Obinna Onwujekwe

Obinna Onwujekwe
University of Nigeria | UNN · Department of Pharmacology and Therapeutics

MD, PhD

About

584
Publications
282,481
Reads
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26,978
Citations
Introduction
Obinna Onwujekwe qualified as a medical doctor from the University of Nigeria, Enugu Campus and later received a Diploma in Public Health and Policy from the London School of Hygiene and Tropical Medicine (LSHTM), University of London where he also received a PhD in Health Economics and Policy. His expertise includes health technology assessment, health policy and systems research, economic evaluation, equity analysis, healthcare financing and public health economics. He is currently a Professor of Health& Policy and Pharmacoeconomics & Pharmacoepidemiology at the University of Nigeria. He is currently the Director of Research at the University of Nigeria and the Coordinator of the Health Policy Research Group (HPRG). He is the editor of the African Journal of Health Economics
Additional affiliations
October 2004 - December 2013
University of Nigeria
July 2004 - present
University of Nigeria
Position
  • Professor (Full)
January 1999 - December 2012
Education
September 1998 - February 2002
London School of Hygiene and Tropical Medicine, University of London
Field of study
  • Health Economics
September 1998 - February 2002
London School of Hygiene and Tropical Medicine
Field of study
  • Postgraduate Diploma by Research (Public Health and Policy)
June 1997 - July 1997
Swiss Tropical and Public Health Institute
Field of study
  • District Health Management

Publications

Publications (584)
Article
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Background: Health policymaking is a complex process and analysing the role of evidence is still an evolving area in many low- and middle-income countries. Where evidence is used, it is greatly affected by cognitive and institutional features of the policy process. This paper examines the role of different types of evidence in health policy develo...
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West African countries are ranked especially low in global corruption perception indexes. The health sector is often singled out for particular concern given the role of corruption in hampering access to, and utilization of health services, representing a major barrier to progress to universal health coverage and to achieving the health-related Sus...
Article
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Background: The need to build capacity for health policy and systems research (HPSR) in low- and middle-income countries has been underscored as this encompasses the processes of decision-making at all levels of the health system. This implementation research project was undertaken in Southeast Nigeria to evaluate whether the capacity-building int...
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Absenteeism among primary health-care (PHC) workers in Nigeria is widespread and is a major obstacle to achieving Universal Health Coverage (UHC). There is increasing research on the forms it takes and what drives them, but limited evidence on how to address it. The dominant approach has involved government-led topdown solutions (vertical approach)...
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Informal payments are widespread in many healthcare systems and can impede access to healthcare and thwart progress to achieving universal health coverage, a major element of the health-related Sustainable Development Goals. Gender may be an important driver in determining who pays informally for care, but few studies have examined this, particular...
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Objectives Negative views of healthcare providers towards adolescent sexual and reproductive health (SRH) services deter adolescents from seeking vital SRH services. This paper assessed the impact of an intervention on the views and perceptions of healthcare providers towards the provision of adolescent SRH services. Design and setting A descripti...
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Background The low demand for maternal and child health services is a significant factor in Nigeria's high maternal death rate. This paper explores demand and supply-side determinants at the primary healthcare level, highlighting factors affecting provision and utilization. Methods This qualitative study was undertaken in Anambra state, southeast...
Article
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Provider payment methods are traditionally examined by appraising the incentive signals inherent in individual payment mechanisms. However, mixed payment arrangements, which result in multiple funding flows from purchasers to providers, could be better understood by applying a systems approach that assesses the combined effects of multiple payment...
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In Nigeria, most basic maternal and child health services in public primary health-care facilities should be either free of charge or subsidized. In practice, additional informal payments made in cash or in kind are common. We examined the nature, drivers and equity consequences of informal payments in primary health centres (PHC) in Enugu State. W...
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Background Public health emergencies raise significant concerns about corruption and accountability; however, these concerns can manifest in different ways across diverse locations. For instance, more developed countries with a stronger rule of law may experience more corruption in vaccine procurement, whereas developing countries may experience mo...
Article
Universal Health Coverage (UHC) can only be achieved if people receive good quality care from health workers, yet in Nigeria, as in many other low‐ and middle‐income countries (LMICs), many health workers are absent from work. Absenteeism is a well‐known phenomenon but is often considered as the self‐serving behaviour of individuals, independent fr...
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Background Research evidence is needed to strengthen capacities in emergency preparedness and response (EPR). However, the absence of a clear research agenda limits the optimal use of research evidence. This paper reports on the prioritization of research questions and topics that could contribute to evidence-informed strengthening of EPR capacitie...
Article
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Background Absenteeism in the health sector is increasingly seen as a form of harmful rule-breaking, with health workers receiving a salary although they are not present to provide care. It is a barrier to achieving universal health coverage yet remains widespread in primary health centres (PHCs) in Nigeria and many other low-resource settings. Tra...
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Background Attainment of universal health coverage (UHC) requires optimal utilization of health services. Poor coverage and inequitable access to healthcare could hinder improvement in service delivery towards UHC. The study analyzed the progress in service delivery coverage and equity in access to care within the Nigerian health systems based on t...
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Many unwanted pregnancies and its associated complications have resulted from refusal of some women of reproductive age to the use of contraceptives in general particularly the hormonal contraceptive in our environment. The fear of side effects, religious belief, ignorance and other myths surrounding the use of contraceptives had contributed to thi...
Preprint
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Background Although the treatment for end-stage renal disease (ESRD) under Nigeria’s National Health Insurance Authority is haemodialysis (HD), the cost of managing ESRD is understudied in Nigeria. Therefore, this study estimated the provider and patient direct costs of haemodialysis and managing ESRD in Abuja, Nigeria. Method The study was a cros...
Article
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Background The COVID-19 pandemic overwhelmed the health systems and socio-economic foundations of many countries, Nigeria inclusive. The study was carried out to assess, understand, document and report the activities/measures that are considered nationally and sub-nationally significant, both in terms of COVID-19 responses and in terms of strengthe...
Article
Background Coronavirus disease 2019 (COVID-19) exposed weaknesses in the health systems of countries such as Nigeria, which affected the effectiveness of the health system response to the pandemic. This paper provides new knowledge on the level of the availability, effectiveness and equity of resources in response to COVID-19 in Nigeria. This is va...
Article
The importance placed on passing Senior Secondary School Certificate Examinations (SSCE) in Nigeria has led to the emergence of ‘Miracle Examination Centres’ (MECs). MECs are schools where candidates get undeserving excellent SSCE results through institutionally enabled malpractice. This undermines the Nigerian education sector and its leadership....
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A BSTRACT Background Despite the benefits of immunization in saving the life of children, about one in every five children in the African region did not receive an initial dose of Diphtheria, Pertussis, and Tetanus. This has been attributed to the inefficient use of data in planning immunization service delivery in many African countries, includin...
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A BSTRACT Background Stakeholders have had a long-standing concern about the quality of Routine Immunisation (RI) data in Nigeria. Digital technology tools like Open Data Kit (ODK) can address this challenge by reducing errors and discrepancies in RI data. However, despite its use in various health promotion programs, ODK is yet to be implemented...
Article
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A BSTRACT Background Studies evaluating what interventions might improve the quality of routine immunization (RI) data and use in decision-making are scarce in Sub-Saharan Africa. This study assessed the effect of a data-focused intervention on the accuracy of RI data and the quality of the data monitoring system (DMS). Methods A ”before and afte...
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A BSTRACT Background Digital technology tools like open data kit (ODK) can improve the quality of routine immunization (RI) data, yet we know very little about how well it performs. Aim This study evaluated the implementation of ODK for RI data capture and transmission. We also discussed the way forward for the uptake of ODK for RI data capture a...
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A BSTRACT Background Immunization data quality is poor, particularly in developing countries. This study evaluated the effect of a low-dose high-frequency (LDHF) capacity-building training approach in improving immunization data quality in Ebonyi State, Nigeria. Methods A randomized controlled study was conducted in 145 health facilities selected...
Article
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A BSTRACT Background Despite the efforts invested in generating quality data for routine immunization (RI) in Nigeria, significant improvement is yet to be reported, largely due to the multiple reporting, summation, and data transfer processes associated with the current paper-based reporting system. Aim This study piloted the use of electronic c...
Article
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A BSTRACT Aim This paper presents stakeholders’ prioritization of implementation research questions for strengthening immunization data systems and improving immunization coverage in Nigeria. Methods The methods used were document review and stakeholder consultation workshop. Twenty-four routine immunization stakeholders from the six geopolitical...
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A BSTRACT Background The need to strengthen the quality of routine immunisation data (RI) has been underscored. Thus; affecting effective decision-making and efficient resource allocation. Aim This study was undertaken to determine the level of acceptability and perceived effectiveness of data dashboard and monitoring chart among RI data managers...
Article
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A BSTRACT Aim This paper provides new knowledge on the outcomes of an intervention implemented to improve the timeliness and accuracy of routine immunization (RI) data reporting for decision-making in Nigeria. Method It used a pre-and post-intervention cross-sectional study design with 600 respondents selected from health facilities through a mul...
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A BSTRACT Background Reliable immunization data are vital for optimal coverage, informed decision-making, and efficient program implementation. Aim This study assessed the quality of immunization data generation and use in primary healthcare centers (PHCs) in Ebonyi State, Nigeria. Methods A cross-sectional study was conducted in 244 health faci...
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A BSTRACT Background Immunization data are critical for the effective delivery of immunization programs, health planning, and-decision-making. It can also help to identify gaps in vaccine coverage and service delivery. Immunization data quality is dependent on the quality of the collection process at individual health facilities and its transmissi...
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A BSTRACT Background Peer learning and support network (PLSN) has been shown to improve real-time accountability processes in data management, foster a supportive learning environment, and contribute to improved quality of immunization data. Aim This study was conducted to assess the acceptability of PLSN and the intervention-related enabling fac...
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A BSTRACT Availability of high-quality data alone, is not sufficient to ensure the effective use of the data in decision making. Therefore, this study aims to identify the facilitators and barriers to generating quality data and usage for decision making in routine immunization program management in Sub-Saharan Africa. Scoping literature review was...
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Background: Diabetes is one of the leading causes of death and disability worldwide, and affects people regardless of country, age group, or sex. Using the most recent evidentiary and analytical framework from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD), we produced location-specific, age-specific, and sex-specific estimat...
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Abstract Background Adolescents are vulnerable to sexual and reproductive health (SRH) risks yet, have poor utilisation of SRH services due to personal, social, and demographic influences. This study aimed to compare the experiences of adolescents that had received targeted adolescent SRH interventions and those that did not and evaluated the deter...
Article
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Background Family planning (FP) is an important public health intervention that is proven to reduce unplanned pregnancies, unsafe abortions, and maternal mortality. Increasing investments in FP would ensure stability and better maternal health outcomes in Nigeria. However, evidence is needed to make a case for more domestic investment in family pla...
Article
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Background: Nigeria is in short supply of health workforce and equipment needed to manage the infected COVID-19 individuals. The rate of occurrence of new cases of infection has the capacity to further deplete the human resources in the sector, putting a dent in the fight against the spread of the virus. This study aims to determine the capacity o...
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Health worker absenteeism is a major form of corruption in the Nigerian health system, reducing the impact of healthcare investment and disproportionately affecting vulnerable communities. Top-down governance and accountability measures to improve attendance have had limited effect, potentially because they have not addressed underlying incentives...
Article
Introduction: evidence-based decision-making in health is an aspiration needed to effectively respond to current outbreaks and prepare for future occurrences. This paper examines the roles and use of evidence in health systems response to COVID-19 in Nigeria. Methods: this was a mixed method study comprising nine key informant interviews and rap...
Preprint
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Background The low usage (demand) of maternity and child health (MCH) services is a key contributor to the high maternal death rate in most regions of Nigeria. A special health programme called the SURE-P/MCH programme had both supply and demand interventions and was implemented over 5 years in selected states in Nigeria. The paper adds new knowled...
Article
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Background: Countries in sub-Saharan Africa, including Nigeria, continue to depend on donor funding to achieve their national HIV response goals. The Government of Nigeria has made limited progress in translating political commitment to reduce donor dependency into increased domestic investment to ensure the sustainable impact of the HIV response....
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Global investments in pandemic preparedness and COVID-19: development assistance and domestic spending on health between 1990 and 2026 Global Burden of Disease 2021 Health Financing Collaborator Network † Show footnotesOpen AccessPublished:January 24, 2023DOI:https://doi.org/10.1016/S2214-109X(23)00007-4 Summary Background The COVID-19 pandemic h...
Article
Background: Security of health facilities in low- and middle-income countries (LMICs) is of vital importance in ensuring that health care can be provided in safe conditions. There is paucity of literature on the issue of threats to the personal safety of primary healthcare (PHC) providers and service users in Nigeria and what should be done. Thus,...
Article
Background There has been an increase in methamphetamine use across the globe, despite widespread control of the drug, prevention, and treatment. Community-based approaches have proven effective in tackling diverse health-related challenges including substance use; however, little is known regarding community programs targeting methamphetamine use....
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Background: Although there are numerous information on sexual and reproductive health (SRH), these vary in content and quality. Objectives: This study examined the sources of SRH information, its value, and their significance for adolescent health programming. Materials and Methods: This was a mixed methods, community-based study conducted in six l...
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Background Human immunodeficiency virus and acquired immune deficiency syndrome (HIV/AIDS) is still among the leading causes of disease burden and mortality in sub-Saharan Africa (SSA), and the world is not on track to meet targets set for ending the epidemic by the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the United Nations Sustaina...
Article
Patient-centered healthcare is a goal for all health systems. However, given the inherent complexities of the health system as one with many nonlinear and dynamic components, the safety of patients could be affected. Therefore, there is the need to study these complexities to manage them toward optimal service delivery. The present study is a quali...
Article
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Background: Primary health centres (PHCs) in Nigeria suffer critical shortages of health workers, aggravated by chronic absenteeism that has been attributed to insufficient resources to govern the system and adequately meet their welfare needs. However, the political drivers of this phenomenon are rarely considered. We have asked how political powe...
Article
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Despite substantial declines since 2000, lower respiratory infections (LRIs), diarrhoeal diseases, and malaria remain among the leading causes of nonfatal and fatal disease burden for children under 5 years of age (under 5), primarily in sub-Saharan Africa (SSA). The spatial burden of each of these diseases has been estimated subnationally across S...
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Introduction: Sexual and reproductive health of young people involve a lot of stakeholders, traverse different sectors, and cut across all levels of government. For a clearer understanding of the activities of these stakeholders in adolescent sexual and reproductive health (ASRH) services, this paper was designed to explore the positions, attitude...
Article
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Background: Studies evaluating immunization data quality and its determinants in low- and middle-income countries are scarce. Aim: Therefore, this study assessed the accuracy of routine immunization data and its associated factors in Enugu State, South-East Nigeria. Materials and methods: This was a descriptive cross-sectional, mixed-method st...
Article
The prevalence of diabetes mellitus and hypertension is increasing yearly in many low- and middle-income countries such as Nigeria. The increasing burden of these noncommunicable diseases has led to an increase in the overall cost of health care. This study aimed at determining the direct and indirect health care costs of diabetes mellitus and hype...
Article
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Background: Health-care needs change throughout the life course. It is thus crucial to assess whether health systems provide access to quality health care for all ages. Drawing from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019), we measured the Healthcare Access and Quality (HAQ) Index overall and for select age gr...
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Background More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehens...
Article
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Infection with HIV/AIDS continues to be a major public health concern around the world, particularly in low- and middle-income nations. To assess the effectiveness of structured health education on the prevention of HIV/AIDS risky behaviours among adolescents in secondary school. A pretest-posttest-control group randomized controlled trial where a...
Article
Objectives: This study aims to understand and report on selected health system interventions considered nationally and sub-nationally of particular significance both in terms of COVID-19 responses and in strengthening the health system for the future.Design: A review of published and grey literature, including journals, news/ media and official doc...
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Background Sexual and reproductive health choices and behaviors of adolescents are shaped by gender norms and ideologies which are grounded in cultural beliefs. This study examined the perspectives of adolescents about the influence of gender norms and ideologies on sexuality. Methods A cross-sectional study was undertaken in three urban and three...
Article
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Background Onchocerciasis is a disease caused by infection with Onchocerca volvulus, which is transmitted to humans via the bite of several species of black fly, and is responsible for permanent blindness or vision loss, as well as severe skin disease. Predominantly endemic in parts of Africa and Yemen, preventive chemotherapy with mass drug admini...
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Background: Understanding the magnitude of cancer burden attributable to potentially modifiable risk factors is crucial for development of effective prevention and mitigation strategies. We analysed results from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019 to inform cancer control planning efforts globally. Methods:...
Article
Background: Promoting the sub-national ownership of national health initiatives is essential for efforts to achieve national health goals in federal systems where sub-national governments are semi-autonomous. Between 2008 and 2015, Nigerian government implemented a pilot free maternal and child health (MCH) programme in selected states to improve...
Preprint
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Introduction: The high rate of absenteeism among health workers (especially those in primary healthcare) has become an issue of significant concern in Nigeria. It was estimated that 34% of staff are absent at any time, with substantial consequences for their ability to deliver safe and effective care. The available literature points to a diverse ra...
Article
Purpose The purpose of this study is to describe the nature and operations of schools commonly regarded as “Miracle Examination Centres (MECs)” in Nigeria, through the lens of stakeholders in education. This study also assessed stakeholders’ perspectives on the possible solutions to the problem of MECs. Design/methodology/approach The study design...
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ABSTRACT Objective: To investigate the effects of six-week cervical traction and infrared therapy on neck pain intensity (PI) and neck disability index (NDI) among individuals with cervical spondylosis. Methods: The study was a non-randomised cross-over cohort design. Forty participants (men=20, and women=20) who were purposively selected, received...
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The ability to deliver primary care in Nigeria is undermined by chronic absenteeism but an understanding of its drivers is needed if effective responses are to be developed. While there is a small but growing body of relevant research, the gendered dynamics of absenteeism remain largely unexplored. We apply a gendered perspective to understanding a...
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Background Experimental and epidemiological studies indicate an association between exposure to particulate matter (PM) air pollution and increased risk of type 2 diabetes. In view of the high and increasing prevalence of diabetes, we aimed to quantify the burden of type 2 diabetes attributable to PM2·5 originating from ambient and household air p...
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Background Community health workers play an important role in linking communities with formal health service providers, thereby improving access to and utilization of health care. A novel cadre of community health workers known as village health workers (VHWs) were recruited to create demand for maternal health services in the Nigerian Subsidy Rein...