Unlocking Context-Specific Solutions: Why Nigeria and Africa Need Indigenous Solutions to Public Health Challenges
By Dr Kelly Elimian
The growing push for stronger and more resilient health systems across Africa has exposed a long-standing gap. Many public health programmes are still designed or led by external organisations whose approaches, although well-meaning, often do not fully match the realities on the ground. This gap makes one fact clear: Africa needs solutions rooted in local knowledge, shaped by local experience, and informed by how its health systems actually function.
Public health challenges in Africa are strongly influenced by context. The performance of any health system is shaped by political and economic structures, community behaviour, infrastructure gaps, and the practical realities of both urban and rural environments. Interventions that fail to reflect these factors often achieve limited or short-lived results. Ongoing problems such as unstable electricity, stockouts of essential supplies, weak surveillance systems, workforce shortages, and migration (popularly described as jakpa in Nigeria), as well as uneven data quality, require local understanding to be solved effectively. This is why indigenous expertise is critical for creating solutions that are realistic, scalable, and sustainable.
Nigeria provides a clear example. The country has highly advanced tertiary hospitals, but also many primary healthcare centres that lack adequate resources. It spans different climate zones and faces complex disease patterns, including infectious outbreaks, climate-sensitive epidemics, and rising antimicrobial resistance. Addressing these issues requires both technical skills and deep contextual awareness—something external partners cannot provide in full without strong local leadership. In practice, programmes that combine global expertise with active participation by local professionals tend to perform better than those in which local actors implement instructions.
This understanding is shaping how international and regional organisations now think about public health programming in Africa. There is a growing expectation that African countries should take the lead in designing and delivering their own health strategies. Indigenous institutions—such as universities, consulting firms, think tanks, and specialised technical groups—have a strategic advantage because they are already part of the system. They have long-standing relationships with ministries, regulators, health workers, and communities. They understand cultural norms, administrative challenges, and political considerations. These strengths allow them to translate global evidence into solutions that fit local needs.
Indigenous solutions also strengthen national ownership and long-term sustainability. When interventions are designed locally, they are more likely to succeed beyond the life of a donor project. They help build local capacity, preserve institutional memory, and reinforce accountability. Most importantly, they shift the narrative from externally driven efforts to African-led innovation—supported, but not overshadowed, by global partners.
As Africa faces emerging epidemics, climate-related health threats, the need for effective vaccination strategies, and the broader demands of global health security, the value of indigenous solutions becomes even clearer. Local actors can respond more quickly, adjust to changing situations, and build trust with communities. Their understanding of the system helps them co-design interventions with frontline workers and policymakers, integrate new approaches into existing structures, and ensure that innovations remain practical and scalable.
Africa is now at a decisive moment. With a growing health workforce, stronger academic institutions, and rising demand for context-specific approaches, the continent is well-positioned to redefine how it addresses public health challenges. Achieving this goal will require investment in local expertise, stronger regional partnerships, and deliberate support for indigenous institutions.
The future of public health in Africa depends not only on solutions developed for the continent, but also on those developed within it.
