Health service resilience in Yobe state, Nigeria in the context of the Boko Haram insurgency: a systems dynamics analysis using group model building (original) (raw)
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2014
Health Systems Resilience: A Systems Analysis is a ReBUILD affiliate research project applying a systems dynamics approach to understand, predict and identify mechanisms that influence the resilience of health systems in contexts of adversity. The project is implemented by the Mailman School of Public Health, Columbia University, in collaboration with the School of Public Health, University of Western Cape. Resilience is now a dominant concept underpinning development and humanitarian support in contexts vulnerable to crisis, including conflict. This paper is an analysis of the circumstances in the health sector in Yobe state in northern Nigeria, related, and in response to the Boko Haram insurgency beginning around 2011 and continuing to the present. The paper makes a number of Key Points: Yobe State has faced severe disruption of its health service as a result of the Boko Haram insurgency. •Population migration and transport restrictions have severely impacted access to health pro...
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HEALTH SECTOR DEVELOPMENT AND SUSTAINABILITY IN NIGERIA USING THE RESILIENT HEALTH SYSTEMS FRAMEWORK
Health care delivery in Nigeria is complex and dependent on several determinants of health. While, re-emerging health threats such as the Ebola which occurred in Nigeria and some other parts of West Africa in 2014 have given rise to the need to understand what it means for a health system to be resilient. Although the present health system in Nigeria remains less resilient, the work of Kruk, Myers, Varpilah, and Dahn (2015) on resilient health systems (RHS) framework is beneficial to develop and sustain it. The resilient health systems framework offers insights on the need for health systems to be aware, diverse, self-regulating, integrated and adaptive in their approach to public health and primary care matters. This paper focuses on how Nigeria can develop, strengthen and sustain its health system by becoming more resilient using the RHS framework.
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F1000Research, 2021
Introduction: Adamawa and Bauchi are cholera endemic states in the north-east region of Nigeria, each with local government areas classified as cholera hotspots. Ineffective implementation of multi-sectoral cholera interventions in both states could make obtaining the global target for cholera control in Nigeria out of reach. A major contributing factor to this challenge is fragility of the region due to persistent Boko Haram insurgency activities, often characterised by the destruction of health infrastruture and displacement of communities to areas with suboptimal living conditions. Given the complexity of disease control in such a fragile setting, this study aims to systematically examine the barriers and/or facilitators influencing the implementation of existing cholera interventions in these states. Methods: The study will use a systems dynamic approach. First, we will conduct a health facility survey to determine the current health system capacity to support multi-sectoral c...
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BMJ Global Health
BackgroundIn the context of universal health coverage in the Sahel, the study focuses on primary health centres and the difficulties of their implementation in the context of insurgency conflicts in central Mali.MethodsThis is qualitative research through a multiple case study. We selected six health centres according to a reasoned choice to bring together contrasting situations. We conducted 96 semistructured interviews and consulted secondary quantitative data on attendance. By focusing on community health centres, the conceptual approach focuses on the process of resilience that unfolds in a dual context of chronic health system dysfunctions and armed conflict.ResultsThe resilience strategies deployed by health professionals were relatively basic and uncoordinated. In the end, it was the individuals who showed absorption. However, their room for manoeuvre was limited. In the most isolated health centres, resilience was based on subordinate, poorly trained staff, often from the lo...
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The Implication of Boko Haram Insurgency on Healthcare Service Delivery in Borno State, Nigeria
Ilorin Journal of Administration and Development , 2017
The insurgency of Boko Haram in the northeastern Nigeria has overwhelming implication on the various developmental sectors. The incessant attacks launched by the insurgent group is reported to have damaged infrastructures and leads to deaths, destructions and displacement of lives, properties and people. Against this background therefore, this paper examines the specific implications that insurgency has on healthcare service delivery in Borno State. The paper utilises secondary data, with bias on healthcare service reports of Borno State Government, Human Rights Watch, Integrated Regional Information Network and Medicins Sans Frontiers. The paper reveals that governmental efforts in healthcare service delivery in the state has been greatly affected, as well as that of profit making establishments. However, the humanitarian based International Non-Governmental Organisations (INGOs) remain fully functional. The paper therefore concluded that efforts must be made to retain the INGOs as well as improve the governmental and private sector provisions of the healthcare services in order to avoid the total collapse of the sector. As such, the paper recommends strong partnerships by governments with donor agencies and individuals sponsoring healthcare programmes in the state. More funds should also be allocated to healthcare in Borno state subsequent budgets so as to revive the sector.
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The case study was conducted principally from the perspective of the International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University, an implementing partner funded by Centers for Disease Control and Prevention (CDC) under the U.S. President’s Emergency Plan for Aids Relief (PEPFAR). ICAP provided technical assistance for HIV- related programming to the Ministry of Health during this period. ICAP supported family- focused and multidisciplinary HIV services in health facilities across the country, working to build district capacity for provision of comprehensive HIV services1. These services included: pediatric and adult HIV care and treatment (including provision of ART); integrated tuberculosis/HIV care and treatment; rapid HIV testing for adults and children; diagnostic testing/analysis (including Dried Blood Spot DNA PCR testing for infants); community outreach; HIV support groups; and peer education programs. While the Ministry of Health (MOH) provided salaries to the majority of health facility staff and was also responsible for the procurement of drugs, ICAP provided salary support to some staff at health facility level such as data clerks.
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The Impact of the Boko Haram Insurgency in Nigeria: A Multi-Sectoral Analysis
Siyasal: Journal of Political Sciences, 2022
Using the Regional Security Complex Theory (RSCT) and qualitative methodological approach, this article examines the impact of the Boko Haram insurgency on the various sectors and arenas of security as proposed by proponents of the Copenhagen School of Security Studies. Findings of the article suggest that the presence and activities of this terror group have impacted the various arenas of security and have also created dire sub-regional and regional implications in spite of the various counter-measures designed by sub-regional and regional actors to counter the threat posed by the terror group. Therefore, to address this challenge, the article offers practical recommendations to critical and relevant actors involved in countering the presence of this group at the various political, military, societal, economic, environmental, sub-regional, and regional levels.
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