The planning process is one of the most important factors in ensuring the success of any project. This is true if you are running a household, a small business, an organisation, or even a state. The popular adage that goes, "If you fail to prepare, prepare to fail," rings true here. For health projects, whether for an intervention or a state's health plan, planning cannot be underestimated, and the most effective plans are those that make use of the best evidence available to chart their course.
The use of evidence in health planning ought to be commonplace by now, but if you were to scan through the health plans of a number of the states in Nigeria, it would quickly become clear that some of the plans put forward have little or no data to back them. As such, budgets are allocated to health plans and projects with shaky foundations, and it becomes a murky affair to understand what kind of progress a project is making, and what kinds of results you can expect from a plan, if any.
Generating evidence for planning is a process that requires research. Research requires time and money. For some state actors and heads of organisations, this rigorous process is one they may argue they do not have the funds, or the patience for, and the lure of shortcuts and hastily implemented projects that may have little or no relevance to the communities they serve often leads those in the power to develop such plans into error.
Understanding the importance of using robust evidence for health planning was the heart of a workshop hosted yesterday by public health consulting firm EpiAFRIC and the World Bank Development Impact Evaluation (DIME) Nigeria, in Abuja. Attendees discussed how evidence is generated, how organisations and states should go about searching for evidence, and how they can develop plans that are based on already existing evidence rather than carry out expensive research.
Dr. Nsofor, Chief Executive Officer at EpiAFRIC, commenced the workshop with a brief pointer on the essence of evidence-based planning and its role in the growth and development of a country, stating that for every health plan proposed, robust evidence must be the driving force. Dr. Oluwole Odutolu, Senior Health Specialist at the World Bank, reiterated the concept of shared prosperity as a binding motive for evidence-based planning in Nigeria. Imal Silva, CEO of Imal Silva & Partners, said that data-driven decision making was important for better forecasting and pointed out the role of private sector practitioners, whom he said can create a synergy with public policy makers to accelerate growth.
Expectations were high among participants who expressed their hopes to see each state take ownership of obtaining evidence-based research data for use in health planning, design and implementation. Dr. Nsofor shared examples of evidence that had been generated through research by various organisations, showing how the evidence was used to inform public policy. Researches ranged from "SURE-P's Improving Access to and Take-Up of Skilled Birth Attendants" to "The Role of Drug Vendors in Improving Basic Healthcare Services in Nigeria". The standout research presentation was the MTV Shuga "Changing behaviour through entertainment education". The show enhanced vital knowledge in sex and sexually transmitted diseases as well as behaviour outcomes with the show's audience 34.8% more likely to get tested.
A panel discussion offered the opportunity for representatives of state planning agencies as well as NGOs to speak on the part their respective organizations have played in the past to employ evidence-based planning in planning and implementing projects. Panellists included Dr. Ada Ogugua of National Hospital Abuja, Dr. Orode Doherty of Africare, Dr. Ibrahim Kana of Saving One Million Lives, Dr.Oluwole Odutolu and Dr. Emmanuel Agogo of the Nigeria Centre for Disease Control.
Dr. Ogugua said the use of data helped to seek out frontline workers at the National Hospital in Abuja. The major gaps identified by the research were a dearth in supervision, poor attitude of the workers, and affordability of health insurance for the elderly. This enabled the National Hospital put plans in place to recruit effective and efficient frontline workers.
Dr. Ibrahim Kana opined that there is a need for capacity building in evidence-based planning as these evidence will spur implementation and development. He spoke of Kano State which was once one of the worst states in terms of facilities but when presented with the evidence by the Saving One Million Lives Program for Results (SOMLPforR), the state government was able to identify loopholes and create a plan for building new facilities and today, Kano State can boast of having some of the best healthcare facilities in the North. Dr. Jennifer Anyanti from the Society for Family Health (SFH) explained how the organization used evidence to deduce that only 5% of those who self-medicate for malaria have malaria, with the remaining 95% contributing to malaria parasite resistance. The evidence was presented to the government which resulted in the training of patent medicine vendors in carrying out Rapid Diagnostic Tests (RDTS).
Speaking on the challenges of evidence-based health planning and the opportunities that lie in addressing those challenges, Dr. Kana explained that from all indications, states are now interested in learning how to use data in health planning. "Let every state employ evidence in attaining Universal Health Coverage on a state by state basis and not merely the ongoing national campaign for UHC", he said. Dr. Agogo of the NCDC said that to support data generation and encourage documentation and availability of thi evidence, being clear of the national aim and aspirations was crucial. Dr. Orode reminded the room that the private sector provides 60-70% of healthcare services in Nigeria, and said that as a nation, we can never achieve UHC success without including the private sector as a key contributor.
By the end of the workshop, it was clear that high-quality evidence saves money, eliminates jargon and produces the best planning documents. Edwin Ikhuoria, Coordinator of the World Bank DIME Nigeria Group, summarised the day by urging everyone to "be an advocate of using evidence as the basis for policymaking".