The German Agency for International Cooperation (GIZ-Deutsche Gesellschaft für Internationale Zusammenarbeit) reveals that it researched five states—Lagos, Edo, Ogun, Plateau, and Niger—to understand the level of awareness and adoption of digital solutions at the primary healthcare level. 

The aim of this is to improve the capacities of national stakeholders and institutions, offering support in healthcare delivery and promoting innovative business and digital solutions for the benefit of citizens and healthcare practitioners. 

In a document seen by Nairametrics, the research revealed challenges, including the dominance of Community Health Extension Workers (CHEWs) at the PHC level, limited awareness of technological innovations, and difficulties in attracting healthcare workers to rural PHCs due to inadequate infrastructure and funding. 

The German Agency for International Cooperation (GIZ) therefore stepped in to support Nigeria’s primary healthcare system through the Pro-Poor Growth and Promotion of Employment Programme (SEDIN) and the BACKUP-Health programme. 

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What they said 

Mr Markus Wauschkuhn of the GIZ-SEDIN programme explained saying, 

  • “To achieve this, SEDIN has carried out desk review, qualitative and quantitative research and analysis, and validation sessions with critical stakeholders. 
  • “Three winners emerged and they developed solutions at different stages of development and commercialization. 
  • “They address core challenges like maternal and infant healthcare delivery, data interoperability and management, mobile-based solutions for patients’ management and continuous learning for healthcare workers”, he said.  

According to Mrs Sina Uti-Waziri, Team Leader, of Local Economic Development, GIZ, 

  • “The research we run allows us to shed a light on the specific needs of primary health care workers”. 
  • “We know that only innovation which meets the needs of healthcare workers can be successfully adopted”. 

The rationale behind GIZ’s intervention 

According to WHO, Primary healthcare (PHC) serves as the closest healthcare system to people, providing basic services at the grassroots level and aiming to reduce maternal and infant mortality, manage illnesses like malaria, and conduct immunization campaigns. 

Despite its potential, PHCs in Nigeria face challenges such as being located in rural areas, resulting in health workers preferring urban areas with better amenities and infrastructure.

Additionally, the remuneration for PHC health workers is lower than in bigger hospitals, discouraging qualified doctors and nurses from practising in PHCs. 

Insights from research 

Ms Margherita Trestini, Marketing Director, Prototipi, said that the SEDIN Primary Health Care Quali-Quantitative Research was carried out between November 2022 and March 2023 focusing on five states. 

 According to Trestini, here are some of the  challenges identified: 

  • Domination of community health extension workers 

“For instance, it showed that the primary level of care is rather dominated by Community Health Extension Workers (CHEWs) and junior CHEWs, who make up about 36.8 per cent of all care providers at the PHC level. 

  • Unwillingness to work in the rural areas 

“Health workers perceive rural life as difficult and lack the desire to work in PHCs located in rural communities…” 

  • Low doctor-to-patient ratio

“….lack of manpower, that is, low doctors to patients ratio, unbalance in service delivery between rural and urban areas.

  • Inadequate budgetary allocation 

“Other challenges are inadequate budgetary allocation by the Federal Government…” 

  • Lack of skilled personnel  

“…lack of skilled personnel and lack of ICT infrastructure, poor funding, bad roads, among others. 

  • Lack of technological adoption 

She also said the research showed that the awareness of the usage of technological innovations in Nigeria’s PHCs is limited to rudimentary and traditional where their operators mainly know about computers and mobile phones. 

  • “Emerging technologies such as drones, AI and blockchain have a very low level of awareness. Some of the reasons why emerging technologies have a low likelihood of adoption included; lack of knowledge about them and their functions as they are perceived to be expensive, very technical, undependable and even not feasible” 

Primary Healthcare Hackathon 

To address these challenges, GIZ organized the Primary Health Care Hackathon, encouraging mobile-based solutions for patient management, medication delivery monitoring, continuous learning for health workers, and solutions to improve women’s health and maternity care services. 

Winners of the hackathon presented their solutions, including AfyaRekod, a patient healthcare platform using blockchain and AI technologies to consolidate and provide access to health records; Natal Care, which leverages mobile technology and machine learning to combat maternal and infant mortality; and Healthstack Solutions, a global healthcare platform digitizing provider organizations to streamline operations and deliver high-quality care. 

Stakeholders concluded by emphasizing the importance of donor agencies and development partners supporting government efforts to fund, equip, and staff PHCs, while urging governments to increase funding and improve working conditions to attract health workers to these vital healthcare centres.