Emeka Chukwu*
Uniquely identifying patients in the health system has eluded the Nigerian health sector players. Digital health tools are being deployed to address different challenges in the Nigerian health system with little showing any sign of scale. Despite global interest in digital identity system and its potential to improve health outcome, little progress has been registered in Nigeria. Nigeria has a convoluted patient identity system at the time of writing with patient identity local to health facility and sometimes department. Functional Identification systems like civic registration of birth, election, and financial services, to mobile telephony identity schemes are variously in place in Nigeria. These functional identity systems were reviewed for size of enrolees, data quality, and possibility of use as health functional identity system. Health sector stakeholders have two options to address the identity crisis. Either to adopt one of the existing functional identity systems or a combination of them or to setup a Master Patient Index (MPI) based client registry for the health system. This work having reviewed the factors necessary to adopt a functional identity system, recommends deployment of State based client registries as a way of addressing this challenge. The recommended framework of action is to develop a policy and strategy to guide implementation, implement as appropriate at different levels and then monitor while improving as appropriate. A good functional identity system will take into consideration necessary behaviour changes, staff workload, State autonomy, political interest, patient privacy, technology and return on investment concerns including total cost of ownership even for open source technology solutions.
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