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The need for strategic communication in combating NCDs in Nigeria 09 Oct 2024

Nigeria is besieged by non-communicable diseases (NCDs). NCDs, such as cardiovascular diseases, diabetes, chronic respiratory diseases, and cancers, are responsible for approximately half a million Nigerian deaths each year. The staggering figure accounts for about 27% of all annual deaths in the country. No doubt, these epidemics demand urgent intervention.

The prevalence of NCDs in Nigeria is driven by lifestyle factors, such as poor diet, physical inactivity, tobacco use, and harmful alcohol consumption. Hypertension, the most common cardiovascular condition, affects over 30% of adults in Nigeria and is a major risk factor for heart attacks, strokes, and other cardiovascular complications.

About 5 million Nigerians are living with diabetes – the highest comparative number among the 54 countries of Africa. The majority of these individuals are undiagnosed, placing them at risk of severe health complications, such as kidney failure, blindness, and amputations. Chronic respiratory diseases, including chronic obstructive pulmonary disease (COPD) and asthma, are also quite prevalent in the country, particularly in urban areas where air pollution and tobacco smoke exposure are common. These diseases rank among the leading causes of morbidity and mortality in the country.

Cases of cancer are also on the rise in Nigeria. Breast, cervical, and prostate cancers are the most common types of the disease, which continues to prove quite deadly especially when it is not detected early. Late diagnosis means many cases of cancer are detected at advanced stages. This, coupled with limited access to treatment, has continued to drive the high mortality rates from the disease. As a result, for instance, only 25% of patients of breast cancer survive for 5 years in Nigeria compared to 80% in the advanced countries.

Nevertheless, these figures only partially highlight the scourge of NCDs in Nigeria. The diseases not only cause premature deaths but also impose a heavy economic burden, draining resources from individuals, families, and the nation, including through medical tourism. The cost of managing these chronic conditions and the productivity loss associated with them take a considerable toll on the economy and undermine the country’s development efforts.

But despite their burden, NCDs have not always gained a high priority place on the national health agenda. This oversight – or simply lack of adequate prioritisation – needs to change. If left unchecked, NCDs and the negative ripple effects they generate can thwart the national development agenda altogether. But to change the trajectory, it is important to adopt a comprehensive approach that goes beyond healthcare provision. An all-encompassing strategy, which integrates prevention, early detection, and management, is imperative. In this regard, the role of strategic communication is, indeed, pivotal.

Effective strategic communication is indispensable in promoting public health. Its role in successfully fighting against NCDs has been established by empirical knowledge. Defined as a specialised approach to distributing and receiving information, strategic communication is necessary across the preventive, early detection, and management measures to reverse the epidemiology of NCDs in Nigeria. This means that health policymakers must view communication not merely as a means of disseminating healthcare policy and programmes but as integral to their design and implementation.

But in advocating the use of strategic communication, it is essential to distinguish between top-down campaigns and community-led initiatives. Traditional campaigns often emanate from central authorities, as may be orchestrated by the government, policymakers, and development partners. While such efforts can be impactful, they often fail to engender adequate community engagement. This, unwittingly, continues to see to the isolation of communities and people who need the policy information and the potential benefits of the health intervention programmes. For example, campaigns that rely solely on billboards, radio ads, or social media may reach a broad audience, but they often fail to spur meaningful behaviour change at the grassroots level.

In contrast, community-led campaigns, particularly those involving faith-based organisations (FBOs) and traditional leaders, have proven to be far more effective in driving change at the community level. These groups hold significant influence in their communities, often serving as trusted sources of information and guidance. When these leaders are actively involved in health campaigns, the messages are more likely to be accepted and acted upon.

For example, in Ghana, a campaign aimed at reducing salt intake, which involved local communities, FBOs, and traditional leaders, led to a 2.5 mmHg drop in systolic blood pressure in the country. Similarly, Senegal’s tobacco control efforts saw a 15% reduction in youth smoking rates through the active role of religious leaders. In Côte d’Ivoire, campaigns deploying community health workers improved NCDs management, resulting in a 30% increase in early diagnosis of diabetes and hypertension in rural areas. These successes highlight the critical role of local engagement and well-tailored communication in public health.

Moreover, it’s important to recognise that NCDs are no longer just diseases of the elderly. Increasingly, they are affecting younger populations, including the youth, who represent the future of Nigeria. With circa 33 million Nigerians active on social media platforms, majority of whom are young people, the youth have a powerful tool at their disposal to raise awareness and drive change. This demographic is not only at risk through deleterious lifestyles but also uniquely positioned to lead the fight against NCDs. By becoming agents of change, Nigerian youths can leverage their influence online and within their communities to promote healthier lifestyles, advocate for stronger policies, and support their peers in making informed decisions about their health.

Addressing the NCDs crisis requires a multisectoral response, involving stakeholders from health, education, agriculture, finance, etc., which must be harnessed through strategic engagement. The Nigeria Health Sector Renewal Investment Initiative (NHSRII), which is nationally endorsed, leverages the tool of Sector-Wide Approach (SWAp). It serves as a critical framework that brings together the expertise and resources of various sectors to drive lasting change. Organisations such as the World Health Organisation (WHO), Resolve to Save Lives, Population Services International (PSI), the National Primary Health Care Development Agency (NPHCDA), among others, have been pivotal in these efforts. This derives from the insight that no single entity can combat NCDs alone. It is only through a whole-of-government and whole-of-society approach, including the private sector and foundations, that the needed resources and political will can be mobilised to make the desired and sustainable impact.

However, despite the key role of strategic communication, success in the fight against the NCDs must start with giving the necessary priority attention to the diseases in the national health agenda and sustaining the current policy momentum fostered by the NHSRII to drive change. Policymakers – especially at the subnational levels, given the work that is already being done at the federal level – must recognise that the economic burden of NCDs poses a significant threat to the socioeconomic wellbeing of their people. Indeed, investing in NCDs prevention and control is not just a health priority, but it is also a socioeconomic imperative.

As we look to the future, the path forward is clear: we must intensify our efforts to communicate the dangers of NCDs, advocate for stronger policies, and foster collaboration across economic sectors and the tiers of government. So doing, we can create an environment where every Nigerian has the knowledge, tools, and support to live a healthier life, free from the preventable burden of NCDs. In this regard, it is heartwarming to note that a major outcome from the 64th National Council on Health was to establish a “Health Promotion Day” in Nigeria to promote preventive healthcare and raise awareness about healthy lifestyles among the populace.

The time to act is now. We should not wait until the statistics become even grimmer. By deploying coordinated actions, the country can turn the tide against NCDs and secure a healthier, more prosperous future for Nigeria. By learning from experiences within Africa and across the globe and fostering multisectoral collaboration, the country can drive meaningful change and build a nation where the overall well-being of the citizens will continue to improve.

Chinedu Moghalu, Senior Special Adviser on Strategic Communication, Stakeholder Engagement and Advocacy to the Coordinating Minister of Health and Social Welfare, is a lawyer and strategist in sustainable development.