Rapid MED response in war and peace time

Nigeria is Africa’s most populous country with over 200 million inhabitants, many of them underserved. There are multiple challenges in accessing adequate healthcare for a large proportion of the populace, particularly for the hard to reach communities .During COVID 19 Pandemic for instance, access to health care was constrained due to lack of adequate isolation centres and transportation challenges to access the available ones due to the restricted movement amid social distancing measures. As a consequence the WHO states that as of March 2023, only about 14% of the total population has received the booster dose, a far cry from the required 70% that ensures herd immunity. The focus of our solution is on the hard-to-reach areas with limited access to the healthcare system where a large proportion of Nigeria’s inhabitants live.

Nigeria has a primary-healthcare system with an administrative unit of the local government areas. There is a central Local government Area store in each LGA of the federation which should be stocked from the state Central store with medicines, vaccines and other essential supplies. However, there is a preponderance of stockouts at the LGA level.

The health centre and dispensary is the basic unit of primary healthcare which is usually managed by a health worker. 

Our solution is two-fold. First, the establishment (or activation where they already exist) of mobile medical teams including at least a community health extension workers and at least one support staff  using enhanced tricycles to provide medical outreach services to the hard to reach communities. A selection of specific tricycle operators in the host communities in order to leverage on existing structures will be employed. These enhanced tricycles can also serve as ambulances to bring the sick to the secondary level care centre in cases of need and should be equipped with telemedicine facilities to allow the remote follow-up of patients on chronic care and consultation of emergent cases.

The second part will be the use of drones to manage stockouts of vaccines and other essential supplies and medicines from the state central store to the LGA stores and in dire emergencies, delivery of medical supplies directly to the patients.

Our solution would be piloted in one state of Nigeria ( Kebbi State), with 21 LGAs. One drone and a back up will be deployed at the state level with 23 enhanced tricycles (including 2 back-ups). The ambulances will be staffed and manned by staff from the state primary healthcare development agency and the referral hospital for telemedicine consultation and referral of patients will be General Hospital Argungu in Kebbi state.

Prompt access to health care will ensure the curtailing of unneccessary deaths and medical complications arising from lack of adequate medical care. Rural outreach will be enhanced, and the cost and quality of health care services will be greatly improved, as more effort can be deployed in improving the standard of already established and functional secondary health care facilities rather than increasing the number of primary health care facilites which comes with added cost and maintenance challenges. The new primary healthcare facilities also tend to be moribund after just a few years of establishment as experience has shown, with the aim of their establsihment summarily defeated. Our mobile teams and facilites can easily be upgraded in order to provide up-to-date services to the communities based on ever changing physical and environmental factors.

The team is built solid, made up of an assemblage of researchers and health care practitioners. We have medical consultants, and biomedically qualified engineers with  foreign expertise and years of solutions delivery. Our team is also domiciled within the host communities, and are either locals, or have sound relationship with them. We engaged in dialogue with the locals during the COVID 19 pandemic and were able to understand these challenges as being critical to the lack of coverage of the populace by the vaccine. Ultimately, these challenges have been found to be sistemic to whole healthcare delivery system of the country, hence the need for a digital revision in conformity with the digital age.

We are still at the conception stage of development and hence haven't engaged any participants.

MIT is known to collaborate wit many higher institutions of learning in Nigeria, with some of my mates at Ahmadu Bello University Zaria having benefitted from such initiatives. Our desire to collaborate with MIT is bore out of this mindset, knowing that with your support our ideas will be able to reach to right channels required for it to become policy in Nigeria. Any initiative such as this one requires props for it to be considered, as for sustainability the Nigerian government has to be a partner, and MIT is very well positioned to serve as a very persuasive prop.