Scaling up health intervention: is planning in Nigeria becoming evidence based?
Babayemi Oluwaseun Olakunde
The Pan African Medical Journal. 2011;10:13. doi:10.11604/pamj.2011.10.13.1133

Create an account  |  Sign in
EPI Helina 2017
"Better health through knowledge sharing and information dissemination "

Opinion

Scaling up health intervention: is planning in Nigeria becoming evidence based?

Cite this: The Pan African Medical Journal. 2011;10:13. doi:10.11604/pamj.2011.10.13.1133

Received: 30/08/2011 - Accepted: 31/08/2011 - Published: 03/10/2011

Key words: Evidence based planning, Nigeria, Cost analysis, Nigeria

© Babayemi Oluwaseun Olakunde et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/10/13/full

Corresponding author: Wole-Ayo Hospital, P. O Box 1561, Ondo, Nigeria (boolakunde@yahoo.com)


Scaling up health intervention: is planning in Nigeria becoming evidence based?

 

Babayemi Oluwaseun Olakunde

 

1Wole-Ayo Hospital, P. O Box 1561, Ondo, Nigeria

 

 

&Corresponding author
Babayemi Oluwaseun Olakunde, Wole-Ayo Hospital, P. O Box 1561, Ondo, Nigeria

 

 

Background

With scaling up effective health interventions towards achieving the health-related Millennium Development Goals high on the policy agendas of many developing nations, the costs and as well as benefits of these health interventions are extremely vital in resource poor settings such as Nigeria [1]. The use of economic perspective as an approach for priority setting is of increasing acceptance as there is need for evidence based planning [2]. Economic analysis involves comparing the costs and benefits of different health interventions. While a cost analysis examines the economic inputs to an intervention, an economic evaluation examines both the cost and output of the same intervention [3,4].

 

Cost analysis is considered a sine qua non for health planning and budgeting. It is useful for estimating resources required to scaling up interventions, estimating the resources required to sustain intervention, advocacy, and resource mobilization [3,5]. Cost analysis is also used as a component for assessing health system performance [6].

 

Despite the body of evidence on the significance of economic analysis, it?s into planning and decision making is limited in developing countries [2,7]. Some of the many factors that have been attributed include lack of political willingness, shortage of technical expertise, and dearth of relevant data [2,7]. Perhaps, the situation in Nigeria is taking a paradigm shift.

 

 

Planning of the ward minimum health care package

Primary health care (PHC) is the cornerstone of the Nigerian health system. However, in the last decades it has been in a dismal state, with a direct consequence on the overall performance of the health system [8]. With the aim of strengthening PHC, the National Primary Health Care Development Agency (NPHCDA) in 2007, after a detailed cost analysis, launched the Ward Minimum Health Care Package (WMHCP) for the plan period 2007-2012. The WMHCP consists of the following components: Control of Communicable Diseases (Malaria, Tuberculosis, STI/HIV/AIDS), Child Survival, Maternal and Newborn Care, Nutrition, Non-Communicable Diseases Prevention, and Health Education and Community Mobilization [9]. An initial costing exercise was conducted in one geopolitical zone, however, the stakeholders requested for further evaluation to cover all the six geopolitical zones. With technical support from Partnership for Transforming Health Systems (PATHS), a second survey in the five other geo-political zones was conducted and the cost for each of the components of WMHCP was evaluated. This was finally adopted by the stakeholders.

 

 

Conclusion

This example shows the determination and commitment of the actors to integrate cost analysis into planning. It illustrates that policy is more likely to be evidence based if evidence is adequate and available at the time it is needed [10]. In addition to this, Nutbeam also stated that evidence that fits with political vision and balance of interests (or can be made to fit), evidence that points to actions for which the resources, capacity, system and infrastructure are more likely to inform policy [10].

 

However, evidence such as economic analysis alone doesn?t make decisions. Other factors such as needs, values and equity have to be considered by decision makers, but the scientific basis to guide decision making should be the evidence [11]. The use of economic analysis to guide planning should be a continuous and an institutionalized exercise to reduce profligacy in countries with limited funds such as Nigeria. Further progress in Nigeria will require health researchers to recognise, understand, and engage more in health policy making process. Health researchers should undertake research relevant to local needs, establish the development of valid and reliable evidence (recognizing the value of systematic reviews and meta-analysis) [12].

 

 

Competing interests

The author declares no competing interests.

 

 

References

  1. Hanson K, Cleary S, Schneider H, Tantivess S, Gilson L. Cost of scaling up health intervention in low and middle developing countries. BMC Health Services Research. 2010; 10(1):I1. This article on PubMed

  2. Hutubessy R, Chisholm D, Edejer TT. Generalized cost-effectiveness analysis for setting national-level priority-setting in the health sector. Cost effectiveness and resource allocation. 2003; 1:8. This article on PubMed

  3. Walker D. Cost and cost-effectiveness guidelines: which ones to use?. Health Policy and Planning. 2001; 16(1): 113-121. This article on PubMed

  4. Hutton G, Rehfuses E. Guidelines for conducting cost-benefit analysis of household energy health intervention. Geneva: WHO. 2006

  5. Collins D, Lewis E, Stenberg K. Scaling up Child Survival Interventions in Cambodia. The cost of national programme resource needs - Geneva: WHO. 2007

  6. Johns B, Baltussen R, Hutubessy R. Programme costs in the economic evaluation of health interventions. Cost Effectiveness and Resource Allocation. 2003; 1:1. This article on PubMed

  7. Hutubessy RCW, Baltussen RMPM, Tan Torres-Edejer T, Evans DB. Generalised cost-effectiveness analysis: an aid to decision making in health. Applied Health Economics and Health Policy. 2002;1:89-95. This article on PubMed

  8. Reid M. Nigeria still searching for the right formula. Bull World Health Organ. 2008; 86(9):663-5. This article on PubMed

  9. National Primary Health Care Development Agency. Ward Minimum Health Care Package. Abuja: NPHCDA.2007

  10. Nutbeam D. How does evidence influence public health policy?tackling health inequalities in England. Health Promotion Journal of Australia. 2003; 14: 154-158

  11. Gray JA. Evidence-based public health-what level of competence is required. J Public Health Med. 1997 Mar;19(1):65-8. This article on PubMed

  12. Lewig K, Arney F, Scott D. Closing the research-policy and research-practice gaps: Ideas for child and family services. Family Matters. 2006; 74: 12-19

 

 

 

 

 

 

 

 

 

 


The Pan African Medical Journal articles are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 27 (May - August 2017)

Article tools

This article authors

On Pubmed
On Google Scholar

Rate this article

Altmetric

PAMJ is a member of the Committee on Publication Ethics

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2017 - Pan African Medical Journal. All rights reserved