Health Informatics : A Bird’s Eye view of Nigeria

1. WAHIFP Inauguration 16th January, 2012 Health Informatics : A Bird’s Eye view of Nigeria By Dr. Francis Ohanyido , FRSPH, FIPH COP |Team Leader Africa ,Synergy PMP i-Novate 2100 Adjunct Professor , Regional Consultant, WHO |AFRO ohanyido@doctor.com

2. NIGERIA strategic resource • Africa’s most populous country with a population of 140 million (NPC, 2006) • shortage of health workforce • High maternal and infant mortality • No health informatics policy • National Information Technology Policy Bill is before the National Assembly for legislation

3. Background •  Its on record that the first computer emerged in Nigeria in 1948 when the Nigerian Ports Authority bought a ‘Visible Record Computer’ from International Computer Limited (ICL). • Historically, Nigerian health informatics took off around 1988-89 when a collaborative research project between the Computing Centre of the University of Kuopio, Finland and Obafemi Awolowo University, and Obafemi Awolowo University teaching Hospital (OAUTHC), Nigeria (Idowu, et al, 2003a) was organised as a component of Informatics Development for Health in Africa (INDEHELA) supposed to be a long-term strategic arrangement. See http://www.uku.fi/indehela/.

4. . • First International Conference on Health Informatics was held in Africa in ILe-Ife, Nigeria, 19-23 April 1993. A watershed. • Health informatics became a major issue in the mid-1990s Nigeria because of the rapid development of the ICT domain , and its attendant plug-in into all facets of medicine. It is now applied to the areas of nursing, clinical care, dentistry, pharmacy, public health, occupational therapy, and biomedical research. • The use of electronic-based ICT systems especially around records and information management systems was further propelled by donor-funded programmes in Nigeria in the late 1990s, through equipment support . • Coupled with these, the establishment of the Nigerian University network (NUnet) linking some of the major universities via the web and basic email facilities for staff and students , created windows for linkage with Teaching Hospitals and computerisation

5. . • Dr. Francis Ohanyido & late Dr. Emmanuel Ikilama two early advocates for Telemedicine and ehealth advocated for the uptake of ICT for health in 1996, and as students worked with the University of Jos Computer programmes unit to examine the basic areas for use. Later Ohanyido wrote a dissertation on the Use of Computers and Internet in Medicine • By 1996-7 there was already a strong need to form a network of students interested in health informatics by Ohanyido & Ikilama in Jos . At that time their focus was more on telemedicine • In the big Universities at Ife and Ibadan in late 1990s, efforts were made to sustain earlier impetus gained from the INDEHELA

6. Professional Bodies • In 2003 the Nigerian Telemedicine Development Alliance (NTDA) was founded and a website hosted on Tripod as an online advocacy and information sharing group by 2004 . It was led by Drs Ohanyido and Ikilama • Later ,the Society for Telemedicine and ehealth in Nigeria (SfTeHIN) was established April 2005 and presided by Dr. Joseph Adebola as President. SFTeHIN is affiliated to the International Society for Telemedicine and eHealth (IST • NTDA was dissolved in 2007 as part of the process of having one coordinating voice in SfTeHIN

7. . • The Association of Health Informatics of Nigeria (AHIN) is another professional group in Nigeria working around Health Informatics which was evolved in 2007. • The National Telemedicine and eHealth Working Group (NTeHWG) was created by stakeholders in 2008 and chaired by FMOH and coordinated by Ohanyido up to 2009

8. Academic Institutions • Several academic establishments offer Health Information Management programmes at various levels, but only a few like Federal University of Technology Owerri, that offer Health Informatics up to postgraduate level. Largely due to the effort of Prof. Egondu R. Onyejekwe a professor of Health Informatics based in the United States. • Center for Professional Development and Learning (CEPDEL) and its partners plan to introduce professional certifications in health informatics and health informatics project management

9. Illustrative ICT Components Informatics Projects • Infrastructure National Transmission • Network (Fiber Optic) VSAT Nework/LAN/WAN Universal and Affordable • Gateway/E-mail Access Telecentres Digital Agencies Computers + Peripherals • Human Capacity • Admin Staff • Accounting Staff • Pharmacy Staff • Nurses • Medical Officers • Other Depts. Content & Applications Databases Education & Research Knowledge Management Archives Telemedicine e-Hospital Services Enterprise Services: Clinical Non-Clinical services Processes Attendants/Admissions Client records Administration/Personnel Finance/Payroll Maintenance Procurement M&E Research • Policy and Regulation • Institutional: • Policy • Vision • strategy Source: Lecky 2011

10. Capacity • This is a major challenge • Capacity Building at all levels needed especially in Ministry of Health, Tertiary ,Secondary and Primary Care levels, • Undergraduate health and IT Programmes in informatics not widespread • General public lacks knowledge of health informatics • Public Sector training cascade of skills for sustainability of informatics projects

11. Informatics-health value-chain strategic resource data information • accurate & relevant • Storage • Durable • Retrieval • Distributed • Analytics • Better decision making • Efficient allocation of resources • Targeted healthcare interventions • Identification of patient and community needs • Preventive health education and changes in health-oriented behaviour • Effective disease management • Better quality care • [Lecky 2011] knowledge action How do you join up this value-chain? What technologies? What approaches and processes? VALUE OF HEALTH INFORMATICS

12. OPPORTUNITIES FOR WAHIFP • The WAHIF Programme is coming at an opportune time • Nigeria is rapidly growing in the health domain and increasingly, professionals will be required to drive the evolution of the sector in the informatics and related domain • Donor –funded projects are increasingly requiring core competencies in the field of health informatics • Nigeria probably has the largest number of diverse categories and population of Health Resource for Health in the African Region, and constitute a veritable market