Experts urge systematic approach to improve healthcare access

Caption: Some experts at the workshop. Credit: Lara Adejoro

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Health professionals have emphasised the need for a systematic approach to understanding and addressing barriers to effective and quality implementation of health interventions, strategies and policies.

They noted that African health systems must strengthen their capacity to understand and solve their implementation challenges, ensuring that life-saving innovations are not just available, but accessible, acceptable, and effectively used.

They made the call on Thursday in Abuja at a two-day meeting organised by the Academy for Health Development, held as part of the European and Developing Countries Clinical Trials Partnership Saving Consortium project dissemination and South–South collaboration workshop on implementation research for efficiency and sustainable access to health interventions.

The event brought together researchers, health agencies, academia, government officials, non-governmental organisations, alongside international collaborators, to examine lessons from a five-year implementation research project conducted in Ghana.

The project, supported by experts from Nigeria, Ghana, and the Swiss Tropical and Public Health Institute, focused on improving access to new health interventions, including vaccines, and strengthening health system performance.

The Principal Investigator at Saving Consortium, University of Health and Allied Sciences, Ghana, Prof. Margaret Gyapong, said there is a need to strengthen collaboration and integrate implementation research into national health planning for improved outcomes.

According to Gyapong, the Saving project was designed to help African health systems manage the continuous flow of new technologies entering the sector.

“In our African health systems, every day, new things are being introduced: new drugs, new vaccines, new policies, and sometimes, people in the health sector get overwhelmed with all these new things.

“So, using the malaria vaccine as an entry point, the project set out to equip health workers and ministries with skills to identify and solve implementation challenges.

“The aim is to train healthcare providers on how to identify implementation challenges when all these new products come into any country. We used malaria as an entry point, but since we started, we’ve had the COVID-19 vaccine, we’ve had the malaria vaccine, and we’ve had Praziquantel. Every day in our health system, new things are being introduced,” she noted.

Explaining the purpose of the Abuja dissemination workshop, she said the consortium wanted to ensure its findings benefit the wider region.

“We feel that we have to engage with our people in the sub-region, so that Nigeria can also learn and then also use the same approach within the health system in Nigeria,” she stated.

Gyapong emphasised that Africa must build the capacity to generate and use its own implementation data.

“There’s an opportunity for building capacity in implementation research, so that academics and people in the health sector can work together and take things into their own hands,” she said.

She added that Ghana has already embedded implementation research into routine operations.

The AHEAD President, Prof. Adesegun Fatusi, said the global health community is increasingly looking at implementation research, which is about dealing with real-life problems.

Prof. Fatusi noted that although vaccines and treatments may be scientifically effective, uptake is often hindered by contextual barriers.

Fatusi, who is the immediate past Vice-Chancellor of the University of Medical Sciences, Ondo, said, “Sometimes people are not taking the vaccine because there are barriers. So, that’s a real-life problem, but implementation research helps experts to find out what the problem is, why it is not working, and the solution that will work with different contexts in mind.

“We need to pay more attention to implementation research to find answers to problems that limit the implementation of health interventions, because that will advance the health of the people.” He stressed that identifying real-life barriers and finding solutions are essential to ensuring that policies, treatments, drugs, vaccines, and health interventions reach the people who need them.”

Also speaking, a consultant at the Consortium and a professor of pharmacology, Prof. Olumide Ogundahunsi, said the meeting aimed to share lessons from Ghana and highlight the value of implementation research in improving access to new vaccines and other health interventions.

Prof. Ogundahunsi added that implementation research is a foundation for enhancing efficient access to health interventions among the population.

Ogundahunsi, who is also a retired Scientist at the World Health Organisation, explained that even when medicines or diagnostics are available, their successful use depends on many factors, including socioeconomic conditions, geography, cultural practices, and information gaps.

“Implementation research actually does that, to see which of these issues is creating the bottleneck, and then coming up with processes and solutions to this.

“So, implementation research is a systematic way of identifying barriers and bottlenecks to the effective delivery of an intervention, because even proven tools such as vaccines fail to make an impact when communities face access challenges.

“Vaccinations are effective, but in some populations, they are not getting access to the vaccines. So, implementation research will help to find out the reasons behind it, and the solution or the way forward,” he noted.

A researcher and Project Officer at the Swiss Tropical and Public Health Institute, Christian Auer, of the Swiss Tropical and Public Health Institute, said the consortium’s central focus was helping countries strengthen their systems to effectively deploy new health technologies.

“There is a need to find the best way to organise the health system so that new tools or health interventions can be deployed effectively and efficiently.

“The Abuja meeting is centred on drawing lessons across countries—lessons learned, what we can learn from each other,” he said. Auer highlighted that Ghana’s experiences must be translated into practical improvements in Nigeria’s health system, especially as new products, like malaria vaccines, are introduced.

“When you have new tools, you can only implement them and roll them out well if your health system is working well.

“So, health workers must be supported, trained, and treated fairly if the system is to function optimally. The healthcare workers have to be supported well so that they can do their job well,” he added.

The PUNCH journalist, Lara, has over 10 years experience covering health, environment and CSOs

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