Nigeria as a country has been on a streak to strengthen its healthcare system. While efforts are being made, we are reminded that the battle against diseases extends far beyond the walls of hospitals. The financial load imposed by illnesses, which poses a danger to the country's healthcare industry's viability and expansion, is openly presented. The financial burden has a significant impact on not only how resources are allocated within the industry but also on how well the economy as a whole is doing for people, families, and the entire country. 

There are an estimated 100 million malaria cases, with over 300,000 deaths per year in Nigeria. Malaria stands out as a common and expensive illness among those that have placed a significant financial load on Nigeria's healthcare sector. There must be significant investments made in the prevention, diagnosis, and treatment of malaria, which is spread by mosquitoes and has a high incidence throughout the nation.  

The purchase of antimalarial medications, the deployment of mosquito prevention strategies, and the supply of medical infrastructure to reach rural locations where the disease is most prevalent all add to the financial burden on the healthcare sector.   

Related: Nigerian and Kenyan healthcare market poised for growth

According to the 2022 World Malaria Report, the nation bears the burden of the disease to the extent of around 27 per cent of the world's population. The survey also reveals that the biggest global proportion of malaria mortality, at around 31.3 per cent, occurs in Nigeria. 

A potential new malaria vaccine was licensed by Nigeria on April 17 this year. In preliminary studies, up to 80 per cent of children who received the R21 vaccine were protected against malaria. Nigeria is a nation in need of malaria prevention. 

The healthcare industry in Nigeria faces financial challenges beyond malaria. This includes the pervasive burden of HIV/AIDS. With one of the largest populations of people living with HIV/AIDS globally, significant investments are required for treatment, testing, and care. Managing opportunistic infections and providing comprehensive support services further strains the industry's finances. 

The cost of treating tuberculosis (TB) in Nigeria's healthcare system is increasing. A huge amount of financing is required for medications, lab testing, and efficient surveillance systems due to the high prevalence of TB cases. Due to a lack of funding, the fight against TB is a financial tightrope walk.  

Related: Nigeria embraces healthtech solutions

Other diseases that make it impossible not to raise an eyebrow are non-communicable diseases (NCDs). Conditions such as cancer, diabetes, and cardiovascular illnesses are recording an alarming increasing prevalence. The cost of receiving specialised care, purchasing medications, and having a chronic disease managed is also high.  

Maternal and child health issues strain Nigeria's healthcare industry financially. Investments in prenatal care, safe delivery services, immunisations, and neonatal care are needed to address high maternal and child mortality rates. The industry faces additional economic burdens from expanding healthcare infrastructure, training healthcare professionals, and procuring necessary equipment. 

The financial challenges are compounded by the need to expand healthcare infrastructure, train healthcare professionals, and procure necessary equipment and supplies. 

To lessen the financial burden on the sector and make sure that Nigeria's healthcare system is capable of efficiently combating these diseases, it is imperative to make sustained investments, employ innovative strategies, and create efficient policy reforms to alleviate the strain on the industry's wallet. Nigeria will be able to create the conditions for a healthier population in the future as well as a more successful healthcare sector if they tackle these issues. 

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Saudi Arabia continues to work towards restructuring its healthcare industry under the umbrella of the strategic socio-economic initiatives under Saudi Vision 2030, showing significant success in its mission to enhance the well-being and health of individuals and the community, including residents, citizens, and visitors. 

The five-year outlook of the Health Sector Transformation Programme, initiated in 2021, seeks to design a thorough, efficient, and integrated health system focusing on privatisation and technological advances. So far, the Kingdom of Saudi Arabia has demonstrated progress in: 

• Quality and efficiency of healthcare services 
• Healthcare service coverage in all regions of Saudi Arabia 
• Digital transformation in healthcare 

As the government plans to invest more than US$65 billion to develop the country’s healthcare infrastructure, the gears are shifting to create a highly comprehensive and accessible healthcare sector.  

Related: Saudi Arabia marks healthcare transformation boom

Here is a look at noteworthy health sector transformation initiatives in 2023. 

Saudi Arabia’s advancements in technology 

At a time when medical practices are under pressure to perform at their highest level of effectiveness, leading organisations like Philips and Wipro are collaborating with the kingdom. The objective is to promote sustainable digital change in healthcare using global clinical best practices while adhering to regional norms and laws. This implies: 

• The healthcare sector will get access to state-of-art technology leading to better health outcomes and improved patient care. 
• The improvement in care and staff experience will help reduce general healthcare costs. 
• It will strengthen and support regional clinical practice, adaptable workflows, data and service integrations, and decision-making. 

Advancements in treatments 

A new era of blood cancer treatment by genetically modifying the patient's white blood cells has been ushered in the KSA with the recent approval of cell therapies for blood cancer. This is led by Kite, a Gilead company based in the US, which has been researching the potential of treating the immune system to fight against cancer since its inception.  

Consistent research on this ground-breaking treatment is likely to improve capabilities, referrals, protocols, and data generation concerning the oncology ecosystem in Saudi Arabia. 

Related: How healthtech solutions are shaping primary care in Saudi Arabia

Progress in research and training  

Mobilising the country’s youth in research and training is also underway and extends to options like 5G solutions to leave an impact on various sectors, including patient health. 

As part of its ongoing Fresh Graduate Programme in Saudi Arabia, Ericsson Saudi Arabia greeted a new cohort of 22 Saudi graduates across engineering, information technology, strategy and commercial management positions. There is growing female representation, with 32 per cent of the new batch including females.  

Though not directly related to healthcare, such developments in science and technology through automation, Augmented Reality (AR), or even the Internet of Things (IoT) will aid overall medical and healthcare progress. 

In essence, it is clear that the Health Sector Transformation Programme is working successfully towards elevating a value-based healthcare system in Saudi Arabia. Besides new strategic models for disease prevention, equitable healthcare access in terms of geography and digitalisation is likely to expand too.  

To learn more about the latest developments in Saudi Arabia's healthcare industry, attend the Global Health Exhibition taking place from 29-31 October at Riyadh Front Exhibition & Conference Center (RFECC). Click here to know more.

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The advent of cutting-edge technologies like genetic testing and data analytics has given rise to personalised nutrition, which aims to optimise dietary choices and elevate overall well-being. The personalised nutrition market today offers tailor-made nutritional recommendations by leveraging an individual's unique characteristics.

The global Personalised Nutrition Market is estimated to be worth US$45.9 billion by 2032 due to rising consumer demand, technological innovations, and the incorporation of personalised nutrition into mainstream healthcare. The market is projected to continue growing in the coming years.

An example of how personalisation is gaining traction can be seen in the success of Complements, a leading player in the personalised nutrition market. Unlike generic supplements that follow a one-size-fits-all approach, the company creates formulas tailored to an individual's biology, lifestyle, and health goals, precisely addressing their specific needs, according to Dr. Rafi Ahmad, the Chief R&D Officer of xNARA (the company behind Complements) and Expert at AstraZeneca in Norway and Sweden.

Related: Special food labels boost patient wellness

Reportedly, customers have benefitted from using Complements and have been found to have increased energy levels, improved digestion, enhanced skin health, weight loss, and heightened mental clarity. According to a voluntary survey of 24,000 customers in May 2023 by xNARA, 98 per cent of users preferred it over traditional supplements, with 88 per cent noticing improvements in at least one health area and 86 per cent observing improvements in two or more health areas. These positive experiences emphasise the effectiveness of personalised nutrition in optimising overall well-being.

Redefining personalisation

Technology and personalisation play a critical role in the global personalised nutrition market. Advances in digital platforms and data analysis enable companies to gather comprehensive information about individuals and generate personalised recommendations. Through user-friendly online assessments and sophisticated algorithms, collected data is analysed to create personalised formulas that address an individual's unique nutritional and health deficiencies. This precise and efficient approach empowers individuals to take control of their well-being, optimising their supplementation for better health outcomes.

Related: Tech solutions set to disrupt healthcare

For example, Complements conduct various assessments and tests to create personalised formulas for individuals. The initial step is the xNARA intelligent assessment, a five-minute quiz that delves into an individual's lifestyle, goals, biology, and overall health. This assessment provides valuable insights into an individual's specific requirements, forming the foundation for personalisation. Additionally, the company offers optional gut profiles and genetic tests to gain further insights into an individual's microbial composition and genetic predispositions. These additional tests refine the personalised formulas, ensuring a highly targeted approach to addressing individual health needs.

Furthermore, Complements incorporate scientific precision and extensive clinical data in selecting ingredients for personalised supplements. For example, the team at xNARA conducts a review process, analysing 20,000 peer-reviewed studies to identify highly active and potent ingredients. Each ingredient is carefully matched to an individual's specific health intricacies, ensuring it addresses specific deficiencies and optimises desired outcomes. This scientific approach ensures that the selected ingredients are backed by credible clinical data and have a proven track record in promoting health and well-being.

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The implementation of artificial intelligence (AI) in healthcare has paved the way for remarkable advancements, revolutionising various medical specialities. In the field of anatomical pathology, the integration of AI-powered tools and applications holds tremendous promise for enhancing accuracy, efficiency, and ultimately, improving patient outcomes.  

Anatomical pathology, a crucial branch of medicine, focuses on studying the impact of diseases on organ structures, aiming to identify abnormalities that aid in disease diagnosis and treatment management. Advanced centres in the UAE, including the Anatomical Pathology Laboratory at Sheikh Shakhbout Medical City are leveraging AI technology to empower pathology teams with enhanced diagnostic precision and create more effective treatment strategies.  

Speaking about the benefits of AI in anatomical pathology, Dr. Rawia Mubarak Mohamed, Consultant Anatomical Pathologist at SSMC, said: “AI algorithms help us analyse digital images of tissue samples, both pathology and cytopathology specimens, and detect features that would have been very difficult for a human pathologist to identify on their own.” 

Related: AI-driven precision medicine boosts higher success rates in cancer patients

Taking the recently opened Anatomical Pathology Laboratory as a reference, she added that cutting-edge AI-powered tools and applications extend to the analysis of digital images of pathology and cytopathology specimens. 

Dr. Rawia Mubarak Mohamed, Consultant Anatomical Pathologist at SSMC

These tools detect intricate features that may otherwise be challenging to identify manually. AI algorithms further ensures higher accuracy rates in diagnosing diseases and complex conditions, enabling pathologists to provide more precise treatment recommendations. Moreover, AI's ability to process vast amounts of data swiftly contributes to expediting the diagnostic process, leading to faster treatment initiation and improved patient outcomes, especially in critical cases such as cancer diagnosis. 

Breast cancer diagnosis serves as an illustrative example of how AI has revolutionised the diagnostic process in anatomical pathology. Dr. Rawia explains that traditionally, pathologists would analyse hormonal markers using immunochemistry stains, providing percentages of each hormone for treatment guidance. However, with AI algorithms and specialised systems in place, pathologists can achieve enhanced specificity and accuracy. By automating the analysis of thousands of cells, AI tools ensure a higher degree of consistency in determining the exact percentage of each hormone. This precise data equips oncologists with invaluable insights, enabling personalised treatment strategies tailored to individual patients. 

Related: Beyond the hype: Generative AI and healthcare in the Middle East

AI's integration into anatomical pathology goes beyond improving accuracy and efficiency. It paves the way for the era of personalised medicine, where treatment approaches are tailored to each patient's unique characteristics. Through AI-driven analysis, pathologists can gather comprehensive data about genetic makeup, lifestyle factors, and medical history, allowing for a more holistic understanding of individual patient profiles. This information empowers healthcare professionals to develop targeted treatment strategies that optimise patient outcomes and minimise unnecessary interventions. The marriage of AI and anatomical pathology ushers in an era of medicine where precision and personalised care take centre stage. 

The integration of AI in anatomical pathology represents a significant milestone in healthcare. As technology continues to evolve, further advancements in AI algorithms and tools hold immense potential for the field. AI continues to mature and is poised to become an indispensable tool for pathologists, revolutionising the way diseases are diagnosed, treatments are recommended, and patient outcomes are improved. 

References available on request. 

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Access the must-read eBook on AI here to discover perspectives on its transformative role in the healthcare industry.

The increasing prevalence of scoliosis, which currently affects two to three per cent of the global population, indicates that there may be substantial growth for the scoliosis management market in the coming years. According to a report by Future Market Insights, the value of the market is projected to reach a value of US$4.5 million by 2032, with North America leading the market for treatment options, followed by Europe and Asia Pacific.  

Early detection and treatment of scoliosis 

Scoliosis affects approximately one in 300 children and involves a sideways curvature of the spine that could potentially result in back pain and breathing difficulties in adulthood. Dr. A. Noelle Larson, Paediatric Orthopaedic surgeon at Mayo Clinic emphasised that early detection and treatment with the aid of braces can help manage childhood scoliosis efficiently.  

“Bracing is very successful for the treatment of moderate curves. There is very good evidence that brace wear can halt curve progression in growing children,” Dr. Larson explained.  

While bracing helps maintain the spine in a correct position by halting the progression of scoliosis and preventing the need for surgery, physical therapy plays a significant role in pain management and improving posture, giving essential support to young patients. 

Related: How technology is shaping the future of surgery

According to Dr. Larson, moderate to severe scoliosis can be managed by motion-sparing surgical options that prioritise preserving spinal flexibility and growth. These innovative approaches offer hope to patients and families navigating the challenges associated with more advanced cases. 

Tech and innovation 

ICT technology and smartphone devices have brought significant advancements to scoliosis management. ICT-based scoliosis management involves standalone software tools, web-based applications, and smartphone apps. Semi-automatic procedures using computer mouse-placed landmarks have further demonstrated reliability and reduced variation. Computerised software tool has enhanced the visualisation and consistency of digitalised X-ray images, while AI applications, such as deep neural networks, can predict vertebral slopes and automatically calculate Cobb angle.  

Smartphones, on the other hand, offer a convenient tool for measuring the Cobb angle, particularly in areas with limited access to digital tools. Smartphone apps enable doctors and spinal surgeons to calculate and measure spinal curvature angles, facilitating screening and monitoring of scoliosis. These apps also allow data comparison, continuous tracking, remote consultation, and potential contributions to scientific research and treatment formulation. Overall, smartphone apps enhance screening accuracy and have the potential to detect scoliosis globally. 

Surgical treatment options for moderate to severe scoliosis 

The traditional approach for severe scoliosis is a spinal fusion surgery where two rods and 12 to 20 screws are placed in the spine to hold it in a corrected position. “This is a very successful surgery that corrects scoliosis, but it eliminates motion and growth over the part of the spine that is curved,” Dr. Larson explained.  

“Patients who have a fusion into the lower back may feel less flexible and may even be at risk for arthritis in the remaining part of the spine that is not fused. Also, some patients who do high-demand sports such as gymnastics or diving may find it difficult to do some activities following a long fusion,” she added. 

There are several motion-preserving scoliosis surgeries currently available. Posterior dynamic distraction (Apofix) involves three screws and a rod with several small joints that allow for motion. It works for patients with a single flexible curve pattern. Vertebral body tethering is a plastic cord that is placed along with screws in the front of the spine.  It can be used in growing children and functions as an internal brace to guide the spine into a corrected position.  

Related: Robotics in spine surgery can elevate accuracy

Compared to fusion surgery, both approaches have a higher chance of reoperation and less correction of the curve. However, children treated with vertebral body tethering typically notice no difference in their spinal motion or function and patients with posterior dynamic distraction find some preserved motion. 

Scoliosis is a challenging condition because in many instances families are taken by surprise that their child has a serious medical condition. “Thankfully, there are reliable, safe treatments for scoliosis. Although fusion surgery is generally successful, motion-sparing procedures provide patients with options to preserve spinal motion and growth,” said Dr. Larson. 

References available on request. 

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The tale of the journey towards affordable healthcare in Africa cannot be told without shedding light on the community health workers that bridge the gap between isolated communities and formal healthcare; the health insurance schemes that pool resources to share the burden; or the education and awareness initiatives aimed towards instilling a culture of preventive measures. These are a lean representation of significant steps taken towards the achievement of affordable healthcare in Africa.  

About 996 million people worldwide spend more than 10 per cent of their household income on healthcare through direct out-of-pocket payments (OOPs), which has driven families into poverty every year. The problem is critical in low- and middle-income nations, particularly those in Africa, where 27 out of 48 nations are heavily impacted by direct OOPs for healthcare services. 

Related: What Africa CDC's new public health order means for Africa and Africans

It goes to prove a point that efficient and effective health financing is the key to achieving affordable healthcare in Nigeria in addition to the employment of result-yielding innovations.  

Toluwani Oluwatola, a public health analyst at Sydani shared, “In the 20th century, Africa faced the devastating AIDS epidemic, prompting African leaders to convene in Abuja for an AIDS conference. The resulting Abuja declaration called for allocating 15 per cent of annual budgets to healthcare. While few countries have fully met this commitment, the century also saw the adoption of community-based and national health insurance schemes in Africa. However, the health financing landscape still faces significant challenges, with a high out-of-pocket expenditure of 36 per cent and low health spending per capita of US$80, indicating the need for further improvements and investments in affordable healthcare.” 

Promoting equitable healthcare access, preventive care, early detection, and cost-effective interventions require accessible and affordable primary healthcare. Most of the population ultimately benefits because it improves health outcomes, lowers health inequities, supports economic development, and enhances the healthcare systems.  

Related: East Africa keenly explores blockchain technology in healthcare

Some of the current initiatives for affordable healthcare in Africa include primary healthcare facilities (PHCs), community health workers (CHWs), insurance plans, telemedicine and mobile health, pharmaceutical partnerships, public-private partnerships (PPPs), investments in health infrastructure, research and development, and international aid/partnerships. Success stories include expanded healthcare access offered by PHCs and CHWs, improved coverage supplied by health insurance programs, expanded reach and efficiency provided by telemedicine, and expanded access to reasonably priced medications provided by pharmaceutical partnerships. 

While these initiatives have shown effectiveness in improving healthcare access, challenges remain, such as inadequate infrastructure and funding. Continued investment, collaboration, and innovation are needed to further strengthen affordable healthcare in Africa. 

There are several possible ways to improve access to inexpensive healthcare in Africa. The following choices seek to solve the present issues and strengthen the current programmes: 

• African countries must use strategic purchasing to make sure that the money allocated for healthcare is spent on the greatest resources at the best possible level of service. Thereby increasing the effectiveness of healthcare spending. 
• Encouraging public-private partnerships for accessible healthcare by developing favourable policy environments, establishing frameworks for these partnerships, and enlisting the expertise, resources, and innovations of the private sector to drive creative financing schemes and facilitate technology transfer is another step in the right direction that African countries should take.  
• Other options to think about include using community-based tactics like health cooperatives and microinsurance models, utilising cutting-edge tech solutions like AI, telehealth, and mHealth, enhancing regional healthcare systems through the growth of infrastructure and human resource capacity, and many others. 

These activities must be implemented using a multifaceted strategy that involves governments, health experts, civil society, and international assistance. Commitment from stakeholders, continuous evaluation, and adaptation to local contexts remain essential to ensure the effectiveness and sustainability of affordable healthcare solutions in Africa. 

References available on request. 

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The challenges of modern life can be overwhelming, from financial burdens to the daily struggles of managing work and family. And for many of us, our jobs present their own unique challenges and pressures, from prolonged hours to overwhelming amounts of work and tight deadlines. All of these high-pressure situations can often lead to burnout at the workplace. 

In my role at Cigna Healthcare, I have seen the direct and indirect impact of mental health on work culture, productivity, and, ultimately, business success. There is a clear link between the employees’ well-being and an organisation’s overall health. 

Recently, the workplace landscape has dramatically shifted. Our annual 360 Well-being Survey illustrates this changing dynamic, revealing high levels of stress among employees and a profound disconnect between what employees expect from their employers and what they receive. Strikingly, 55 per cent of respondents in the UAE expressed a desire to change jobs – a number that has significantly increased in the past year, compared to a global average of 36 per cent. These findings underscore a pressing need for action. 

It is especially concerning that Gen Z employees seem to be particularly vulnerable and suffer from poor mental health at the workplace. Again, in our Cigna Healthcare survey, we found that 91 per cent of Gen Z workers, aged 18 to 24, reported feeling stressed, compared to the average of 84 per cent. There are various theories as to why this might be – this is a generation that studied for their degrees in isolation during the pandemic, heightening social anxiety, with precarious economic situations also taking a toll on them.  

Related: Harnessing virtual reality therapy for improved mental health

When placed in high-stress fields like the medical industry, where decisions can literally be a matter of life and death, the impact of such pressure on young professionals becomes even more apparent. This pattern is not limited to one profession alone – as employers, we have a responsibility to address these challenges wherever they appear. 

Internally, we recently launched a campaign called “The 5% Pledge”, urging CEOs, business leaders, and people managers to make a public commitment to set aside 5 per cent of their annual working hours to foster transformation in organisational cultures, proactively address employee well-being, and eliminate stigmas associated with mental health issues. By doing so, we can cultivate a progressive culture and attract top talent. 

But investing in mental health is not just about mitigating stress or reducing employee turnover, although these are important outcomes. It is about fostering a holistic, supportive environment that recognises the fundamental role of mental health in overall well-being. As we spend a significant portion of our lives at work, the workplace must be a space that promotes not just physical safety but psychological well-being too. 

The workplace often represents a primary social interaction hub, particularly for single employees, and a mentally healthy workplace can contribute positively to overall mental well-being. On the contrary, a toxic work environment can have severe repercussions, driving employees to seek other opportunities, as our survey reveals. 

Addressing gaps in mental healthcare 

Unfortunately, the current landscape lacks sufficient support for mental health guidance, not only in the medical field but across industries. There are significant gaps that need to be filled, and it is crucial for companies to address this. Tackling these challenges requires a multi-faceted approach that involves listening, developing, and implementing meaningful changes. From a business perspective, investing in mental health makes sense, as happier employees are more likely to perform better and stay with the company. 

Business and healthcare leaders play a pivotal role in creating a supportive work environment that promotes mental well-being. Organisations should foster a culture of openness and acceptance, encouraging employees to seek help without fear of judgement. Leaders should also invest in resources that support mental health, such as employee assistance programmes (EAPs), counselling services, and wellness initiatives. This could range from exercise and mindfulness sessions to reward schemes and guest speakers.  

Related: Diversity will lead the way to success in HealthTech

Also consider the wider company culture. For example, do employees feel they keep providing with no acknowledgement or reward, particularly when helping the company through difficult times? And how much does the ‘always on’ culture, with employees contactable via WhatsApp or email after hours, interfere with the work-life balance? Do you ever consider what is a reasonable amount of stress a person can endure? And are employees allowed enough breaks? 

Cigna Healthcare is uniquely positioned to understand the mental health challenges faced by individuals and organisations. These can lead to decreased productivity, increased absenteeism, and higher healthcare costs. By investing in mental health, businesses can create a positive work environment that attracts and retains talented individuals and ultimately lead to better output. 

It is our responsibility as employers to recognise the challenges faced and provide guidance where needed. By creating a culture of acceptance, investing in mental health initiatives, and promoting well-being, we can build a workplace that not only benefits employees but enhances productivity and overall success.  

Jerome Droesch is CEO of Domestic Health and Health Services at Cigna Healthcare

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