NIGERIA — For years leaning on decades, scientists in Nigeria have faced barriers to conducting and disseminating their research. This has impeded progress in the prevention, treatment and diagnosis of diseases. Despite research publications doubling from 2,500 in 2008 to more than 4,000 in 2017, the impact of research in Nigeria remains the lowest among countries in West Africa. This low impact comes despite the particularly high disease burden of neurological disorders like stroke, which affects up to 195,846 Nigerians every year. This also comes in light of high poverty rates, which now entrap up to 82.9 million Nigerians and counting. However, stroke research in Nigeria can actually help people in poverty.
The Acha Memorial Foundation
The Acha Memorial Foundation is a stroke advocacy nonprofit in Nigeria. It stated that improving stroke healthcare can be as simple as encouraging every person to have their blood pressure checked regularly. Designing colorful infographics that remind kids to act F.A.S.T. can be done using basic stroke knowledge. In fact, through its flagship project called MasterStroke, the Acha Memorial Foundation is already hard at work turning these interventions into awareness-raising realities.
According to scientists at the University of Maiduguri, research is essential to developing more effective policies for stroke education. The Hindawi’s Stroke Research and Treatment is a journal founded to assess all things stroke and science-related. In addition to analyzing stroke education, it’s many publications are a testament to the benefits of research in Nigeria on stroke-related healthcare, particularly for the poor. In the past, stroke research in Nigeria has revealed important information.
High Stroke Treatment Expenses
Although researchers point to drug treatment as the most cost-effective way of treating hypertension, they also identify the unavailability and cost of stroke medications as a significant barrier. Another study revealed that post-stroke care can cost between $600 and $4,860 in the first 36 weeks following a stroke. Researchers called this sum “unaffordable by the average Nigerian stroke sufferer.”
Former Nigerian Minister of Health, Professor Onyebuchi Chukwu, announced a government initiative to subsidize stroke rehabilitation, improving accessibility to both long-term and acute stroke treatment in 2013. Nonprofits like the Acha Memorial Foundation are also offering low-cost care to those families living below the poverty line.
Inaccessibility of Stroke Treatments for Rural Communities
A study by the African Journal of Neurological Sciences (AJNS) factors in a large distance to treatment facilitates as a reason for the suboptimal management of stroke in Nigeria. Despite the importance of CT scans in differentiating between different types of strokes, stroke diagnosis is oftentimes conducted without a CT scan in Nigeria. This is mainly due to the cost or absence of imaging facilities. Fewer than 10% of Nigerians can afford a CT scan.
Researchers note that an intervention as simple as frequent CT scan referrals can help promote the development of private sector neuroimaging facilities. Meanwhile, a fancier intervention might come in the form of health tech advancements, which the Acha Memorial Foundation is currently working to develop in attempts to better connect healthcare experts with those in need. Studies in other rural areas support telemedicine in particular. A low-cost initiative called the Remote Evaluation for Acute Ischemic Stroke (REACH) program was found to be effective in providing video-based acute stroke care in rural Georgia.
High Stroke Burden Among the Poor
The poor in sub-Saharan Africa have a particularly tough time controlling stroke risk factors, such as hypertension. Although the diet of most rural Africans is considered to be healthy, increasing urbanization has introduced diets higher in fat and cholesterol. Globally, the poor now carry the highest cardiovascular disease burden.
Stroke research in Nigeria to date has been conclusive. Introducing effective prevention policies is key to reducing stroke risk factors. Organizations like StrokeAction Nigeria are hard at work organizing prevention, management and self-care clinics. Clinics monitor patients’ BMI, blood pressure and diet while stroke outreach campaigns provide advice on managing blood sugar and physical activity to schools, faith and community groups.
Removing Barriers to Research in Nigeria
Of course, stroke research in Nigeria alone doesn’t necessarily guarantee the healthcare improvements listed above. According to researchers at the Ignatius Ajuru University of Education, the ability to develop countries to translate biomedical research into products and decisions is stunted. A 2015 publication brought the full complexity of the problem to light by listing barriers to human capital development and research in Nigeria. These barriers take many forms, from inadequate funding to poor communication networks, and require “drastic and far-reaching education policies and programs” to remedy.
Thankfully, the extent of the problem didn’t dissuade researchers at the Elsevier Foundation from jumping into action. In 2013, the foundation launched Researchers Without Borders, an initiative aimed at increasing the “discoverability” of research conducted in Africa by pairing leading biomedical journals in the U.S. and U.K. with 10 African health journals. The purpose of the partnership, according to Elsevier, is to improve publishing operations and strengthening the global impact of African health research.
Companies like FinLab Nigeria have also been stepping up to improve research in Nigeria by updating lab facilities. Mr. Uzo Nwaije, the marketing director of FinLab Limited, told the Guardian Nigeria that the company is planning on expanding production for educational and health institutions in accordance with increasing demand.
Meanwhile, in the research education scene, student organizations like the Innovators in Global Health are also regularly engaging local technicians in workshops regarding the principles of medical device design. Its staff training, and the training of others, is paying off. Between 2012 and 2016, Africa demonstrated the highest growth in scientific production at 38.6% and an even larger 43% increase in the amount of published scientific authors.
Working Towards the Future
Still, much remains to be done to improve stroke research in Nigeria. Translating research into healthcare improvements is a process that has many potential benefits. Improvements in treatment expenses and clinic accessibility and stroke research can have a meaningful impact on Nigeria’s people, particularly those 40% living in poverty.
– Petra Dujmic