Nigeria often referred to as the ‘Giant of Africa’ owing to its large population and economy, shoulders approximately 10% of the global disease burden1 and 20% of all global maternal deaths. Nigerians face inequities to health services due to financial barriers with high rates of out-of-pocket expenditure, ineffective national health insurance systems, and poor service integration. Human resources shortages and “brain drainage” from Africa to other developed economies further compound healthcare outcomes.2 Non-implementation of relevant policies, programmes and disagreements between government and the various healthcare workers have frequently led to healthcare worker strikes and consequently prevented optimal healthcare delivery to the Nigerian population.3

KEY HEALTHCARE INDICATORS4,5,6,7,8

63%

of total deaths due to communicable, maternal, perinatal & nutritional conditions

43%

maternal deaths due to postpartum haemorrhage (PPH)

62%

neonatal deaths due to pre-term and intrapartum complications

219

per 100,000 Tuberculosis cases

0.4

Physicians per 1,000 population

43%

maternal deaths due to postpartum haemorrhage (PPH)

63%

of total deaths due to communicable, maternal, perinatal & nutritional conditions

219

per 100,000 Tuberculosis cases

Postpartum haemorrhage (PPH) and pre-eclampsia or eclampsia account for 43% and 37 % of all the maternal deaths in Nigeria respectively.9

Neonatal deaths10 in Nigeria account for 32% of child deaths out of which:
  • 31% occur due to pre-term birth complications
  • 31% due to intrapartum complications
  • 16% due to sepsis
  • 7% due to pneumonia
  • Remaining deaths occur due to other causes such as tetanus, diarrhoea, etc.
Other causes for child deaths in Nigeria10 can be attributed to:
  • Malaria (14%)
  • Pneumonia (10%)
  • Diarrhoea (10%)
  • Remaining deaths due to other causes such as Meningitis, Injuries, Measles, AIDS, etc.
  • Total fertility rate (15-49 years) : 5.8
  • Early Childbearing (% of women age 20-24 years who had at least one live birth before age 18) : 30.8%
  • Unmet need for contraception : 27.6%

Health Systems
challenges

  • Shortage of human resources in health (HRH)
  • Varying levels of quality of care
  • Comprehensive data collection tools for frontline workers (FLWs)
  • Robust mechanisms for last mile vaccine delivery and immunization tracking
  • Robust mechanisms for biomedical equipment management & maintenance
  • Engaging private sector to enhance service delivery
  • Innovative funding mechanisms for health programmes

Source: WHO. Trends in Maternal Mortality:1990 to 2015 : Estimates developed by WHO,UNICEF,UNFPA,World Bank Grp and the UNPD, Geneva

Source: Key Demographic Indicators :Nigeria UNICEF accessed Mar,2021

Source: Key Demographic Indicators :Nigeria UNICEF accessed Mar,2021

Source: Key Demographic Indicators :Nigeria UNICEF accessed Mar,2021

References:

  • 1 Muhammad, F., Abdulkareem, J., & Chowdhury, A. (2017). Major Public Health Problems in Nigeria: A review. South East Asia Journal of Public Health, 7(1), 6-11. https://doi.org/10.3329/seajph.v7i1.34672
  • 2Obinna O Oleribe, Jenny Momoh & Benjamin SC Uzochukwu et al (2019) Identifying Key Challenges Facing Healthcare Systems In Africa And Potential Solutions. International Journal of General Medicine,12,395-403.
  • 3 Adeloye D, David RA, Olaogun AA, et al. Health workforce and governance: the crisis in Nigeria. Hum Resour Health. 2017;15(1):32. doi:10.1186/s12960-017-0205-4
  • 4 https://www.who.int/nmh/countries/nga_en.pdf
  • 5 Sageer et al. BMC Pregnancy and Childbirth (2019) 19:63
  • 6 Nigeria Every Newborn Action Plan. Federal Ministry of Health 2016
  • 7 TBFACTS.org
  • 8 https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?locations=NG
  • 9 Sageer et al. BMC Pregnancy and Childbirth (2019) 19:63
  • 10 Sageer et al. BMC Pregnancy and Childbirth (2019) 19:6
  • Limited trigger mechanism for identification and early referral of high-risk pregnancies (HRPs)

    • Prevalence of HRPs in Nigeria is 40%.11
    • Only 57% women (aged 15-49 years) received 4 antenatal checkups.12
  • Limited availability of sterile disposable consumables for maintaining asepsis and hygiene during childbirth

    • Puerperal sepsis is one the leading causes of maternal mortality.
    • 16% of neonatal deaths have reportedly been attributed to sepsis13.
    • Some of the identified risk factors that contribute to infections are caused by poor hygiene practices during and after delivery
  • Limited availability of monitoring devices for neonatal hypothermia

    • 31% of neonatal deaths due to pre-term birth complications14.
    • Pre-term and low birth weight neonates are particularly vulnerable to hypothermia due to immature temperature regulation abilities.
    • Neonatal hypothermia has been reported to be 62% in Nigeria15.
  • Inadequate mechanism for digitization of patient health records in order to facilitate efficient record keeping and retrieval

    • Paper based record keeping carries the risk of loss of health records and limits the informed decision making process and reduces the operational efficiency.

References:

  • 11 Federal Republic of Nigeria. 2018. Nigeria Demographic and Health Survey
  • 12 Federal Republic of Nigeria. 2018. Nigeria Demographic and Health Survey
  • 13 https://cdn2.sph.harvard.edu/wp-content/uploads/sites/32/2016/11/Nigeria-Every-Newborn-Action-Plan-Launch-Version.pdf
  • 14 https://cdn2.sph.harvard.edu/wp-content/uploads/sites/32/2016/11/Nigeria-Every-Newborn-Action-Plan-Launch-Version.pdf
  • 15 Ogunlesi TA, Ogunfowora OB, Adekanmbi FA, Fetuga BM, Olanrewaju DM, Point-of-admission hypothermia among high-risk Nigerian newborns. BMC Pediatr. 2008 Oct 6;8:40. https://pubmed.ncbi.nlm.nih.gov/18837973/
SI No. Name of the pilot Name of the piloting solution Total no. of sites activated Number of facilities activated Total no of beneficiaries enrolled
1 Registration, tracking and management of through novel “CareMother” kit CareMother 2 18 796
2 Prevention of contracting infection by adhering and maintaining clean birth practices using Janma Birth Kit Janma Birth kit 3 9 260
3 Monitoring and identification of Neonatal Hypothermia through Bempu TempWatch and administration of Kangaroo Mother Care Bempu TempWatch 3 4 24
4 To use Doxper for digitization of health records Doxper 1 2 222

PILOT PROJECTS IN NIGERIA

  • Name of the Pilot

    Registration, tracking and management of through novel “CareMother” kit

    Problem Statement

    Limited trigger mechanism for identification and early referral of high-risk pregnancies (HRPs)

    Our Piloting partners

    CareNX Innovations Pvt Ltd (Indian healthcare solution provider),
    PanAfricare (local implementation partner)

    Description of our pilot solution

    CareMother is a platform with 3 components:
    (a) antenatal kit – includes 8 portable solar-powered battery-operated diagnostic devices/items;
    (b) mobile App – for use by the health-workers & doctors, and
    (c) web portal – for data management & analysis

  • Name of the Pilot

    Prevention of contracting infection by adhering and maintaining clean birth practices using Janma Birth Kit

    Problem Statement

    Some of the identified risk factors that contribute to infections are caused by poor hygiene practices during and after delivery. Thus, there is a need for maintaining clean and aseptic conditions during childbirth.

    Our Piloting partners

    ayzh Health and Livlyhood Pvt Ltd (Indian healthcare solution provider),
    PanAfricare (local implementation partner)

    Description of our pilot solution

    Janma birth kit is a low cost, high quality birth kit for use in hospitals and other clinical settings. This disposable kit enables healthcare providers in low-resource settings to provide the “Six Cleans” recommended by WHO to prevent infection among mothers and newborn during childbirth.

  • Name of the Pilot

    Monitoring and identification of Neonatal Hypothermia through Bempu TempWatch and administration of Kangaroo Mother Care

    Problem Statement

    Limited availability of monitoring devices for neonatal hypothermia

    Our Piloting partners

    Bempu Health Pvt. Ltd. (Indian healthcare solution provider),
    Africare (local implementation partner)

    Description of our pilot solution

    Bempu Health’s hypothermia alert device (TempWatch) is a simple neonatal bracelet that continuously monitors the temperature of an infant day and night for 28 days in the hospital and home setting. If the infant is hypothermic, the device sounds an alarm and flashes an orange light alerting the mother. The care givers are trained to give Kangaroo Mother Care (KMC) to warm the infant well before injury or death can occur. Should the baby continue to be hypothermic despite warming actions, the device continues to alarm nudging the mother to seek skilled care since hypothermia is a sign of sepsis and other potentially fatal complications.

  • Name of the Pilot

    To use Doxper for digitization of health records

    Problem Statement

    Inadequate mechanism for digitization of patient health records in order to facilitate efficient record keeping and retrieval

    Our Piloting partners

    InformDS Technlogies Pvt. Ltd. (Indian Healthcare solution provider) & Gwagwalada Clinic & Maternity and Tabitha Medical Center (Local implementation partners)

    Description of our pilot solution

    Novel Doxper device is used for digitization of patient health records in order to facilitate efficient record keeping and retrieval, use of patient data analytics for evidence-based decision making, improving continuity of care through monitoring and promoting patient compliance to follow-up visits