Epidemic preparedness: Experts proffer ways to decentralise health security

Experts have enjoined the federal government to strengthen human resources and accountability structures at the national and sub-national levels. 

They said doing so would strengthen health security and ensure a decentralized health system for epidemic and pandemic preparedness in the country.

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 The experts, who comprise stakeholders from across national and subnational levels, the private sector, development partners/donors and civil society organisations, stated this during a health security policy dialogue organized by the Nigeria Health Watch.

The theme of the forum was ‘Decentralising Health Security, Lessons from COVID-19’.

UNICEF Country Representative, Peter Hawkins, said Nigeria did well in its response to COVID-19 by setting up initiatives like CACOVID.

However, he said there were challenges with the response at the state level.

He said governance, data and decentralisation of finance are key to improving decentralisation in service delivery.

He also said Nigeria has very little accountability in its governance structure and physical responsibility, adding that, “Getting the human resources right has to be our number one priority.

“The second is looking at top-down planning and bottom-up accountability.”

 On the way forward, he said, “I suggest looking at accountability mechanism; looking seriously at human resources, ensuring that the surveillance system is robust and, most importantly, ensuring the surveillance and response mechanism is timely and robust in itself. And that the finances are available at state level with accountability alongside it so that they can plan for health security and be held accountable when there is evidence of an epidemic, with a degree of security and confidence to respond to that epidemic.”

 Dr Ifedayo Adetifa, the Director General, NCDC,  said the agency would continue to push for states to realise their power to change the health outcomes in their areas as it is critical to strengthening the country’s health security.

The Managing Director of Nigeria Health Watch, Mrs Vivianne Ihekweazu, said it is important to build on the gains of the COVID-19 responses in the country in order to strengthen health security at the sub-national level.

She said strengthening primary healthcare service delivery is also important in achieve universal health coverage (UHC) and health security in the country.

 The Director, Public Health Department of the Federal Ministry of Health, Dr Morenike Alex Okoh, said strong sub-national systems that are interconnected are a building block for effective national architecture for health emergency preparedness and response.

Dr. Anne Adah-Ogoh, Head of Policy, Private Sector Health Alliance of Nigeria, said investing in the private sector is critical to strengthening health systems at the subnational levels as evidenced in the organisation’s ‘Adopt a PHC’ initiative.