The Nigerian health information system policy review of 2014 : the need, content, expectations and progress.

BACKGROUND: Nigeria's national health information system (HIS) data sources are grouped into institutional and population based data that traverse many government institutions. Communication and collaboration between these institutions are limited, fraught with fragmentation and challenges national HIS functionality. OBJECTIVES: The objective of this paper was to share insights from and the implications of a recent review of Nigeria's HIS policy in 2014 that resulted in its substantial revision. We also highlight some subsequent enactments. REVIEW PROCESS AND OUTCOMES: In 2013, Nigeria's Federal Ministry of Health launched an inter-ministerial and multi-departmental review of the National Health Management Information System policy of 2006. The review was guided by World Health Organization's 'Framework and Standards for Country Health Information Systems'. The key finding was a lack of governance mechanisms in the execution of the policy, including an absent data management governance process. The review also found a multiplicity of duplicative, parallel reporting tools and platforms. CONCLUSION: Recommendations for HIS Policy revisions were proposed to and implemented by the Federal Government of Nigeria. The revised HIS policy now provides for a strong framework for the leadership and governance of the HIS with early results.

Duplication of effort across Development Projects in Nigeria: An example using the Master Health Facility List.

OBJECTIVE: Duplication of effort across development projects is often the resultant effect of poor donor coordination in low- and middle- income countries which receive development assistance. This paper examines the persistence of duplication through a case study of health facility listing exercises in Nigeria. METHODS: Document reviews, key informant interviews, and a stakeholder's meeting were undertaken to identify similar health facility listing exercises between 2010 and 2016. RESULTS: As an outcome of this process, ten different health facility listing efforts were identified. DISCUSSIONS: Proper coordination and collaboration could have resulted in a single list grown over time, ensuring return on investments. This study provides evidence of the persistence of duplication, years after global commitment to harmonization, better coordination and efficient use of development assistance were agreed to. CONCLUSIONS: The paper concludes by making a proposal for strategic leadership in the health sector and the need to leverage information and communications technology through the development of an electronic Health Facility Registry that can archive the data on health facilities, create opportunity for continuous updates of the list, and provide for easy sharing of the data across different country stakeholders thereby eliminating duplication. KEYWORDS: Aid Effectiveness, Donor coordination; Health Facilities; Health Information System; Health Systems; International Cooperation; Master Facility List.

Investing in health information management: The right people, in the right place, at the right time.

AIM: To describe the process adopted to review the academic curriculum for training health information management professionals in Nigeria. CONTEXT: Health information management professionals are responsible for managing patients' health service records and hospital information systems across health facilities in Nigeria. An assessment found many are inadequately skilled in information and communications technology (ICT) skills believed to be needed for them to play leadership roles in hospital information systems and function effectively. This was traced to a dearth of relevant ICT courses in their academic training curriculum. CASE STUDY: A review of the curriculum for training health information management professionals was instituted following an agreed need to address these issues. LESSONS LEARNED: Health records management is evolving across the world including the developing countries. This advancement requires evolution of training programs to meet the increasing application of ICT in this sector. CONCLUSION: After several sessions, a new curriculum that addresses all the identified educational deficiencies has been developed. It is believed that this step will help improve the quality of training programs.

Development of a master health facility list in Nigeria.

UNLABELLED: Abstract. INTRODUCTION: Routine Health Information Systems (RHIS) are increasingly transitioning to electronic platforms in several developing countries. Establishment of a Master Facility List (MFL) to standardize the allocation of unique identifiers for health facilities can overcome identification issues and support health facility management. The Nigerian Federal Ministry of Health (FMOH) recently developed a MFL, and we present the process and outcome. METHODS: The MFL was developed from the ground up, and includes a state code, a local government area (LGA) code, health facility ownership (public or private), the level of care, and an exclusive LGA level health facility serial number, as part of the unique identifier system in Nigeria. To develop the MFL, the LGAs sent the list of all health facilities in their jurisdiction to the state, which in turn collated for all LGAs under them before sending to the FMOH. At the FMOH, a group of RHIS experts verified the list and identifiers for each state. RESULTS: The national MFL consists of 34,423 health facilities uniquely identified. The list has been published and is available for worldwide access; it is currently used for planning and management of health services in Nigeria. DISCUSSION: Unique identifiers are a basic component of any information system. However, poor planning and execution of implementing this key standard can diminish the success of the RHIS. CONCLUSION: Development and adherence to standards is the hallmark for a national health information infrastructure. Explicit processes and multi-level stakeholder engagement is necessary to ensuring the success of the effort.

Predictors of condom-use among young never-married males in Nigeria.

This study examined the factors that influence condom-use among young never-married males in Nigeria. Such information can help improve the design of a prevention programme for young never-married, especially, males to reduce their vulnerability to sexually transmitted infections (STIs) and HIV/AIDS transmission. Data were derived from the 2003 Nigeria Demographic and Health Survey (NDHS). Analysis of data was restricted to 827 males aged 15-24 years, who had never married or lived together with a woman. Both descriptive and analytical methods were used for assessing the net effects of socioeconomic factors on condom-use. The analysis used logistic regression models for determining the predictors of sexual behaviour and condom-use among young never-married males in Nigeria. About 43% of the study population was sexually experienced, and the use of a condom remained low. One in five reported the use of a condom at sexual debut. Level of education, place of residence in childhood, urban/rural region, religious affiliation, economic status index, and exposure to mass media were associated with sexual experience and use of protective measures. Economic status index and mass-media exposure were associated with the use of a condom by the respondents during their last sex encounter. About two-fifths (43%) of the young unmarried Nigerian men were sexually experienced but the condom-use remained low, thus making this sub-group of Nigerian population highly vulnerable to STIs, including HIV/AIDS.

Fertility desires of Yoruba couples of South-western Nigeria.

Using the matched wife-husband (763) sample from the data collected from Ogbomoso and Iseyin towns in Oyo State, Nigeria, this paper examines factors associated with couples' fertility intention. The analysis used logistic regression models for predicting the effects of selected socioeconomic background characteristics on a couple's fertility intention. Results indicate high levels of concurrence among husbands and wives on fertility intention. Where differences exist, husbands are more pronatalists than their wives. About 87% of pairs of partners reported similar fertility preferences. Of these couples, 59.5% wanted more children while only 27.8% reported otherwise. The logistic regression models indicated that a couple's fertility intention was associated with age, education, place of residence, frequency of television-watching and number of living children. Therefore, programme interventions aimed at promoting fertility reduction in Nigeria should convey fertility regulation messages to both husbands and wives.

Perceptions of Nigerian women on domestic violence: evidence from 2003 Nigeria Demographic and Health Survey.

To facilitate the design of effective programmes to eliminate violence against women in Nigeria, this paper examined women's perceptions of wife beating. The data were derived from the 2003 Nigeria Demographic and Health Survey (NDHS). Both descriptive and analytical methods were used to assess the net effects of socio-demographic factors on women's perceptions of domestic violence. The study demonstrates that a large percentage of Nigerian women agreed that a man is justified in beating or hitting his wife; 66.4% and 50.4% of ever-married and unmarried women respectively expressed consent for wife beating. Respondents' approval of wife beating or abuse varied by personal attributes. Ethnic affiliation, level of education, place of residence, wealth index and frequency of listening to radio were significantly related to concurrence with wife beating. This paper highlights the cultural factors responsible for, and negative effects of, domestic violence against women in Nigeria and makes a case for raising public consciousness against it.

Determinants of condom use among monogamous men in Ondo State, Nigeria.

This study examined the factors that influence condom use among monogamous men in Ondo State, Nigeria. Such information can help improve the design of male-involvement interventions in reproductive health and campaigns to reduce the spread of HIV among the general population. Overall, analysis was restricted to 394 men who were in their first union and reported a monogamous marriage at the time of interview. The analysis used logistic regression models for predicting the effects of selected socioeconomic background characteristics on ever-use of a condom and reasons for its use. Findings showed that 30% of monogamous men had ever used a condom, while about 15% of men were currently using the method. The findings further showed that prevention of pregnancy was a concern among monogamous men, much more than prevention of sexually transmitted infections (STIs), including HIV/AIDS. The logistic regression models indicated that ever-use of a condom was associated with age, education, and having been counselled on family planning, while place of residence, frequency of television-watching, and exposure to family-planning counselling were factors associated with motivation for condom use. Although prevention of pregnancy is a major motivation for condom use, many men would use a condom for protection against STIs and prevention of pregnancy simultaneously. Therefore, programme interventions aimed at promoting the use of condoms among men should convey both pregnancy and STIs/HIV/AIDS-prevention messages in one programme.