Health research influences political manifestos in Nigeria



Robert Walgate




The report of a Nigerian health systems scientist on progress in addressing political obstacles to equity in access to health care services in south-western Nigeria, received a warm welcome at the seventh meeting of the Global Forum for Health Research in Geneva, 2–5 December.

"It really is a legitimate area of research in and of itself," said Dr Tikki Pang, Director of WHO's Research Policy and Cooperation department. "How do you connect and talk to the politicians and decision-makers?" he asked.

Dr Lola Dare who works for the African Council for Sustainable Health Development — a partnership between African civil society, governments, private sector and development partners — and a team of researchers have begun to provide the answer. Dare and her team have been studying access to health care services in Nigeria's Ondo State, an oil and mineral producing region with a population of 3–4 million.

They found that the number of general hospitals available to Ondo's wealthier population was 2–3 times as many as the figure recommended by the national health care plan. For the poor, however, there were only one-tenth of the recommended number of dispensaries, health clinics and health posts.

The Commissioner of Health for Ondo State, Dr Oluremi Akinbobola described the disparity. "We have many private hospitals in Nigeria ... but the poor have no access to them," he said. "We have 203 political [constituencies] in Ondo and 289 basic health centres. Yet there are 54 [constituencies] without a single basic health care centre," he said.

Dare described how she used her research to work with potential state governors to develop manifestos which respond to the inequities in health care experienced by Ondo's poor. The conclusions of her research have influenced the manifesto of the current state administration, she said.

Dare's research led to a move away from free health care in Ondo to selective exemption fees for certain categories of people. Access to the data resulting from her research was essential in order for Ondo's government to reach this decision. "You can't over-emphasize the value of evidence-based policy dialogues ... even politicians want evidence to show that they can change the way the electorate votes, if they do this or that," she said.

This kind of research — which translates knowledge into action by decision makers — is the kind that Pang hopes to see more of. He predicted that 2004 would be a "fantastic year" for health research. In 2004, WHO will publish a report on health research — The world report on knowledge for better health — a draft of which will be distributed in January. In November 2004, the World Summit on Health Research is scheduled to take place in Mexico City and will coincide with this year's annual meeting of the Global Forum for Health Research. The objective of both the WHO report and the forthcoming summit is to find ways to turn research products into actions for health through health systems research that breaks down delivery and access barriers.

World Health Organization Genebra - Genebra - Switzerland