MSc Health and International Development and MSc Development Studies students Fisayo Okanlami, Janna Rudolf, and Mogomotsi Chiminye share their consultancy experience working with the African Health Observatory Platform (AHOP) to understand stakeholder priorities, motivations and barriers to implementing Universal Health Coverage in Nigeria and Ethiopia.
Our team consisted of a group of four students in the Health and International Development and Development Studies Programmes. While our department, International Development, brought us together, our professional backgrounds spanned research, biomedical science, public health as well as work with NGOs and consulting. Having such a range of backgrounds within our group allowed us to divide tasks within the project based on each other’s strengths, and also provided the opportunity to learn from one another’s skills. This diversity of experience proved invaluable in our approach to the project. Our client was the African Health Observatory Platform (AHOP), a consortium of the LSE, AFRO WHO, and European Observatory on Health Systems and Policies. The project focused on understanding stakeholder priorities, motivations and barriers for implementing Universal Health Coverage (UHC) in Nigeria and Ethiopia, two countries where our client held partnerships.
The foundation for our research was the WHO’s definition and framework for UHC. This put forth three critical dimensions to address when ensuring all individuals have equitable access to quality health services they need without suffering financial hardship. Firstly, population coverage, the number of people who have access to healthcare. Secondly, service coverage, what healthcare services are available. Finally, financial coverage, which refers to the ability of individuals to comfortably afford healthcare.
Therefore, the goal of our project was to explore how UHC was understood and conceptualised in literature and how it compared or differentiated from UHC being interpreted and prioritised by stakeholders, working to implement UHC. To achieve this, we conducted a literature review as well as stakeholder mapping of those actively involved in UHC efforts for the respective countries. Our research required both qualitative and quantitative research and analysis of results, revealing significant steps being taken towards UHC in Ethiopia and Nigeria. While the presence of gaps found between literature and practice provided evidence as potential hindrances to the progress of UHC.
Our analysis revealed a total of 115 stakeholders across Ethiopia and Nigeria, demonstrating diverse engagement across the UHC dimensions but also highlighted several gaps within implementation of UHC. Notably, we identified that stakeholders held significant focus on policy and governance, financial support, advocacy, and technical assistance. While gaps such as limited information on Public-Private Partnerships and specific financial commitments remained.
The primary challenges in this project included refining our Terms of Reference (TORs) to ensure our deliverable was feasible within the given timeframe. While initially we had hopes of gathering real-time feedback on UHC motivations from identified stakeholders, this was one aspect we had to modify in order to meet our deadlines. Additionally, navigating group dynamics proved challenging at the outset with team members having varied commitments and responsibilities, but through consistent communication with both the client and team members, we were able to overcome these obstacles. Our final deliverable included a comprehensive report, a database of key stakeholders, proposed survey questions for stakeholders and a presentation of our project.
Working with Miqdad and Lesong at AHOP was a positive and encouraging experience. They were great clients to work with due to their collaborativeness and responsiveness throughout the project. They provided us with a clear framework and constructive feedback, making it easier to align our work with their goals. Furthermore, they created an environment that was conducive to success, given the open channels of communication and support.
Quotes:
Janna: “This experience was invaluable for learning how to work with a diverse team, and I believe will be as close a simulation to a real-world working scenario one can get before actually entering the work force.”
Motsi: The Africa Health Observatory Platform (AHOP) project was a valuable learning experience in several ways. From a topic perspective, it enabled me to deepen my understanding of health systems and policies in Africa—a region I am deeply passionate about. It was fascinating to explore the complexities of healthcare in various African countries and the efforts being made to strengthen health systems. Professionally, the project provided me with hands-on experience in health policy analysis and research, highlighting the challenges and intricacies of working within a collaborative, multi-stakeholder environment. In this sense, the project was both intense and challenging, but ultimately one of the most rewarding and insightful aspects of my master’s programme at LSE.
Fisayo: This project was an exciting opportunity to work on a globally relevant project for a real life client. Coming from a non-consulting background, it allowed me not only to improve my research and writing skills but also to develop my soft skill working in a team, while balancing other university commitments. Overall, I was happy to have gained valuable experience working on a global health topic and providing insights into sustainable healthcare development in Africa.
The views expressed in this post are those of the author and in no way reflect those of the International Development LSE blog or the London School of Economics and Political Science.
Featured image: Health extension worker Elsebeth Aklilu refers to a family health card while counselling a woman, Ethiopia. Via UNICEF Ethiopia via Flickr. CC BY-NC-ND 2.0.
