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Born as a princess and Ada to the late HRH Igwe na Ezuruoha one of Obinagu Uwani Akpugo of Enugu State, a role she didn’t apply for, Dr. Dorothy Jeff-Nnamani through this fate, which later set her apart in life learnt benevolence, humility, respect for others, wisdom, hard work, confidence and integrity.
While the palace shaped her into an all-round woman, who is proud of her heritage, tradition, and roots, Jeff-Nnamani was born into community service and care through her father before the life of her family Doctor honed her interest in Medical Science, where she now practices care on a larger scale.
Today, Jeff-Nnamani is not only a Medical Doctor but one who is changing the narrative around access to healthcare with the help of technology across the African region through Novo Health Africa, an organisation she founded after managing PHB Healthcare Limited, a subsidiary of the then Bank PHB. Providing financial leeway for healthcare, Jeff-Nnamani has been very particular about the World Health Organisation (WHO) and Sustainable Development Goals (SDGs), particularly universal health coverage mandate due in 2030.
After her first degree in University of Nsukka, Jeff-Nnamani left her love for pediatrics for public health at the University of Lagos where she obtained her Master of Public Health (MPH). As a public health specialist, she later got fascinated by the endemicity of communicable diseases and went further into getting an MSc in Infectious diseases and a course of study in health financing from the London School of Hygiene and Tropical Medicine.
In this interview, she shares the many sides to her story and the solutions to pressing issues around healthcare as well as gender and women with KINGSLEY JEREMIAH.
How was your growing up? Tell us about your family, childhood experiences and the memories that still stand out for you?
I am the first child from my Mother -Igbos will say Ada and being an Ada came with its own socio-cultural responsibilities. Though my Dad had an earlier marriage which produced three older sisters before me, I still wore the Ada crown nevertheless. My late Mum was the most beautiful woman that I ever saw and I remember teasing her of a possible foreign lineage. We were quite close and had marathon gist sessions till wee hours in the morning. I still love silly stories that make you laugh from your belly till it aches. That was the kind of friendship I had with my mum till she passed on in 2002. She started off as a homemaker but joined my Dad in his distributorship business as we got older. On the other hand, my father of blessed memories was the Igwe (King) of our town and fondly titled as His Royal Highness, Igwe na ezuruoha 1 of Obinagu Uwani Akpugo (meaning the king that is sufficient for his people). He was so very fond of me. An astute entrepreneur and philanthropist. He loved football so much and one of his philanthropic endeavours was floating a football club – The Olympic football club, through which he raised many legendary football players like former Eagles coach, Christian Chukwu and others that played in the Rangers football club of Enugu State.
Many young students at the time played in this youth club and that endeared them to my father, like the former Senate president, Ken Nnamani. As a man of the people not only in Enugu but also in the Old Anambra state, this meant there was no hiding place. I remember a very busy household, always hosting people and housing holiday makers. I remember being the little girl to accompany my dad to football matches at the Enugu stadium and other public functions. I remember snuggling close to my dad even as he had social meetings and he will always ask for my opinion, which made people laugh. I remember hilarious monopoly nights in which neither me nor my siblings ever won my dad -even if you win. Being an Igwe, my dad never spoke to us in plain language. He will always use Igbo proverbs and then ask you to go and think about it…This means waking you up very early in the morning to discuss the proverbial issue at hand and how similar challenges will be averted. He taught us wisdom in so many ways. Those were fun times…indeed the good old days.
The memories that will stand out are all the Christmas holidays spent with my siblings at the palace in the village-The Palace of the people (from my Nursery school to university days. No Christmas was spent outside my village. My husband and I have carried this tradition onwards with our children), and non-stop entertainment for all and sundry through the entire holiday season.
My father will always say that food never finishes in a king’s palace so we must serve everyone regardless of who and what time they came. Those were bonding times which brought closeness and love in our family and for our community. My siblings and I are quite close and they look up to me…I hope I did not disappoint them. My childhood taught me benevolence, humility, respect for others, wisdom, hard work, confidence, integrity and has made me an all-round woman, proud of my heritage, tradition, and root.
Let’s talk about your education and career. The young medical student that year is heading one of the outstanding medical solutions firm on the continent. What got you interested in medicine and how did you get here?
I was influenced into taking up career in medicine by our then family Doctor in Enugu. She is of blessed memories. I started admiring her and the way she cared for people, especially children as she was a pediatrists. In her practice, she had a small children’s play area which made me look forward to playing with other children. It never really felt like a hospital, of course until you see the jab coming.
Magically, she would get you settled as soon as possible, and you would forget the injection. That was my nursery and primary school days. This interest never waned, and I got into medical soon at the College of medicine, University of Nigeria Nsukka, Enugu Campus. In my secondary school at Queens College Yaba, Lagos, I was a science student and I did pretty well in all my classes and passed the senior secondary school examinations with As in science. I had 7As and 1C. In medical school, I had wanted to be a pediatrician of course, but as we progressed into fifth year we were introduced to community health. I believe that at this point I began to put the pieces from my childhood together and see how becoming a public health physician can equip me in solving our common health issues on a much larger scale and faster for a healthier society.
Being someone rooted in culture I was able to connect and appreciate socio-cultural practices, economics and political factors as determinants of health. Many people who visit the hospital have no business being in their precarious situation if only these various factors were addressed. That settled my decision and endeared me to public health. I got an MPH from the College of Medicine, University of Lagos. As a public health specialist, the endemicity of communicable diseases was quite frustrating and this pushed me further into getting an MSc in Infectious diseases and a course of study in health financing from the London School of Hygiene and Tropical Medicine. Today, ending the epidemics of these communicable diseases like malaria, tuberculosis, HIV/AIDS is one of the bold commitments of the United Nation in SDG3 under the sustainable development goals 2030. So, I can say that I am going in the right direction and will bring purposeful value to our society.
Health burden is growing rapidly in Nigeria just as medical tourism. Unlike before, cases of cancer and other life-threatening illnesses are common in almost every family. What is your take on this?
I mentioned above that there are economic, political and socio-cultural determinants of health. With the worsening economic situation, many families can neither afford to eat well to stay healthy nor can they afford to imbibe necessary health promotion and preventative activities. This will make them vulnerable and more exposed to ill-health.
This takes us to the vicious cycle of poverty and ill-health. The more exposed they are the more likely they will get sick and because they are having economic challenges, they do not seek health on time, they get sicker, then when it becomes life threatening, they spend their meager wage trying to save life, they lose their few assets like land and spend the little money they have. Then they get poorer, and the cycle continues like this. This is why many schools of thought, including institutions like the world bank, have pronounced that we can never achieve SDG 1 which is eliminating poverty if we do not achieve SDG3 – Good health and well being for all.
Our government needs to understand the interdependence of health and development and with all the poverty alleviation programmes, the success remains far from insight until we redeem our health system.
Again, with changes in lifestyle in these modern times and social indulgences, we are witnessing exposures to diseases linked to these lifestyles. People are eating a lot of unhealthy off-the-counter foods, consuming different supplements and undergoing unnecessary risky procedures for whatever aesthetics. Some of the ingested stuff are said to have carcinogens associated with cancer. Again, it is not that cancer never existed, however, exposure and awareness have influenced early detection and so there is an increased record of those seeking and receiving treatment.
Lack of political will by the government to strengthen the health system has also denied families the comfort of functioning, well-resourced and well-equipped primary health care services where there can be early detection of many ailments before they become life-threatening. Even at the life-threatening stage, there is the high risk of death as we do not have modern medically equipped facilities that can save life and return people to their normal productive state. Many families are therefore suffering the loss of loved ones or morbidity as the case may be.
What is Novo Health Africa all about and how is the organization solving this health burden in the country?
Novo Health Africa is all about providing health management solutions for individuals, families and communities through a variety of health programmes and health financing options. Health insurance is at the core of what we do, and we are able to pool people into the health system and support their health care journey.
The most widely accepted health financing option is health insurance, and it is proposed as the tool for achieving universal coverage for health by the year 2030 by WHO. Novo Health has joined many organizations across the globe in creating awareness on the importance of health insurance to the public, offering public and private health insurance packages that cover individuals, groups and families and participating in public discussions and advocacy centered on universal health coverage.
Health burden is not only about the bodily ailment or disease limitations, signs and symptoms experienced by the individual. It has financial risks in which case those paying out of pocket may experience catastrophic expenditures associated with the ill-health. Health insurance plans will protect people from such situations. The more you spend on health without budgeting or wedging your financial risks though health insurance, the more you drain your finances. Ill-health is also a major loss of productivity in the workplace and accounts for over half the time of absenteeism and presenteeism in the workplace.
As a country, this burden reflects on decreased GDP per capita with poor economic growth and development. Novo Health Africa services commit to creating value through excellent coordination and efficient delivery of healthcare services, better client experience during hospital visits and enhanced client engagement in their own health care to reduce medical errors and improve clinical outcomes.
When people have health insurance they exhibit better health seeking behaviour, they are more confident in going to hospital to seek care and have better outcomes. In Nigeria, most times people do not see themselves as customers in the hospital because they come with a beggarly attitude because they are worried about the cost of care and expecting that the hospital will give them a hand of charity.
This already puts you at a disadvantage and disenfranchises you in being part of the decision making in your own health. Like in every other purchase, the customer is king and when you have health insurance you feel protected and deserving of purchasing your health needs. Novo Health Africa helps relieve the burden so that people maintain good health which allows them to work, play and enjoy life.
Across the world, tech is helping to reach unserved and underserved populations in expanding healthcare access. What is the situation in Nigeria as we work towards achieving sustainable development goals?
Technology advancements are usually fueled by the need for better options, be it affordability, durability, expanding reach, more convenience, ease, personalization, or efficiency. Nigeria has a population of over 200 million people across various cultures and religions with over 70 per cent of them living in some dimension of poverty.
It is therefore expected that technology will play a pivotal role in harnessing every opportunity to bring them into the health insurance pool and ensure access to healthcare if Nigeria is going to achieve sustainable development goal 3-SDG3 by the year 2030.
Novo Health Africa acknowledges this fact and with a good background understanding in the business of healthcare and health financing, we set out from the start as a data driven and a technology driven organization. Technology is built on data and all the advancements you see is a reaction to what data is telling us. As they say – numbers don’t lie!
Our software-Ijele™ is an in-house built software that identifies and can solve the peculiar Nigeria health insurance industry management and administrative problems. It communicates with our hospital networks, client organizations and all registered members. To reach the underserved we curated data from multiple sources and with that developed a health insurance plan that will serve their most pressing health needs then using technology we were able to offer them a suitable payment model. Most of the underserved are in the informal sector and find it hard to budget for anything as they live by the day.
They have not been enrolled massively like people in the organized private and public sector because of the difficulty in designing an appropriate payment and administrative system as they do not have disposable funds to tie down. We were able to enroll in a community in Ajegunle. Unfortunately, the economy got worse and it affected the programme.
For the organized sector we have been innovating around all the administrative bottlenecks and deploying technology wherever necessary supported by data to accommodate all the socio-economic groups in this population especially the poor amongst them. To provide value, Novo Health deployed technology in enrollment of large groups of people across the nation. This e-registration allows for easy, faster and efficient registration and creates value for the hard-to-reach areas due to insecurity and other terrain problems.
We also have the e-Identification cards which we commenced during Covid to lessen contact with physical surfaces, and we encouraged social distancing using Telehealth to grant access to care. We provide health promotion and awareness programs to people in hard-to-reach areas through virtual on-line health services.
Our most recent technology guided transformative initiative has just been launched July 2023, called the Novo Apoyo. It is a digital process that has disrupted the traditional way of visiting the hospital on a health insurance plan thereby solving a monumental headache in our industry. This is the first of its kind in our industry and the official unveiling comes up in October this year. Novo Apoyo is a self-check-in on-line technology that empowers our enrollees and their families in many ways, empowers our hospital network and provides real time data to support workplace health and safety programs so that organizations can improve productivity of their staff and in turn increase their revenue and profit. It is a win-win for all.
A lot of young women are looking forward to attaining your kind of position. What advice do you have for them?
I will say, believe in yourself, focus and work hard. To focus and work hard does not mean that you will not fail nor have down times for rest and other commitments. It means that after a down time you pick yourself up and when you fail, you fail forwards.
There is really no formula. Life is a journey and for as long as we are alive, we are all striving and learning along the way to no destination. You keep going because it can always be better…till infinity.
How do you relax? What are your favorite colours, Nigerian delicacies, books and quotes?
I am an exercise Junkie really. I get my relaxation in the gym or on the dance floor. I have always thought that if I wasn’t a medical doctor, I would probably have been a professional dancer.
I love Navy blue, white, brown and green.
I love Nigerian delicacies when done right. My favorite Nigerian delicacy is my traditional soup (Ofe Awa-made with fried or boiled moulded egusi balls and the awa leaf )with pounded yam. I like Abacha (local salad), Isi ewu (goat head) and Anyu (pumpkin porridge).
My favorite quote is “Pay now and Play later or Play now and Pay later…either way you must pay. So choose wisely!” I sing it to my children, and I think it gives them strength as they reflect on it every day.
Who are your role models? Tell us about an experience that almost forced you to give up; from your days in medical school till now?
I have three role models. They are all Nigerian women who have achieved in their various careers and are directors in large national and multinational enterprises and I think they all know themselves because they are my go-to persons. They are my support system. I would not want to mention their names so as not to infringe on their privacy.
As for giving up, honestly, I think there are some of us who are thick skinned and wired differently. I am a solutions person and I believe that there is always a way so giving up is not really a luxury that I am opportune to experience. My family, friends and colleagues know not to distract me with a problem without revving it up with possible solutions. However, the solution in certain circumstances may be walking away from whatever I consider unpleasant. But I never feel deflated or defeated. That must be a strength and I acknowledge that I equally have my share of weaknesses too.
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