Road accidents are responsible for the country’s high death rate, a former Chief Medical Director (CMD), Lagos University teaching Hospital (LUTH), Idi-Araba, Prof Akin Osibogun, has said.
He spoke at the yearly Faculty of Public Health Lecture of the National Postgraduate Medical College of Nigeria.
The theme was: Economics, politics and health-The Nigerian challenge.
According to Osibogun, drivers’ faults, vehicles’ and roads’can be controlled from outside the health sector.
He said the health sector does not have the power to certify vehicles’ road-worthiness, but that it could collaborate with others to determine the visual ability of drivers as well as assess physical and psychological status of driver’s licence applicants.
“Licensing authorities are in the best position to initiate this collaboration since they are empowered by law. Another group of factors that is impacting on the health status of Nigerians is life style, the use of tobacco and other substances, bad dietary habits, lack of adequate exercise and risky social behaviour. Tobacco snuffing has long been associated with nasopharyngeal tumours just as tobacco smoking has been associated with long cancer,”he said.
He explained that sedentary lifestyles are associated with obesity, diabetes and cardiovascular heart diseases. “Risky social behaviours, such as unprotected sexual intercourse and intercourse with multiplicity of partners, have been associated with transmission of certain infectious diseases, such as gonnorrhoea, syphilis and HIV/ AIDS. While the health sector continues to provide health education, he said it has no power to stop people from smoking, compel them to exercise or to regulate their sexual habits,’’ he said.
Yet, the health sector, he said, would be burdened by the consequences of the various unhealthy lifestyles.
Osibogun identified the environment as another major source of exposure to health hazards.
He asked: “How many people sleep in one room? Does the room even have cross-ventilating windows? Are the windows kept opened or shut? Are the kitchen and toilets adequately structured and distanced from one another? What is the source of drinking water? Is it pure or “poor” water? Do the communal drains flow or are they stagnant and thus promoting the breeding of vectors? What are the individual and communal arrangements for refuse disposal?”
He continued: “The physical environment is responsible for the prevalence of malaria, diarrhea diseases and respiratory tract infections which are the leading causes of morbidity and mortality in the country.
“A national policy on waste management has been adopted but largely, it is local and state laws and by-laws that can be used to improve our physical environment from the way the Nigerian constitution has shared powers between the tiers of government. The Federal Ministries of Health and Environment will jointly and separately continue to provide national guidance while action is expected locally.
“The political economy and distribution of wealth has obvious implications for health and health status. The poor are more likely to be sick and when sick, least likely to access health services promptly. The cost of illness is not just the cost of treatment, but it must incorporate the cost of treatment seeking activities, such as transportation to the hospital and the cost of opportunities foregone. Increasing poverty levels will, therefore, mean increasing number of sick people. Lack of personal resources among the poor also means they would only seek treatment when conditions have become catastrophic. Seeking treatment late is calling unfairly on health workers. This often creates desperation on everybody’s part. On the part of patient’s relatives, the health worker is expected to perform miracles and on the part of the health worker, a fear of imminent failure.”
Osibogun added: “The solution to the above is a health care financing mechanism that can ensure for Nigerians prompt access to quality health care.The government has established the National Health Insurance Scheme and coverage is expected to be increased over a period of time. The challenge will be to break cultural and religious barriers and encourage Nigerians to embrace health insurance. The private sector must also be ready to complement the efforts of government, particularly by designing and implementing schemes that are culturally acceptable and affordable to provide cover for rural and informal sector citizens.”