Abuja: The Health Policy Research Group (HPRG), University of Nigeria, Nsukka, is seeking the establishment of urban health units nationwide to improve access to quality healthcare services in urban slums. The group made the call during a policy dialogue on Thursday in Abuja.
According to News Agency of Nigeria, the theme of the dialogue was: ‘Developing and Institutionalising Health Systems Linkages Between the Public and Informal Sectors to Improve Equitable Provision and Use of Appropriate Essential Health Services in Urban Slums in Nigeria’. Speaking at the event, HPRG Coordinator Prof. Obinna Onwujekwe, highlighted that urban slums were often neglected and perceived as needing less intervention than rural areas, despite largely relying on Informal HealthCare Providers (IHP).
Onwujekwe emphasized the importance of urban health units in connecting IHPs with the formal health system. He stated that this initiative would ensure the provision of quality healthcare services to urban slums, which is crucial for their wellbeing and productivity. The HPRG, through the Community-Led Responsive and Effective Urban Health Systems (CHORUS) project in Nigeria, conducted a study across eight slums in Enugu, revealing the dominance of IHPs, weak referral pathways, and poor supervision.
He noted that the project’s intervention showed that linking informal and formal providers significantly improved care quality, particularly in diagnosis, follow-up advice, documentation, and supervision. The intervention included the establishment of urban health units and the creation of community governance and accountability structures, demonstrating the effectiveness of linking the two systems.
Onwujekwe explained that the study was prompted by investigations revealing that urban slums are usually neglected with a focus on rural areas. Many residents in urban slums suffer due to a large concentration of informal providers who are not linked to the formal system, creating an ungoverned space. By linking these providers, the formal system can monitor and enhance the services offered.
The Enugu Government has adopted the recommendation to establish an urban health unit, recognizing the importance of urban health. An urban health unit now exists within the ministry of health and the state primary health care agency with urban desk officers tasked with sustaining the project’s achievements and improving the health system within urban slums and areas.
The policy dialogue aimed to share the project’s evidence at the national level for potential adoption and scaling up across the country. The discussion sought to explore ways to contextualize urban health units and other successful intervention parameters to improve health systems in various states.
Onwujekwe stressed the necessity of linking informal healthcare providers with formal systems, noting that the informal sector delivers over 50 percent of health services overall and more than 90 percent in urban slums. He affirmed the enduring presence and importance of informal providers in offering services to impoverished populations, advocating for their integration into the formal sector through training and support.