Is the Nigerian government one step closer to evidence-based decision making in health?

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Editor’s Note: This week’s Thought Leadership Piece was contributed by Olusesan A. Makinde, Senior Health Information Systems Advisor with MEASURE Evaluation project, Abuja, and Kolawole A. Oyediran, Senior Monitoring and Evaluations Advisor with the MEASURE Evaluation project in Arlington, Virginia. They highlight the recent inauguration of the National Health Data Governance Council, evaluating how critical this body is for strengthening the National Health Information System.  MEASURE Evaluation is a USAID-funded project with a mandate to strengthen health systems in low-resource settings. MEASURE Evaluation has provided technical support to the Federal Government of Nigeria since 2004.

On January 19, Nigeria’s National Health Data Governance Council (NHDGC) was formally inaugurated by the Honorable Minister of Health, Professor Isaac F. Adewole. This inauguration has been long overdue, as the NHDGC was prescribed under the revised Nigeria Health Information System (HIS) Policy back in 2014 as a means of addressing the leadership and coordination issues challenging the National Health Information System. However, this governance structure has only recently been formally put in place. The inauguration of the NHDGC sends a strong signal to stakeholders of the political will to strengthen the National Health Information System.

Health Information Systems (HIS) is one of the six building blocks of the health system and is made up of six components: resources, indicators, data sources, data management, information products and information use. This system governs how data is collected in the health sector and how that data is used by governing bodies to make important decisions that eventually affect the everyday Nigerian.

Courtesy: Health Metrics Network, WHO

Previously the components of the HIS in Nigeria have not been organized in such a way to provide reliable health information for effective and efficient planning, monitoring and evaluation of health programmes in the country. This made it unable to provide adequate evidence for decision making that would improve the health status of Nigerians. The National Council on Health at its 55th session recognized these shortcomings and approved the revision of the National Health Management Information System (NHMIS) policy.

The new HIS policy addressed the challenges that have long plagued the HIS in Nigeria. Its goal was to ensure evidence-based decision making for the health sector by producing timely, reliable and accurate data for informed policy-making, programming and resource allocation for health care at the three tiers of government.

Dr. Nosa Orobaton, a former Deputy Executive Secretary of the Health Metrics Network, who led the drafting of the policy in 2013/14, sent a congratulatory tweet, describing the inauguration as a crucial step.

The problems that have plagued the HIS in the country are well known, and so the Inauguration of the NHDGC is seen by many as a crucial step towards addressing those problems. Challenges that have been repeatedly identified in previous diagnostic studies carried out include weak governance, poor coordination and poor collaboration by the multiple institutions involved in health data generation in the country.

Minister of Health, Prof. Isaac Adewole, centre, with Senator Udoma Udo Udoma, Minister of Budget and National Planning, left, and Eze Duruiheoma SAN, Chairman National Population Commission, at right, at the Inauguration of the Health Data Governance Council. Photo: Nigeria Health Watch

A key intervention proposed in the policy was the setting up of governance structures at the Federal and State levels to enhance coordination, collaboration, and partnerships among institutions and agencies generating and using health data.  The Policy prescribed that the National Health Data Governance Council be chaired by the Honorable Minister of Health and the State counterparts headed by the Honorable Commissioner for Health.  It further strengthened the already existing Health Data Consultative Committee (HDCC) by making the HDCC the technical warehouse to the NHDGC. This structure is also expected to be adopted by the states to aid improving the performance of the HIS at this level.The inaugurated NHDGC includes the following members:

  1. The Honorable Minster for Health (Chair)
  2. The Honorable Minister for Budget and National Planning
  3. Executive Director, National Primary Healthcare Development Agency
  4. Executive Secretary, National Health Insurance Scheme
  5. The Director General, National Agency for Food and Drug Administration and Control
  6. Director General, National Agency for the Control of AIDS
  7. Chairman, National Population Commission
  8. Statistician General, National Bureau of Statistics
  9. World Health Organization Representative/ Representative of the Development Partners Group
  10. Directors of relevant data producing Departments in the Federal Ministry of Health
    1. Department of Health Planning Research and Statistics (Secretary)
    2. Department of Public Health
    3. Department of Hospital Services
    4. Department of Food and Drugs
    5. Department of Family Health
Some members of the newly inaugurated Health Data Governance Council. Photo: Nigeria Health Watch

The NHDGC is expected to meet twice a year and will be tasked with the following terms of reference:

  1. To develop a mechanism for pooling resources across the different government agencies and partners, which will be used for financing the National Health Information System (HIS)
  2. To track the amount of money allocated to HIS and the amount released for each year
  3. To ensure the maintenance of the integrity of the National HIS architecture
  4. To approve of the national indicator list on the recommendation of the NHDCC
  5. To identify challenges regarding the non-release of funds and instituting a mechanism for improving the release of funds
  6. To advocate to the legislature for improved financing of HIS.
  7. To ensure the incorporation of findings from the HIS into decision-making in the country
  8. To ensure that best practices are adhered to in the deployment of different applications for managing different components of health data in the country
  9. To deliberate on any other emerging issues on Health Information System in the Country.

 

With the composition of the NHDGC, the HDCC is expected to actively identify key issues to be presented to the NHDGC in the coming months during its first meeting. An accompanying five-year National HIS strategic plan was also developed to guide the implementation of this policy. With the active commencement of implementation of the HIS policy and strategy, the expectations from stakeholders are high.

It is our hope that this renewed commitment to the National HIS by the leadership in the Federal Ministry of Health will produce significant, evidence-based results for the sector in the near future.

Discussion2 Comments

  1. Thanks for the article.
    The health information system is a key component that cannot be shoved aside if we don’t just want to be paying lip service to health system strengthening. It is sad that despite clear policy to integrate the health information system, vertical systems are still very rampant without any check. I see this as a great step forward as I await decisive actions to be taken by the NHDGC in order to convince me that this is not “just another council” without political will. I also hope that the states will quickly inaugurate their HDGCs to complement the NHDGC.
    Overall, the article was a nice write-up except that the part on strategic plan for the HIS policy was wrongly placed. I think it should have come after the policy was mentioned.

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