NHIA Advances Health Tech Reforms to Reduce Waste and Boost Coverage

The Role of Health Technology Assessment in Nigeria's Healthcare System

Health Technology Assessment (HTA) is gaining momentum as a crucial tool for improving healthcare delivery in Nigeria. By evaluating the medical, economic, social, and ethical implications of health technologies, HTA aims to ensure that resources are used efficiently and effectively. This approach is particularly important in a country where healthcare systems are fragmented and resources are limited.

The National Health Insurance Authority (NHIA) has taken a leading role in promoting HTA. According to Yakubu Agada, the Director of Standard and Quality Assurance at NHIA, the agency is driven by the need to make informed decisions about healthcare interventions. He emphasized that without proper data, previous efforts to design benefit packages have been lacking in evidence-based support. "Every naira must count," he said, highlighting the urgency of adopting HTA to ensure transparency and accountability in resource allocation.

Establishing a National Framework for HTA

Agada also outlined the importance of creating an inclusive system that involves federal and state governments, academia, and development partners. He stressed that collaboration is essential for the success of HTA initiatives. "We want to encourage the NHIA to take the step, but we are going to do it together. The states should support NHIA, and the federal government must also be included," he explained.

He further mentioned that while the goal is to eventually establish an independent HTA institution similar to the National Institute for Health and Care Excellence (NICE) in the UK, the immediate priority is to start implementing a modest system. This phased approach allows for gradual growth and adaptation to the unique challenges faced by Nigeria’s healthcare sector.

Legal and Institutional Support for HTA Reforms

Francis Ukwuije, a health economist at the World Health Organization (WHO), highlighted the need for strong legal and institutional frameworks to sustain HTA reforms. He warned that without such backing, the progress made could be easily reversed with changes in political leadership. "HTA must go beyond cost considerations to include safety, clinical effectiveness, equity, ethics, and the unintended consequences of health technologies," he said.

Ukwuije also pointed out that countries like the UK and Australia have successfully implemented HTA through legal mandates, ensuring credibility and continuity. A well-mandated HTA body would not only focus on cost-effectiveness but also address broader issues of fairness and impact on public health.

Overcoming Data and Expertise Challenges

One of the key challenges in implementing HTA in Nigeria is the lack of high-quality data. However, Agada argued that this should not hinder progress. "HTA is just a tool for decision making, and decisions must be made whether or not the data is perfect. What matters is building an inclusive system where no one is left behind," he said.

To address this gap, Nigerian universities, especially in Enugu, have started training experts in health economics. Additionally, several NHIA staff members are undergoing specialized training abroad. Kamil Shoretire, director of Health Planning Research and Statistics at the Federal Ministry of Health and Social Welfare, emphasized the importance of integrating HTA into Nigeria’s education system and policy framework. "Embedding HTA in the training of tomorrow's leaders is critical for sustainability," he stated.

HTA and Universal Health Coverage

The panellists agreed that HTA plays a direct role in health insurance and universal health coverage. By guiding which interventions to fund, HTA can help Nigeria deliver essential services equitably and sustainably. This aligns with the broader goal of ensuring that all citizens have access to quality healthcare, regardless of their socioeconomic status.

In conclusion, the adoption of HTA represents a significant step toward improving Nigeria’s healthcare system. Through collaboration, legal support, and investment in education and data systems, the country can build a more efficient, equitable, and sustainable healthcare framework.