondered on how communication tools (not just the media) can remit their quota to salvage these alarming and fortunately amenable drawbacks.

Before I share my thoughts, I decided to do a bit of study on Nigeria’s health care system. Here’s an overview of the system

• Nigeria’s health care is on the concurrent legislative list, so that means that it is the responsibility of the three tiers of government- federal, state, and local governments
• Before the coming of the British empire, Nigerians relied solely on traditional herbal medicine treatments.
• The private health care providers are major stakeholders in the system. This is unlike other thriving health care systems in Iceland, South Korea, the Netherlands, etc where their government manage the system.
• In 2021, for her over 200 million citizens, just 7% (N547 billion of N547 billion) of the year’s budget was allocated for health care. This is neither encouraging.
• Most citizens procure alternatives or self-medication rather than visit the ‘expensive’ private health outfits.
• There is a glaring health access inequality because the majority of the health facilities are in urban areas.

So, given the centrality of communication tools (such as the media or word of mouth) in society, where do they come to play in solving these seemingly ’insurmountable’ challenges? There are my submissions, taking cues from the ongoing pandemic situation:

Total Shape from Unsplash

Effective programming

During the heat of the pandemic, the major stories on mainstream media about the disease usually on the news bulletin were negative and appalling, although they were facts. You can agree with me that you saw more stories of death figures, rising cases, vaccine misinformation, etc.

However, it is the social responsibility of the media to create diverse types of health programs that are geared towards satisfying the needs and wants of their audience. Various programming formats that can be adopted include documentaries, musicals, interviews, jingles, discussions, and magazine programs.

The media wields immense power over a vast population but to adequately explore this ‘power’ for the benefit of all, media houses must juice up their programming creativity while considering their audience’s time and expectations.

Multidimensional Approach

Nigeria is currently plagued with diverse infrastructural challenges, so in the creation and selection of any program, intervention, and channel, the existing health inequality and our culturally polarized society, and the socio-economic stances of the audience must be roundly considered.

For instance, internet services have not entirely penetrated many remote communities across the country. Some villages do not even receive broadcast signals from radio or television.

And I discovered that during the pandemic, the communication approach adopted by health agencies to create awareness was strictly digital i.e online, news on the media (radio and television), SMS blasts, etc. Particularly, the SMS blasts were only in the English Language.

So in this case, the government should have considered other local languages for the sake of illiterate residents and other alternatives such as word of mouth (to be discussed) to reach the remote areas. Research revealed that vaccine hesitancy and conspiracy theories about the disease were and are still popular amongst rural dwellers.

During my research, I conversed with an individual who mentioned that in his village in Ekiti state (southwest Nigeria), none of the villagers still believe in the existence of the disease and he particularly never used a face mask unless he was coming to town!

Word of mouth

We should never underestimate the power of interpersonal communication. ‘Word of mouth’ is another effective communication tool that has been explored extensively in the marketing/advertisement industry. If the healthcare system must strive, we must strategically utilize this tool.

Awareness about the COVID-19 pandemic could have been more effective if community workers such as social workers were mobilized to visit communities for sensitization about the disease, preventive measures, vaccines, myths, etc, and not just mere surface information about the disease on the television and radio.

Well, I want to believe that there were a few NGOs that deployed social workers based on their limited resources, but it would have been more effective if government stakeholders have explored this option too especially in remote areas.

That is, a one-on-one conversation with individuals and groups of individuals to first understand their opinion about the disease and then help them understand why they must take necessary precautions. In short, communication WITH and not AT them.

Amble investment in the media

Certain sectors have benefited extensively from the media such as entertainment, sports, food, etc. There are a plethora of channels dedicated to these programs such as Supersports, E!, African Magic, etc and we can all see the rewards.

I do not yet know of any channel that is entirely health-based. What we have are weekly 30 minutes health programs where a medical expert is invited to share insights about a topical health issue.

It is not out of place to have a dedicated health channel that has diverse types of health programs which I would discuss in my next article. I will share some insights into different types of health programs that can be educative, instructive, and entertaining!

We should have programs should highlight the health intervention efforts of the government, project the works and breakthroughs of medical practitioners, bring the government accountable for any loopholes, recommend legislation and reforms that can reinstate the system, etc.

To achieve this, however, it will take the synergy between the government who should pump in adequate resources, and the available communication outfits.

The media and institutionalizing traditional medicine

Nigerians in their various cultural groups still consume herbal medicine which they created for every kind of disease including fever, caesarian session, typhoid, bone fracture, malaria, etc.

We still have herbalists, bone setters, traditional psychiatrists, traditional birth attendants (midwives), etc. In fact, during the heat of the pandemic, there was a glaring rise in the sale of garlic and ginger as it was regarded as a very potent preventive remedy.

Although, despite the positive impact of this medicine, there are still reported cases of misuse, misinformation, and biases since it's an unregulated industry to date.

So, I strongly believe that the media can play a major role here in spotlighting the industry and aiding the audience to understand the efficacy and safety of traditional medicine through strategic enlightenment campaigns/programs. Media houses can:

1. Educate the public about the benefits of traditional medicine to get rid of the usual religious and cultural biases.
2. Bring the attention of the government to this potential industry and then project the efforts of the government in institutionalizing and regulating the traditional medicine industry.
3. Invite traditional medical doctors to share their thoughts on diverse diseases and recommend government-approved medications.

As I conclude, the health care sector can benefit significantly from the strategic use of communication tools, but it will take the synergy of major stakeholders such as media organizations, relevant government parastatals, health-based NGOs, and health practitioners to achieve this rewarding task.

We also do not have to wait for another major health turmoil before we take necessary actions!