Risk Management in Nigeria Health Sector, Post COVID-19 Challenges 

By Dr. Osinowo Temitope Irmuk, MSC

West African nations, including Nigeria, have experienced outbreaks of infectious diseases such as Lassa fever, Ebola virus disease, monkeypox, yellow fever, and now Coronavirus disease (COVID-19) over the past few years. Insights into the response to previous outbreaks have revealed significant gaps in risk communication in the affected nations. COVID-19 pandemic has underscored the need for nations to reevaluate their approach to risk communication and management, particularly regarding the effective dissemination of messages during public health emergencies. Clearly, risk communication activities must be tailored to the realities and resources of the target population. Nigeria, the most populous nation in Africa, is a multicultural and multiethnic nation where over 600 languages are spoken. The planning and implementation of risk communication activities are complicated by these realities. The purpose of this paper is to identify the challenges to implementing effective risk communication activities in Nigeria.

Is the Nigerian health system ready to respond to an outbreak? Some countries are more susceptible to epidemics due to disparities in the capabilities of their health systems, which could have significant health and socioeconomic repercussions from out- breaks. 

A resilient health system necessitates preparedness and response capabilities the ability to prepare for and respond to public health emergencies at all levels of the health system under the direction of a national public health institute. Preparedness is essential for containing the spread of an out- break and reducing the burden on the health system. Preparedness is largely the result of system-level capabilities, such as financial resources, a competent workforce, and a defined and tested preparedness plan. 

Effective risk management activities are influenced by leadership and coordination, adequate funding, and available and skilled human resources. In Nigeria, the health system faces a multitude of challenges across all of its components, and health emergencies strain the already fragile system. 

The nation’s ability to prevent and respond to a disease outbreak were 41% and 46%, respectively. The Nigerian health system is plagued by ineffective leadership and co- ordination, inadequate funding, insufficient human resources, and unequal access to care. 

During a health emergency, it is difficult to coordinate with various actors due to the fragmentation of health service delivery. Risk communication has been identified as a deficiency in the response to health emergencies in Nigeria and other African nations, which could compromise efforts to contain outbreaks.

Although globalization has been advantageous in facilitating the free movement of people, goods, and services, the ease of movement of cross-border pathogens has increased the risk of international public health emergencies in recent years. 

Risk management and mitigation is an integral part of every country’s response during public health emergencies such as the coronavirus disease (COVID-19) pandemic. 

To effectively increase adherence to guidelines during health emergencies, it is essential to understand the impact of social, cultural, political, and environmental factors on people’s behaviours and lifestyles in any given context, as well as how these factors influence people’s perception of risks. 

During the recent response to the COVID-19 pandemic in Nigeria, the need to comprehend these influences was pronounced, and these influences ultimately shaped risk communication in Nigeria. We have identified risk communication challenges in Nigeria based on sociocultural diversity, the complexity of the health system, the impact of social media on communications, and other contextual factors surrounding multisectoral partnerships. To achieve global health security, these challenges must be addressed in resource constrained countries like Nigeria. I emphasize the need to contextualize risk communication strategies to improve their effectiveness during health emergencies. In addition, we urge increased country commitment to a multi-hazard and multisectoral effort, deliberate investment in subnational risk communication systems, and investments in capacity building for risk communication activities. 

I further encourage the government funding allocation for risk communication and management during and post covid resurgent planning in the budget. In many nations, including Nigeria, there are competing health sector and non-health sector priorities for the nation’s limited resources. There are insufficient discussions regarding policies and strategies for both the long-term funding of health systems and health security, as well as a distinct and sustained budget for risk communication. 

During the COVID-19 response in Nigeria, significant efforts were made to mobilize resources to address this health emergency. Yet, funding for risk communication activities at the national and subnational levels in Nigeria remains inadequate. Globalization and environmental changes define the 21st century, and epidemics are not far off. Priority must be given to budgeting for risk communication and management planning during health emergencies and post covid planning strategy.