LEVERAGING POLICY TRANSFER FOR ENHANCED HEALTHCARE DELIVERY AND PATIENT OUTCOMES THROUGH DIGITAL HEALTH TECHNOLOGIES IN NIGERIA
Awojobi ON1*, Adeniji OA2, Kwabia E1
1Johnson Shoyama Graduate School of Public Policy, University of Regina, Canada
2School of Health Sciences, University of Surrey, UK
*Correspondence: Oladayo Nathaniel Awojobi; firstname.lastname@example.org
Download full article in pdf format
Background: Digital health technology involves using electronic and digital tools to enhance healthcare, improve outcomes, and elevate patient experiences. However, Nigeria, as an emerging economy, lags behind countries that have effectively integrated digital health technology for better healthcare access.
Opinions: Policy transfer offers Nigeria a way to adopt these technologies. By learning from successful strategies in other nations, Nigeria can strengthen its healthcare system, make informed choices, overcome challenges, and ultimately boost healthcare access and patient outcomes through digital advancements.
Keywords: Digital health technology, Healthcare, Nigeria, Policy transfer.
Cite this article: Awojobi ON, Adeniji OA, Kwabia E. Leveraging policy transfer for enhanced healthcare delivery and patient outcomes through digital health technologies in Nigeria. Yen Med J. 2023;5(3):79–84.
Digital health technology encompasses the utilization of digital and electronic technologies to enhance healthcare delivery, improve health outcomes, and elevate patient experiences.1–3 In the realm of healthcare and related domains, these technologies encompass computing platforms, networking, software, and sensors; offering a versatile range, from applications for general wellness to medical devices.4 That is, technologies developed for medical use, integrated within medical products, serving as companion diagnostics, or complementing other medical products such as devices, medicines, and biologics.4
In the context of Nigeria, digital health technology assumes pivotal significance in augmenting healthcare accessibility. Its capacity to surmount geographical constraints, enhance healthcare efficiency, and empower patients underscores its importance. By leveraging tools such as telemedicine, mobile health applications, and electronic health records, digital health technology can effectively bridge the gap between remote areas and medical expertise. It facilitates remote consultations, connects underserved regions with medical professionals, and streamlines the exchange of medical information. This becomes particularly noteworthy in Nigeria, where a substantial population coupled with constrained healthcare infrastructure often obstructs prompt access to quality healthcare. The potential of digital health solutions to bridge these gaps is evident, ultimately rendering healthcare more accessible, efficient, and centred around patient needs.
Nigeria’s status as an emerging economy positions it behind certain countries that have adeptly incorporated digital health technology to enhance healthcare accessibility. In contrast to these nations, which have seamlessly integrated digital health tools, Nigeria’s utilization of such technology within its healthcare system remains limited. Consequently, the nation faces challenges in effectively capitalizing on digital solutions to expand healthcare access and elevate patient care standards.
In recent years, the concept of policy transfer has gained significance as a pivotal mechanism for disseminating policy innovations across international borders. Utilizing policy transfer, Nigeria can adopt successful strategies from countries that have effectively leveraged digital health technology to improve healthcare accessibility and enhance patient health outcomes.
The term “policy transfer” was coined by Dolowitz and Marsh,5 and subsequently, Evans and Barakat defined it as a broad concept wherein knowledge about institutions, policies, or delivery systems at one governance level or sector is employed in developing similar aspects at another governance level or sector within a different country.6 Researchers have utilized this concept to elucidate policy change processes both within a single political system and on an international scale.
Operating as a versatile framework, policy transfer involves the notions of lesson drawing and policy learning. Its dynamics can be influenced by political, economic, and educational considerations. Rose argues that when challenges arise, policymakers across various levels of governance and nations can draw insights from responses elsewhere.7 This approach offers the potential for policymakers to acquire valuable lessons that can be applied to their specific issues. In instances where successful policies exist, these can be transferred and adapted.7 Policy-oriented learning occurs through exchanges between ministers, civil servants, think tanks, academic experts, and practitioners across nations, often facilitated by digital communication means.8 Alternatively, policymakers from one country might visit another to gain insights into improving population health.
Policy learning through transfer can transpire through two primary modes: coercive and voluntary transfers.8,9 Coercive transfers occur when external entities, such as states or international bodies, exert pressure on political actors to adopt specific policies.10 Conversely, voluntary policy transfer emerges as an intrinsic endeavour to enhance an existing condition in the absence of external or internal pressures.11 Sacks underscores that in pursuing policy learning for improvement, the state becomes an “autonomous actor,” making decisions aligned with national interest.12–14 Consequently, governments seeking solutions to novel or evolving challenges often turn to external sources for guidance.5 Through policy transfer, Nigeria has the opportunity to incorporate successful digital health technology strategies from other countries, thereby reinforcing and enhancing its healthcare system.
The importance of using policy transfer to implement digital health technology in Nigeria
The utilization of policy transfer holds significant importance in implementing digital health technology in Nigeria for several compelling reasons:
- Accelerated Adoption: Leveraging policy transfer allows Nigeria to expedite the integration of digital health technology by drawing on the successful experiences of other countries. This can help bypass initial trial-and-error stages and lead to quicker implementation. For example, from the early 1980s, British legislation and programmes linked to welfare-to-work and workfare have been imported from the United States.5
- Learning from Best Practices: Examining the policies and strategies of countries that have effectively implemented digital health technology enables Nigeria to identify best practices and avoid potential pitfalls. This knowledge can guide informed decision-making and enhance the likelihood of successful outcomes. A case in point is how the Australian government successfully transferred the Child Support Enforcement System (CSES) from the United States.5
- Tailored Implementation: Through policy transfer, Nigeria can adapt existing digital health solutions to its unique healthcare context, while considering local infrastructure, cultural factors, and healthcare challenges. This ensures that the technology aligns with the country’s specific needs. Ghana, for example, was able to transfer and successfully implement a social health insurance scheme by borrowing ideas from the healthcare systems of the United Kingdom, Chile, Germany, Thailand, Tunisia, and Zimbabwe to suit its social, economic, political and cultural environment.15
- Policy Innovation: By studying various policy approaches from different countries, Nigeria can foster innovation and creativity in designing its digital health strategy. This can lead to the development of novel solutions that address specific healthcare challenges. Ghana had to learn different social health insurance models from different countries, which enabled it to adopt a social health insurance system to solve the problem of healthcare access.15
- Stakeholder Engagement: Policy transfer involves engagement with stakeholders from various sectors, including government, healthcare providers, technology experts, and communities. This collaborative approach can ensure a well-rounded implementation strategy and foster ownership among stakeholders.
- Mitigating Risks: Learning from the experiences of others can help Nigeria identify potential risks and challenges associated with digital health technology implementation. This foresight allows the country to develop mitigation strategies and contingency plans.
- Enhanced Accountability: Policy transfer encourages transparency and accountability by benchmarking progress against successful implementations in other countries. This can lead to better monitoring, evaluation, and governance of digital health initiatives.
- Global Networking: Engaging in policy transfer facilitates international networking and collaboration, enabling Nigeria to tap into a broader knowledge pool, access expertise, and stay updated with the latest technological advancements.
Policy transfer serves as a valuable tool for Nigeria to effectively implement digital health technology. By learning from the experiences of other nations, Nigeria can make informed decisions, tailor solutions to its context, and navigate challenges more effectively, ultimately enhancing healthcare accessibility and patient outcomes through digital innovations.
The importance of digital health technology in improving healthcare delivery and patient outcomes in Nigeria
By adopting and implementing digital health technology, Nigeria hopes to transform healthcare delivery and enhance patient outcomes for a multitude of compelling reasons:
- Enhanced Accessibility: Digital health solutions, such as telemedicine and mobile health apps, bridge geographical gaps, bringing healthcare services to remote and underserved areas. This extended reach ensures that even those in distant regions can access medical expertise.
- Timely Care: Through telemedicine and virtual consultations, patients can receive prompt medical attention, reducing waiting times and ensuring timely interventions for acute conditions.
- Efficient Information Sharing: Electronic health records and health information exchange platforms streamline the sharing of patient data among healthcare providers. This seamless communication facilitates coordinated care by reducing redundant tests and enhancing treatment accuracy.
- Improved Diagnoses: Digital tools aid medical professionals in making accurate and timely diagnoses. Advanced imaging technologies, AI-assisted diagnostics, and predictive analytics enhance accuracy, enabling early detection and effective treatment planning.
- Chronic Disease Management: Wearable devices and remote monitoring tools empower patients to actively manage chronic conditions. Real-time data tracking allows healthcare providers to intervene when necessary, preventing complications and hospitalizations.
- Patient Empowerment: Digital health technology enables patients to access their health information, understand their conditions, and participate in treatment decisions. This empowerment fosters a collaborative patient-provider relationship, leading to better adherence and outcomes.
- Preventive Care: Mobile health apps deliver personalized health information, preventive measures, and lifestyle recommendations to users. This proactive approach encourages healthy behaviours and reduces the burden of preventable diseases.
- Health Education: Digital platforms disseminate accurate health information to a wider audience, promoting health literacy and enabling informed decision-making about treatments, vaccinations, and preventive measures.
- Efficient Resource Management: Digital solutions optimize resource allocation, reducing administrative burdens and operational inefficiencies. This cost-effective approach allows healthcare facilities to allocate resources more effectively to patient care.
- Data-Driven Decision-Making: Digital health tools generate vast amounts of data that can be analyzed to identify trends, patterns, and insights. This data-driven approach informs evidence-based policy decisions, resource allocation, and healthcare planning.
- Public Health Initiatives: Digital health technology supports disease surveillance, outbreak detection, and monitoring of population health trends. This is especially crucial in Nigeria for managing infectious diseases and improving public health interventions.
- Capacity Building: Implementing digital health technology encourages skill development among healthcare professionals, fostering a tech-savvy workforce that can adapt to evolving healthcare practices.
By implementing the following recommendations, Nigeria can effectively leverage policy transfer to enhance its healthcare system through the integration of digital health technology.
- Develop clear and comprehensive strategies outlining how lessons from other countries will be integrated into Nigeria’s healthcare system. Define specific goals, timelines, and responsible stakeholders for each strategy.
- Evaluate Nigeria’s healthcare system thoroughly to identify specific areas where digital health technology can have the most significant impact. Tailor policy transfer efforts to address these specific needs effectively.
- Allocate resources to improve the technological infrastructure necessary for digital health implementation. These include internet connectivity, data storage, cybersecurity measures, and training programs for healthcare professionals.
- Encourage research and development in digital health technology within Nigeria. Support local innovation and startups, fostering an environment of creativity and technological advancement.
- Engage a wide range of stakeholders, including government agencies, healthcare providers, technology experts, policymakers, and patient advocacy groups. Their collective input can provide valuable perspectives and ensure comprehensive policy development.
- Organize visits for Nigerian policymakers, healthcare professionals, and technology experts to countries with successful digital health implementations. These visits can provide firsthand experiences and insights that are invaluable for policy transfer.
- Develop and enforce regulatory frameworks that ensure the ethical use of digital health technology, patient privacy protection, and data security. Clear regulations provide a foundation for successful implementation.
- Educate the public about the benefits of digital health technology. Increase awareness about available services, how to access them, and the importance of active participation in digital healthcare initiatives.
- Establish a robust monitoring and evaluation system to assess the impact of implemented policies. Regularly collect data, analyze outcomes, and be prepared to adjust strategies based on the results obtained.
Digital health technology offers a pathway to improving healthcare accessibility in Nigeria. Given the current limited adoption of digital technology, policy transfer presents an avenue to facilitate the uptake and integration of digital health solutions, ultimately amplifying access to healthcare services.
While replication of policies across jurisdictions is not guaranteed to ensure success, Nigeria can draw inspiration from nations with prosperous digital health technologies. By customizing these elements to suit Nigeria’s unique social, economic, and political context, the country can foster effective implementation and advancement.
- Silberman J, Sarlati S, Kaur M, Bokhari W. Outcomes assessment for digital health interventions in diabetes: A payer perspective. In: Klonoff DC, Kerr D, Weitzman ER, eds. Diabetes Digital Health and Telehealth. Cambridge, MA: Academic Press; 2022:291–304. https://doi.org/10.1016/B978-0-323-90557-2.00023-6.
- Awad A, Trenfield SJ, Pollard TD, Ong JJ, Elbadawi M, McCoubrey LE, et al. Connected healthcare: Improving patient care using digital health technologies. Adv Drug Deliv Rev. 2021;178:113958. https://doi.org/10.1016/j.addr.2021.113958.
- How Digital Transformation is Shaping the Healthcare Industry. Published June 28, 2023. Available from: https://kissflow.com/solutions/healthcare/how-digital-transformation-shaping-healthcare/.
- S. Food and Drug Administration. What is Digital Health? FDA. Published November 09, 2020. Available from: https://www.fda.gov/medical-devices/digital-health-center-excellence/what-digital-health.
- Dolowitz DP, Marsh D. Learning from Abroad: The Role of Policy Transfer in Contemporary Policy-Making. Governance. 2000;13(1):5–23. https://doi.org/10.1111/0952-1895.00121.
- Evans M, Barakat S. Post-war reconstruction, policy transfer and the World Bank: The case of Afghanistan’s National Solidarity Programme. Policy Stud. 2012;33(6):541–565. https://doi.org/10.1080/01442872.2012.722293.
- Rose R. What is Lesson-Drawing? J Public Policy. 1991;11(1):3–30. https://doi.org/10.1017/S0143814X00004918.
- Hulme R. The Role of Policy Transfer in Assessing the Impact of American Ideas on British Social Policy. Glob Soc Policy. 2006; 6(2):173–195. https://doi.org/10.1177/1468018106065365.
- Bößner S, Suljada T, Johnson FX, Bruno A, Morales JR, Hu M, et al. Policy transfer processes and renewable energy penetration: A comparative analysis of Peru, Thailand, and Uganda. Sustain Earth. 2020;3(1):2. https://doi.org/10.1186/s42055-019-0019-4.
- Bender K, Keller S, Willing H. “The Role of International Policy Transfer and Diffusion for Policy Change in Social Protection—A Review of the State of the Art,” IZNE Social Protection Working Paper. Augustin, DE: International Centre for Sustainable Development, Bonn-Rhein-Sieg University of Applied Sciences: 2015. DOI: 10.18418/978-3-96043-017-9.
- Seixas AA, Olaye IM, Wall SP, Dunn P. Optimizing Healthcare Through Digital Health and Wellness Solutions to Meet the Needs of Patients With Chronic Disease During the COVID-19 Era. Front Public Health. 2021;9:667654. https://doi.org/10.3389/fpubh.2021.667654.
- Sacks PM. State Structure and the Asymmetrical Society: An Approach to Public Policy in Britain. Comp Polit. 1980;12(3):349–376. https://doi.org/10.2307/421931.
- Hall PA. Policy Paradigms, Social Learning, and the State: The Case of Economic Policymaking in Britain. Comp Polit. 1993;25(3):275. https://doi.org/10.2307/422246.
- Common R. Public management and policy transfer in Southeast Asia. In: Evans M, ed. Policy Transfer In Global Perspective. Oxfordshire, ENG: Routledge; 2004.
- Awojobi ON, Adeniji OA. Policy transfer and health policymaking process: The case of social health insurance in Ghana. Health Econ Manag Rev. 2023;4(2):1–23. https://doi.org/10.21272/hem.2023.2-01.