The Nation Newspaper

Tag: health

  • Badaru, Lamido and Jigawa’s health sector

    One of the beauties of democracy is the freedom of speech only that we do not allow justice and truth to be killed on the table of egotism, envy, hatred and ingratitude. I have been thinking what Jigawa government under Alhaji Muhammadu Abubakar Talamis wants to achieve by always attacking and discrediting Sule Lamido’s visible and pragmatic achievements in Jigawa.

    Instead of recognizing and appreciating what he did and continuing from where he stopped, they keep belittling him by using people to mislead the general public particularly those who have not visited Jigawa or heard of what Lamido did in the state.  A first time and even a wayfarer through Jigawa can attest to the work Lamido did in the state. Records and legacies don’t lie.

    Before the coming of the Lamido administration in 2007, the health budget of the state was never above five percent. From 2007 there was a gradual increase in the size of the budget reaching 15% in 2013 making the state the only one in the federation to attain the Abuja Declaration.

    In 2007 when Lamido took over as the governor, he introduced a decentralized and integrated district health system known as Gunduma Health System to improve access to healthcare and reach out to the rural dwellers within the limit of available resources and he succeeded.

    Lamido’s vision in the initiating Gunduma Health System, was to have a healthy and productive population in Jigawa State and to promote the health status of the people through improved integrated health care service, awareness on health and health related matters, to ensure good resource mobilization and practices with increased public – private partnership and effective participation and ownership to ensure that basic health services are made available, accessible, affordable and acceptable to the people of Jigawa State.

    This came with a number of gains including:  the revamping of the infrastructure, improvement in health care financing, strengthening of the human resource, improving health services delivery, sustaining drugs supply and equipment provision and promoting community participation and ownership. Gunduma Health System was created to focus on improving health service delivery while the state Ministry of Health maintained its stewardship role for policy direction.  Before Lamido became the governor in 2007, Jigawa State had the highest maternal and infant mortality rate in the country; the health sector then, was a sham. The Gunduma Healthcare System he initiated was messiah for entire health sector in the state.

    When Lamido took over in 2007, his administration inherited only 21 doctors, six pharmacists and less than 200 nurses/midwives in what undoubtedly showed and proved a decaying health sector. Because workers are the engine of any institution, before Lamido handed over power in May 29, 2015, there were 160 doctors, 685 nurses/midwives, 34 pharmacists – in a healthcare system having 6,136 staff strength in different cadres. What a passionate, brilliant and a caring leader!

    The health sector has witnessed improved financing options from the government since 2008. The percentage of state budgets allocated to the health sector has witnessed a sustained increase in budgetary allocation to the health sector from nine percent in 2009, 11 % in 2010, 14% in 2011 to 14% in 2012. This upward trend is due to implementation of Consolidated Health Salary Structure (CONHESS) and Consolidated Medical Salary structure (CONMESS).

    The only School of Nursing in the state was operating in a local government council secretariat for almost 19 years, but because of Lamido’s prudence, and the value he placed on the health sector, built a new brand one in Birnin-Kudu which is one of the best in the country. Lamido built General and Cottage Hospitals, Primary Health Centres, Dispensaries and Health Posts, Basic Health Centres, Psychiatric Hospital, Tuberculosis and Leprosy etc. He also renovated and expanded the Rasheed Shekoni Specialist Hospital and School of Health Technology Jahun among others. At the time of handing over in May last year, Lamido’s administration left behind a total of 676 functional health facilities (Hospitals) in the state.  And there were provision of high quality free and affordable drugs in all the hospitals (medical buildings) in the state.

    The Haihuwa Lafiya programme introduced in 2008 ensured that there was 5.5 million hospital attendance in 2014, against 1.2 million in 2008; 3.3 million children seen, against 0.5 million in 2008; 35 percent pregnant women delivering in Jigawa hospitals, against only seven percent in 2007. By May last year, the rate of women attending ante-natal rose to the all-time high of 89 percent.

    Apparently, the assertion about the so-called neglect of the health sector started since the advent of the present administration in the state, especially with the retrenchment of all health casual workers in the state, stoppage of allocation to all Jigawa health institution (including free drugs to the masses) and Haifuwa Lafiya scheme, the present plan to reduce the health workers salary and other entitlements (welfare), and also the outbreak of cholera in Hara and Kafijiba villages of Dutse LGA of the state recently. As the record reads, about 40 people, most of them children, are reported to have died as a result of the outbreak of a disease suspected to be cholera. Also, the outbreak was linked to lack of good drinking water because their well in the village which served as the source of drinking water is not functioning now and there was a suspicion whether the disease was a result of contamination of drinking water.

    Today, one cannot write complete history of Primary Health Care under one roof without recourse to newly structured health system in the state which has enviably provided impetus to the general re-structuring of the health system across the nation. In fact, during Sule Lamido administration, several states visited Jigawa to study the health system or some components of the system towards adopting or adapting according to their individual peculiarities. Among the states that visited Jigawa are Bauchi, Enugu, NasarawaYobe, Bayelsa, Zamfara and Kano.

    What Sule Lamido did to Jigawa and humanity in general is a true sign of good leadership and no question about the obvious. The entire populace are convinced that the political gladiators in the state, region if not in the country cannot produce a match to Lamido in terms of political participation, his ideologies, credentials, principles and achievements.

    Jigawa before Lamido was at the peak of political, social and economic degeneration but within a short time, Lamido restored a new social order for the people. Because of the facilities provided by Sule Lamido, the socio-economic landscape of the state has changed for good. Jigawa has not only improved positively, it that can compete with many states in the country most especially in the health sector. Governor Badaru is advised to take counsel from former U.S President, Harry S. Truman (1884-1972) who said –  “Do your duty, and history will do you justice”.

    • Adamu wrote in from Kafin-Hausa, Jigawa State
  • Free health care for residents

    Free health care for residents

    The lawmaker representing Apapa Constituency 1 in the Lagos State House of Assembly, Hon Mojisola Lasbat Lawal, has organised a five-day free dental care for residents of her constituency.

    The programme, which began at Oluwole Health Post, Apapa and ended at Ojora Palace, was organised in conjunction with MOCARE Initiatives. It was aimed at fulfilling the electoral promises made by the All Progressives Congress (APC) chieftain. The focus was on dental consultation, medication, screening and treatment.

    Speaking at the event, Hon Lawal said the gesture was to enable residents enjoy dividends of democracy.

    According to her, their primary assignment as members of the House of Assembly may be lawmaking, but that would not hinder her from fulfilling promises made to the people.

    The lawmaker said dental care was chosen among other health challenges because only few people pay attention to the issue.

    She, therefore,  urged residents to ensure that all parts of the body are well taken care of, saying no one is expected to wait until he/she is affected with diseases on any part of the body before going for medical treatment.

    Hon Lawal pledged to organise eye, hypertension and diabetics screening after the exercise.

    The Head of the Dental Consultancy team, Dr Oladipo Bamgbose, thanked Hon Lawal for organising such an event, saying it would enable the people to know their dental status.

    He said it was very sad as the government doesn’t pay much attention to dental or oral health.

    He thanked the Lagos State Government for the awareness, even as he urged that more of such programmes be organised for the benefit of the people

    Dr. Bamgbose urged the people to ensure that they visit a dentist at least twice a year for oral examination, saying  mouth is the gate way to the body and whatever we take through the mouth goes down through the body and gives nutrient to other parts of the body.

    According to Bamgbose, some of the drugs people take are placed under the tongue for effective use. So, for good health, oral health is very important.

    Sharing his experience during the exercise, Bamgbose said: “I advise that we should brush our teeth twice daily, in the morning immediately we wake up and at night when we are about to go to bed. Secondly, we should endeavour to visit the doctor regularly for medical checkups.

  • Traditional medicine has reduced cost of health services, says expert

    Traditional medicine has reduced cost of health services, says expert

    •Group’s leaders sworn in

    The cost of health services has been reduced, with the approval granted traditional medicine practitioners almost 10 years ago, an expert, Dr Idowu Ogunkoya has said.

    Speaking at the inauguration of the National Association of Nigerian Traditional Medicine Practitioners (NANTMP) in Lagos, Ogunkoya said traditional medicine’s importance could not be over-emphasised.

    Ogunkoya, who chaired the group’s electoral committee, described it as a non-partisan body.

    He said: “It is not owned by any ethnic group or group of individuals. Members of the executive  will hold office for a tenure of four years only and relinquish their office to another democratically elected executive. A Board of Trustees is appointed to hold office for one single term of five years and a new board is appointed as NANTMP constitution requires.”

    Ogunkoya said:“The importance of Traditional Medicine in Nigeria cannot be overemphasised. It is a holistic health providing sector,  creating jobs, supporting agriculture and its derivatives in its own capacity; traditional medicine reduces cost of health provision and related services in a country that recognises and legalises it, such as Nigeria.

    Mr Andrew Akarachi Anyanwu emerged  national president with 42 votes, against Usman Ibrahim, Sunday Gbakanlado and Dada Nakowa scored zero vote, Ibrahim Jawa eight votes, Muhammed Salih Damansani 16 votes, and Baba Ejiga, 38 votes. Shaba Mekudi Sani is the deputy president; vice-president 1 (South-west) Samuel O. Banjo, vice president 2, (South east) Cyril Okwudili Umezele, vice-president 3 (South-south) Igene Mutairu, vice president 4 (North-west) Halihu Ashiru Maikada, vice president 5 (North-central) Muhammed Baba Beji.

    Prof Dayo Oyebanjo Oyekole as secretary general, assistant secretary Adeagbo Kamorudeen Kunle, treasurer, Franca Nkem Mordi,  assistant secretary,  Hakeem Atanda and Ikechukwu John,  public relations officer (PRO).

    The election was held last December 15 at the National Centre for Women Development, Abuja. Three delegates were chosen from each state of the federation including Federal capital territory (FCT).  108 delegates were accredited. Candidates were allowed to campaign and defend their manifesto for two minutes. The voting started at 1pm. Unopposed candidates took the floor to tell the delegates about their qualities and how they will move the association forward. They said  being unopposed candidate showed that they would deliver.

    John Okeke polled 30 votes. Regina Ikenwilo, 34 votes and Cyril Okwudili, 38 votes to emerged Vice President Southeast. Vice President, North West- Saad Isa Ahmed, 35 votes, Ashiru Makaida 70 votes; Secretary General- Elder Jacobs, 36 votes, Dayo Oyekole 61 votes. National Treasurer- John Bubba, 47 votes,  Franca Nkem Mordi 57 votes. Deputy President- David Akan 12 votes, Lateef Adeyeye 16 votes, Shaba Mekudi Sani 75.

    Ogunkoya said supplementary election would be conducted for Vice President, Northeast and Auditor- General.

  • Best brains in medicine, still in Nigeria – Nwaneri

    Best brains in medicine, still in Nigeria – Nwaneri

    Dr. Chukwuemeka Nwaneri is a doctoral researcher in type 2 Diabetes at the University of Chester and The Wirral University Teaching Hospital Foundation Trust, Arrowe Park Hospital, Upton, UK, under the auspices of the Gladstone Fellowship.  The   Founder of Continuing Medical Education Consult in Nigeria, shared his passion for medicine and other sundry issues in an online interview with HANNAH OJO.

     

    Can you look back and tell us what influenced the choice of a career in the medical profession?

    My choice of career was solely influenced by my grandfather in the late 1980s. I was only a child when I used to see him treat sick people with local herbs and leaves. I was a very inquisitive child and asked for explanations on how those shrubs, roots and herbs worked to stop the illness; for example, a convulsing child or toxic effects of snake venom. My grandfather was so gifted and people travelled from far and wide to consult him. My interest developed from there. However, I was very good in science subjects and mathematics.

    Let us into your Educational Background?
    Before  I join the University of Chester, I  was a Research Assistant at the University of Dublin, Trinity College Dublin; researching on the EU-FP 7 project on Global Health.  I have worked in Ireland in various clinical capacities, from Psychiatry to Emergency Medicine at various hospitals between 2004 through 2008.  I was the Community Medical Immunization Officer with the Hibernian Healthcare, Ireland for a short time in 2009. I also worked as an Honorary Senior House Officer at King’s College Hospital NHS Trust, London in the department of Medicine for the Elderly, in 2005. Prior to this, I had worked in the Nigerian Health System as Medical Officer in different disciplines of Medicine in different hospitals.
    With your experience practicing medicine in developed countries, how do you rate the Nigerian Medical line?

    Nigerian doctors remain a force to reckon with. We are products of high quality trainings from highly rated colleges of Medicine in Nigeria. We are constantly asked where we trained and told that we have good skills, knowledge, etc. This can be buttressed by the fact that many Nigerian doctors work across the globe, from Australia, UK, USA to Canada. However, there is need to changing the concept of contracts and the award of such in the refurbishing of hospitals. All we need is to translate these new skills and acquisitions to the practice at home where standards are yet to be met. This will improve the healthcare and standardise care.

    Most of the best brains in medical line practice abroad. What is your take on this?

    This is not entirely true at all! Unsurprisingly, most of the best brains are in Nigeria. Our teachers are the best brains; our colleagues in Nigeria are the best brains. What you see is that many of us abroad are either people who have opportunities or those who failed to acquire training positions in Nigeria, as the training positions are very competitive. It is the enabling environment that makes the difference and supports transatlantic migration of healthcare workers.  1955 through 1975 witnessed an exodus of British doctors from the National Health Service to Canada. In 2008; droves of Canadian doctors began migrating to the United States. When the Nigerian environment becomes enabling, you will see the exodus of Nigerian doctors out of Europe and USA back to Nigeria, like the way the Israelites travel upon establishment of the State of Israel in 1948. The government has to encourage us to come home to help establish solid healthcare structure. The structure is not gigantic buildings and large offices but system structure.

    Dr NwaneriMany Nigerians prefers to seek medical treatment abroad thereby developing medical tourisms in those countries, what is the difference obtainable in medical care home and abroad?  

    Ignorance is a disease by itself. Sometimes people say it is the culture of the people that make them successful. However, culture is dynamic. The major difference is that abroad, medicine is practiced with standards, protocols and guidelines. Your services (as a doctor) can be reviewed, reproduced, critiqued and transparent. Patients are given medications or prescriptions to procure themselves from pharmacies or administered by hospital pharmacists. These medications are not fake products. Nigerians struggle with recognition of fake medications. Medications are not easily sold on the streets.

    People are accountable to what they do. Doctors are accountable to both patients and governments. Patients have rights to know what you are doing and why you are doing so. There are complaints procedures which are transparent. If Nigerian patients are empowered as such, they can contribute not only financially but to the way they are treated. Again medical practitioners abroad undergo continuing medical education and development. In addition, annual appraisal and 5 yearly revalidations are carried out for all doctors despite your position in the hospital. These approaches help improve the skills and knowledge of all doctors. You can now see the reasons why Nigerian politicians and the likes travel abroad for health care needs. Even India has become a destination area for unwell Nigerian businessmen and politicians who cannot access Europe or America. Both the private sector and government should invest greatly in health.

     

    How can government intervene in the situation?

    Government can intervene directly by investing enormous resources in health and addressing the key issues in the provision of standardised healthcare by putting evidence into practice (setting up guidelines, protocols and standards of care practice), and updating equipment with newer technologies  while also benchmarking them for performances. This will reduce the variations in the treatment of patients and improve outcomes. Indirectly, they can do the same by advocating for continuing medical education for our doctors. The health and education sector account for less than 35% of government expenditure in Nigeria. We hope to work with governments at local, state and federal levels to help contribute to education, training, research and development of our health professional and therefore, reduce excess mortality.
    What inspired you to establish the Continuing Medical Education Consult (CMEC)? What has been your experience so far?

    The love I have for Nigeria and Nigerians inspires me. The experiences acquired from other colleagues outside Europe particularly Asians in uplifting their home medical practice individually and collectively is another inspiration. I have been able to convince experts within my horizon to help impact their skills and knowledge to our colleagues back home in Nigeria. We have realised how difficult it is for government alone to provide these services. CMEC is a professional services organisation dedicated to providing high quality professional development to medical and other allied health care staff.  We strive to be one of the leading providers of credible up-to-date programmes, trainings and short courses nationwide for doctors, dental surgeons and other allied health care professionals. We provide face-to-face on-site continuing trainings in areas of electrocardiography, emergency radiology, arterial puncture and arterial blood gas analysis, emergency ultrasound level 1, basic Life Support, advanced life support, advanced Trauma Life Support, etc.  We will also run workshops on Article writing and publication of articles in Journals.  We also hope to support the efforts of our dedicated lecturers and medical practitioners in Nigeria by running Master Classes in major clinical emergency conditions with the aim of improving standards of practice.

    How affordable is the CMEC service module to the average Nigerian doctor?

    The CMEC module has a global reputation for delivery of some of the best training courses in medical education particularly ECGs, ABGs, emergency diagnostic analysis and other investigative tools in Nigeria. We hope to make it affordable as possible so that every medic can be able to procure a number of courses or trainings. As a result of the cost effectiveness, we have participants who have attended our courses more than twice since its inception.

    Many diasporians lament about the challenges of running business in Nigeria, what has been your experience in this regard?

    One of the greatest challenges is cost and attitude change especially as it relates to convincing our doctors on the need for change in the approach to treatment. In the words of Richard Hooker in 1554-1600, “change is not made without inconvenience even from worse to better”. We hope to ameliorate this by seeking the support from government and the pharmaceutical industries. This is because our staff strength incorporates both experts from the best teaching hospitals at home and our international partners. The synthesis of their wealth of experience from the foundation of the high quality teaching and training delivered by CMEC.

    Now that a new government is in power, what areas of reforms would you want to see  in the health sector?

    The most important area of reform in the health sector is in the area of emergency medicine and approach to critically ill patients. People who present in the emergency units with critical and emergency health conditions should be treated in the first 48 hours without asking for payments or with-holding treatments because of lack of payments. We also need to follow the ABCD approach and standardise assessment and treatments. For the past 15 to 20 years, healthcare has been dwindling and standards compromised because of funding politics, and lack of appropriate educational trainings. Politicians are trading off quality health care for their selfish political gains. I have communicated to the new health minister, Prof Isaac Adewole to implement the use of ECGs in all government hospitals as part of initial triage system for patients coming to emergency units with chest pain, or in fact in all those above 45 years of age.

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  • A community’s health challenge

    A community’s health challenge

    In the Federal Capital Territory (FCT), there are communities where untrained traditional birth attendants deliver women of their babies. TONY AKOWE reports that the situation results from lack of health care centres to take care of the people’s health needs

    Residents of Yimitu community in Kabusa Ward in the Abuja Municipal Area Council of the Federal Capital Territory (FCT) are still grappling with lack of health care centres where women could be delivered of their babies. As a result of this, their women are delivered of their babies at home by untrained birth attendants.

    The husbands of expectant mothers secure the services of these untrained traditional birth attendants as the last resort; because they lack health facilities. The requisite experience of these birth attendants are being grandmothers and, perhaps, having carried out the exercise for several years. A piece of cloth which they spread on the floor, a small stool which the elderly woman seats on while holding the woman in labour, hot water and a new razor blade serve as their “labour room” equipment.

    If an expectant mother dies in the process of being delivered of her baby, they believe it is an act of God.

    If the woman bleeds during or after delivery, they give her local concoctions which they believe will stop the bleeding. They boast of recording huge successes in carrying out this exercise.

    It was also discovered that many women in the community which is located close to the city centre still give birth at home with the aid of elderly women who serve as traditional birth attendants.

    However, some of them attributed the situation to lack of health care facility in the community and the long distance to the closest health care centre.

    One of the traditional birth attendants, Laraba Danjuma, told North Report that she has been assisting women to deliver their babies for several years.

    She said: “When a woman is in labour, I sit on a small stool behind her. I always have hot water standby and when the baby comes out, I will tie the placenta before cutting it. We give the woman the hot water to drink, press her stomach with it and apply it to the navel of the baby.”

    She said she delivers at least two women of their babies in a month. While admitting that many of the women in the community currently go to the hospital to give birth to their babies, she revealed that “when a woman gives birth and begins to bleed, we have one native drug which the woman will be given and once she drinks it, the bleeding will stop. No woman or child has died during delivery in my care”.

    Residents of the community are angry with successive administrations in the FCT. It is not only lack of health care facilities that residents have to contend with. Their roads are impassable. They said they had made several efforts to make successive area councils and the FCT Administration to consider their plight and help them. To access health care, especially for expectant mothers, residents of the community travel to the nearest health care centre located at Waru.

    The Village Head of Yimitu, Dauda Hassan, told North Report that they had made several appeals to the FCT Administration and authorities of the Abuja Municipal Area Council to come to their aid by establishing a clinic for them.

    He regretted that expectant mothers in the area have to make the long trip on the bumpy road to either Waru which is the closest health care centre to them and about 30 minutes drive on a motorbike or they go to Kabusa Health Centre which is about one hour drive. Some have to go to the health centre at Garki for their medical needs.

    He said: “From here, we take them to Kabusa, Waru or Garki. From here to Kabusa is about 30 minutes ride on motorbike, 15 minutes to Waru and almost one hour to Garki. We have the old women who usually assist expectant mothers to deliver them of their babies. No woman has died as a result of pregnancy in the village.

    “We appeal to the government to establish a primary health care centre for us, repair our road and build a primary school. We will be happy if the government can do these for us and make us feel that we are part of those they govern.”

    Narrating the ordeal women in the community has to pass through, Rahila Danjuma, a mother of six who had to deliver most of her children outside the community said it was unfortunate that successive administrations in the FCT left them to their fate.

    She said: “I delivered three of my children at Area 3 Hospital and in 2007; I delivered one at Kabusa General Hospital. I delivered my last baby at home at in Figbasama alone.

    “Our problems here are lack of a clinic, good road, water and school. Four of my children of school age are not going to school.”

    Happiness Sabastine is not happy that she has to pay so much to access medical services. She wished the government will come to their aid.

    She said: “I want the government to come to our aid by building a health care centre in our community. Our road is also not good. But we want the government to also help us repair the road. We will not be suffering so much if we have a clinic here.”

  • Nigeria needs N79bn for health insurance, says NHIS

    Nigeria needs N79bn for health insurance, says NHIS

    Nigeria will need at least N79 billion to provide health insurance for vulnerable Nigerian in the new year, according to the Acting Executive Secretary of Nigerian Health Insurance Scheme (NHIS), Mr Femi Akingbade.

    Akingbade said the agency is targeting at least 40 million Nigerians for the scheme in 2016 alone.

    He expressed hope that the fund needed could be generated internally rather than looking towards international donors.

    Akingbade said: “I am not so much an advocate of international donors and things like that. I believe that all the funds that are needed can actually be generated internally.

    “So, if for any reason there is a subsidy and it is earmarked for health, it will be a step in the right direction for us.

    “From the brief calculation that we have done, even been modest and saying we want to pay the capitation of about N250 per person per month, the total amount that will be needed for 2016 for capitation alone to take care of 45 million Nigerians is N67.5 billion.”

    Buttressing his claim that the N67 billion needed could be raised internally, Akingbade noted that “last year alone, private sector initiative spent in excess of N79 billion for health system.

    “But you will find that a lot of these monies come as vertical programmes. They don’t have that high impact because everybody is running their thing on their own.”

    Akingbade also hinted that the current enrollment for the scheme was not encouraging as there were only 7.9 million people currently on the scheme.

    He however blamed the current nature of health insurance in the country for the poor enrollment figure.

    “While it is not mandatory, the only class of people that it has been made mandatory for are the public servants at the federal level. And that is one of the things we are still trying to tell the states that it should be made mandatory for state government workers,” he said.

    On what the agency is doing concerning people living with HIV, Akingbade said they are only covered in the scheme at the level of screening, education and awareness.

    He however said that the scheme was starting a collaboration with NACA to actually see how it can be of help.

  • WHO’s book to improve Nigerians’ health

    WHO’s book to improve Nigerians’ health

    How can Nigerians enjoy good health in 2016? It is by adopting the World Health Organisation (WHO) template, report OYEYEMI GBENGA-MUSTAPHA and WALE ADEPOJU. 

    The World Health Organisation (WHO) is the global policeman  for health matters. It has a template for member-countries in healthcare delivery.

    According to the WHO, the right to the highest attainable standard of health  requires a set of social criteria that are  conducive to the health of all people.

    In addition, the availability of health services, safe working conditions, adequate housing and nutritious foods is non-negotiable. This is because achieving the right to health is closely related to that of other human rights- the right to food, housing, work, education, non-discrimination, access to information, and participation.

    Nigerians do not enjoy optimum healthcare. Some do not even have access to.

    To WHO,  the right to health includes both freedoms and entitlements:

    Freedoms include the right to control one’s health and body (e.g. sexual and reproductive rights) and to be free from interference (e.g. freedom from torture and from non-consensual medical treatment and experimentation).

    Entitlements include the right to a system of health protection that gives everyone an equal opportunity to enjoy the highest attainable level of health.

    Health policies and programmes have the ability to either promote or violate human rights, including the right to health, depending on the way they are designed or implemented. Taking steps to respect and protect human rights upholds the health sector’s responsibility to address everyone’s health.

    Disadvantaged populations and the right to health

    According to WHO, vulnerable and marginalised groups in societies are often less likely to enjoy the right to health. Three of the world’s most fatal communicable diseases – malaria, HIV/AIDS and tuberculosis – disproportionately affect the world’s poorest populations, placing a tremendous burden on the economies of developing countries. Conversely the burden of non-communicable disease – most often perceived as affecting high-income countries is now increasing disproportionately among lower income countries and populations.

    Within countries, some populations, such as indigenous communities are exposed to greater rates of ill-health and face significant obstacles to accessing quality and affordable healthcare. This population has substantially higher mortality and morbidity rates, due to non communicable diseases such as cancer, cardiovascular and chronic respiratory diseases, than the general public. People who are particularly vulnerable to HIV infection, including young women, men who have sex with men, and injecting drug users, are often characterised by social and economic disadvantage and discrimination. These vulnerable populations may be the subject of laws and policies that further compound this marginalisation and make it harder to access prevention and care services. Nigeria can do well by looking into this.

    Violations of human rights

     in the health sphere

    Violations or lack of attention to human rights can have serious health consequences. Overt or implicit discrimination in the delivery of health services violates fundamental human rights.Many people with mental disorders are kept in mental institutions against their will, despite having the capacity to make decisions regarding their future. On the other hand, when there are shortages of hospital beds, it is often members of this population that are discharged prematurely, which can lead to high readmission rates and sometimes even death, and also constitutes a violation of their right to receive treatment.

    Similarly, women are frequently denied access to sexual and reproductive healthcare and services in developing and developed countries. This is a human rights violation that is deeply engrained in societal values about women’s sexuality. In addition to denial of care, women in certain societies are sometimes forced into procedures, such as sterilisation, abortions or virginity examinations.

    Human rights-based approaches

    A human rights-based approach to health provides strategies and solutions to address and rectify inequalities, discriminatory practices and unjust power relations, which are often at the heart of inequitable health outcomes.

    The goal of a human rights-based approach is that all health policies, strategies and programmes are designed with the objective of progressively improving the enjoyment of all people to the right to health. Interventions to reach this objective adhere to rigorous principles and standards, including:

    Non-discrimination: The principle of non-discrimination seeks to guarantee that human rights are exercised without discrimination of any kind based on race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status such as disability, age, marital and family status, sexual orientation and gender identity, health status, place of residence, economic and social situation’.

    Availability: A sufficient quantity of functioning public health and healthcare facilities, goods and services, as well as programmes.

    Accessibility: Health facilities, goods and services accessible to everyone. Accessibility has four overlapping dimensions: Non-discrimination; physical accessibility; economical accessibility (affordability); and information accessibility.

    Acceptability: All health facilities, goods and services must be respectful of medical ethics and culturally appropriate as well as sensitive to gender and life-cycle requirements.

    Quality: Health facilities, goods and services must be scientifically and medically appropriate and of good quality.

    Accountability: States and other duty-bearers are answerable for the observance of human rights.

    Universality: Human rights are universal and inalienable. All people everywhere in the world are entitled to them.

    Policies and programmes must be designed to be responsive to the needs of the population as a result of established accountability. A human rights based-approach identifies relationships in order to empower people to claim their rights and encourage policy makers and service providers to meet their obligations in creating more responsive health systems.

    Federal and state ministries of health expected response

    WHO has made a commitment to mainstream human rights into healthcare programmes and policies on both national and regional levels, by looking at underlying determinants of health as part of a comprehensive approach to health and human rights. In addition, WHO has been actively strengthening its role in providing technical, intellectual and political leadership on the right to health including the following, which Federal and state ministries of health can adapt:

    • Strengthening the capacity of WHO and its Member-states to integrate a human rights-based approach to health;
    • Advancing the right to health in international law and international development processes; and
    • Advocating health-related human rights, including the right to health.

  • Firm committed to oral health

    Oral-B, a brand of Procter & Gamble, has restated its commitment to Nigerians’ oral health need.

    Its Brand Manager in Sub-Saharan Africa, Aliza Leferink, said the company’s mission is to make Nigerians  have stronger and healthier teeth.

    He spoke at last year’s National Oral Health Week in Lagos.

    Leferink said: “Healthy teeth and gums are fundamental to overall health and well-being. We want Nigerians to have stronger teeth, which comes from forming a great daily care habit, consistency and the right toothpaste use.”

    He continued: ”Maintaining healthy teeth can be achieved by following a number of simple principles, and Oral-B wants to help consumers on their way to better oral-care-routines.”

    Leferink advised people to brush twice daily and floss regularly, stressing that most people find it difficult to brush at night. “But this is one of the most effective ways of preventing germs, gum disease and tooth decay in the long term. Brushing at least twice daily will help to prevent acid build up from the breakdown of food by bacteria,” he added.

  • Averting crisis in health sector in 2016

    In his all-time classic, ‘The Art of war’, Sun Tzu narrated how a lord of ancient China once asked his physician, a member of a family healers, which of them was the most skilled in the art.

    The physician, whose reputation was such that his name became synonymous with medical science in China, replied, ‘My eldest brother sees the spirit of sickness and removes it before it takes shape. He cures sickness when it is still extremely minute. As for me, I puncture veins, prescribe potions, and massage skin when sickness has already settled in, and so, from time my name gets out and is heard among the lords. And so, by this, my eldest brother is the best.

    This ancient story is the premiere classic of the science of strategy in conflict as it teaches that the peak efficiency of knowledge and strategy is to make conflict altogether unnecessary. It shows that understanding a conflict as well as taking a rational, rather than an emotional approach to the problem of conflict can lead not only to its resolution, but even to its avoidance altogether. Pride, anger and greed are the fundamental causes of disharmony. Weapons of war are inauspicious instruments, not the tools of the enlightened. Winning without having to fight is the noblest.

    Everyone believes that there is an ‘incurable’ disease afflicting our health sector. It was earlier thought of as a teething problem. After it persisted for a while, we altered our perception of it as a perennial problem and right now, it has assumed the status of a terminal, and incurable disease. But we made it so!

    The pundits have said that in a year, an average Nigerian doctor in the public health sector spends six months working and the other six on strike, defying the Hippocratic oath (that some have re-christened Hypocrites’ oath) to which they swore an unconditional allegiance.

    Their colleagues and partner in the same art (pharmacists, nurses and other health workers) are not any better, following the same vicious pattern. At some point, they turned industrial action into a relay race, passing the baton of strike over to each other as they play games with human lives, which they all swore at induction into their various professions to protect first, no matter what (except at the cost of their personal safety). Hence, they forget their humanitarian calling!

    Some years ago, I was practicing as a pharmacist in University Teaching Hospital, Ado Ekiti when something gory happened. Health professionals were on strike as usual, in a bid to press home demands from the state government when a sick woman, (probably pregnant too) was rushed to the hospital. On getting to the gate, they were first told that a strike action was on-going. Even though we claimed to continue to render emergency care services, the news of the strike killed the little life left in that woman, so she died at the gate! How many more such cases have happened, how many more of our fellow country men and women we have condemned to untimely death all in a bid to gratify our lusts and massage our ego or just to ‘make a statement’ to the government?

    Cataloguing the unfortunate incidents of the past or sorrowing in it will be like an east wind that blows no man any good. It is time to sit up and fix it. I belief this is very possible. How do I know? Yes, some pessimists or stoics had once thought Nigeria’s case (the polity) is beyond redemption; that the politics of ‘anywhere belle face’ will continue to have it, till kingdom come, until the 2015 general elections that proved them all wrong.

    Successive governments have tried without success to heal the public health sector. They failed because they were only using Dane gun to hunt mother elephant or attempting to cure metastatic cancer with Chinese balm! They came up with cosmetic solutions which only lasted as long as cosmetics do. They tried to change the fruits without first working on the roots. Little wonder those quick fix solutions never worked, or seemed to work for a while before another bigger problem erupted.

    To overcome a challenge, we must first of all understand it. We must go back in time to the era of no challenge, see where the challenge came in and how. Why other nations don’t have the same challenges as we do and see how to apply (domesticate) their methods to our situation. Some may criticize this as a neo-colonialism, but we shouldn’t give a dog a bad name because we want to hang it. Such should recall that the books we used in both secondary and tertiary schools were also written by them and we use the principles set forth in those books in practice and get good results. These are not matters of morality, which we can derive from Holy Scriptures. They are evidence-based, scientifically proved principles and we must apply them to our own situation in management to achieve any success.

    Now, they say a fool is he that does the same thing and expects a different result. You cannot clean a plate with dirty hand. Unfortunately in Nigeria, we appoint people to positions as policy makers, permanent secretaries, ministers, etc without an in depth drilling and grilling. Appointments are usually based on good political standing and networks of influence and individual has; and we think we’re going somewhere? Never. It will take some miracle of sort for that to happen.

    In all policy making positions, and more so in multi-disciplinary positions like in health industry, a thorough evaluation of individual’s antecedents is needed before giving them sensitive and decisive responsibilities. Their history from primary school, secondary level and tertiary institution; their professional history, relationship with other colleagues in allied disciplines over their career span, antecedents in leadership at all levels interdisciplinary conviviality personal and professional philosophies must be looked at very closely.

    As long as we continue to appoint individuals with adversarial philosophies as policy makers in health ministry, and not those with ‘esprit de corps’, we can only brace up for more crises in the sector; as they will only fan the embers of discord and compound the sectoral woes. They will continue to hold secret meetings with a particular group of health professionals and instigate them against others and even the government! And we said we are going forward? Never! It does not work out that way.

    I partially agree with the philosophy that you don’t appoint a Nigerian referee as umpire in a game that involves Nigeria and another country because, as long as blood runs in his veins, he will be prejudiced towards his fatherland. So, in this wisdom, a neutral umpire is usually appointed. But while the administration of health ministry is not a game, so to say, as that will give it an adversarial outlook, individuals to serve in policy making positions MUST be able to act rationally rather than emotionally on issues. They must detach themselves emotionally from their primary constituencies (their own personal professional fields), and act for the general good of all and in the best interest of the nation. It is only an irrational mind that will oppose a rational stance (not decisions or actions motivated by personal and emotional prejudice) and such a one need not be taken seriously.

    This kind of mind-set and approach will help avert crises in health sector altogether.

    In his address to Americans at the height of great economic depression of 1983, Ronald Reagan came out bold as he declared that the government could not address the economic problem on ground because the government itself was the problem! Did you get it?

    So, when lay people comment ignorantly, like Senator Godswill Akpabio recently did on shortage of residency positions for doctors, I just laughed at the height of his ignorance on such issues. He did not ask the policy makers whether they follow the terms on length of Residency Training first. The six-year term spelt out in the rule of engagement for the programme is flagrantly flouted as some people have been residents for over 10 years and still counting! Tell me then where and how new doctors will come in when the old students refuse to graduate and the institutions do nothing?

    When we begin to do things right, then we begin to get it right and the earlier we begin, the better, for harmony and prosperity for all.

    • Pharm. Olalekan writes from Airport Road, Abuja

  • Lagos may make health insurance compulsory

    Lagosians may be forced to  take the health insurance policy in the new year.

    Commissioner for Health Dr. Jide Idris gave the indication during his maiden briefing on the activities of the Ministry in the outgoing year and its plan for next year.

    He said: ‘The state government is considering making health insurance mandatory for residents by the second quarter of the new year. We intend to target specific diseases and emergencies.’’

    Idris said health facilities across the state are overstretched by patients who come from within and outside  the state. ‘’So, we are considering running double schedules in a day,” he said.

    “We can assure that all health projects started by the past government in Lagos would be completed by the new government and upgrade others to meet the demand of the growing population.”

    The focus would be the Primary healthcare and the completion of Ayinke House – the Gynaecological/Obstetrics Department of the Lagos University Teaching Hospital (LASUTH).

    “The contract of Ayinke House has been terminated and awarded to a new contactor, who has assured of completion in another nine months. TB/HIV and other communicable diseases will be aggressively adressed through campaigns and public awareness,” he added.

    He listed challenges facing the ministry to include, “influx of patients from other states, finance, inadequate workforce, old structure, equipment breakdown, attitude of some bad eggs among others. All these are being addressed to ensure lagosians get the best healthcare delivery without wasting their time.”