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Tag: Healthcare

  • Consumer Protection: Healthcare as a Case Study (3)

    Note: The excerpts culled from the book: “Personal Injury & Clinical Negligence: Consumer Rights & Provider’s Responsibilities” which will be published in this column in the coming weeks was granted with the kind permission of the publisher, Strategic Insight Publishing.  The author of the book is Dr. Joel Akande. The book being sold in Nigeria for N2500, went on sale worldwide on 4 September 2018.

    • Continue from last week…

    Clinical Negligence

    Anyone who had ever attended a hospital, clinic or any health giver Centre in Nigeria will have something to say for good for all. There is no such thing as neutral. Such saying may be in the filth (or otherwise) of the environment where the care is being given or it may be in the personal character, attitudes and conducts of the healthcare professionals:  be it in personal presentation or the conducts of the said professional. Comments may also concern the overcrowding and the clinical delay that the healthcare consumers experience. On the other hand, consumers of healthcare service in Nigeria are often concerned about the undignified manner by which they, the patients, had been handled during their most vulnerable periods induced by illness in their person or illness in the member of their family.

    Still, concerns may be raised as a result of faulty treatment, poor communication between patients and their carer or between the professionals: all leading to worsening of the illness or leading to even death. Very often, receivers or consumers of healthcare service do not know where to turn to for redress nor being aware of their rights under the law. Of major concern to patients in Nigeria especially our elites and executives is the confidentiality and safety of the information that have been kept in the hands of their doctors, pharmacists, physiotherapists, nutritionists and nurses.

    In sum, Nigerians and patients in Nigeria are apprehensive about the quality of healthcare in the country. Notwithstanding the state of the Naira, the national currency, Nigerians spend over a billion dollars each year in medical tourism (seeking treatment overseas) according to various estimates. Yet, there are competent Nigerians at home (and in the diaspora) to handle the most complex of medical issues.

    Of all these, it would appear that Nigerians, are aware of human limitations, being so deeply a religious people. The most concerning seems to be the different shades of attitude such as lack of empathy and poor communication of clinicians that attend to their needs. Nigerians are not different. They want, in spite of poor financial credit system and poor infrastructure, the best quality of health. Like any other human beings when Nigerians perceive a quality, they appreciate it.

    On the other side of the coin, the blames for poor quality of healthcare cannot be blamed entirely on the clinicians. The healthcare consumers who prefer to spend large US dollars overseas would attempt to obtain healthcare in Nigeria for a fraction of the overseas’ cost of the same care. Further, national infrastructure such as energy supply, speedy dispensation of equitable justice, transport, rigorous and fair regulation of professionals are at best weak. Doctors in Nigeria operate within such weak infrastructure. Few, if any medical devices and clinical equipment are made in Nigeria. Most, if not all required medical equipment are imported at high scarce foreign currency exchange values.

    Only the politically and financially powerful, well connected and mighty could afford to provide such clinical equipment. Even if most clinicians desire to provide the best medicare, they often fail to achieve their aims.

    Doctors aspire to high standards but are let down and frustrated by manifold factors of lack of previously mentioned infrastructure, corruption and lack of national coordination.

    As at the time of writing, there does not exist a national database of all healthcare users in Nigeria that could be accessed for the care of patients, by qualified clinicians at any point anywhere within the frontiers of Nigeria.  The entire system is fragmented and chaotic.

    What is contained in this book is meant to inform the public, including clinical professionals (doctors, nurses, physiotherapists and everyone that receives and or gives care to another). It is not intended as a persecutory tool of any sort. In short, a receiver of healthcare has a legal right, as we shall see below, to be treated rightly and with dignity.

    Similarly, clinical professionals (doctors and allied professionals) are entitled to a good quality way of life and deserve to practice their professions in a safe and secure environment.

    Wherever there is a conflict between the interest of the healthcare consumer and the provider of such service, a neutral, competent legal authority should dispense a fair justice immediately. It is only in so doing and where there are checks and balances that the glory of Nigeria’s healthcare will dawn.

     

    • Continue next week…

     

  • Consumer Protection: Healthcare as a Case Study: 2

    Note: The excerpts culled from the book: “Personal Injury & Clinical Negligence: Consumer Rights & Provider’s Responsibilities” which will be published in this column in the coming weeks was granted with the kind permission of the publisher, Strategic Insight Publishing.  The author of the book is Dr. Joel Akande. The book being sold in Nigeria for N2500, went on sale worldwide on 4 September 2018.

     

    Continue from last week…

    Personal Injury

    Those injuries be they physical, mental or injury that you, the reader, for example sustain that are not due to your own fault but due to the fault of others, are called personal injuries. Personal injury is a legal term for an injury to the body, mind or emotions, as opposed to an injury to physical property such as your car or house.

    Personal injury term is most frequently used to denote a type of tort (offence) in which the person suing (the injured person or victim or his relation), or “plaintiff,” has suffered harm to his or her body or mind. Personal injury lawsuits are filed against the party or entity that caused the harm through the act of negligence, gross negligence, reckless conduct or behavior, or intentional misconduct. Different legal jurisdictions describe the damages (or, the things for which the injured person may be compensated) in different ways, but damages typically include the injured person’s medical bills, pain and suffering, and diminished quality of life.  Very often, the compensation or restitution is financial or economic.

    Justice requires evidence. The legal system needs evidence to arrive at the cause and effect and hence to give you fairness of judgement.

    Between you, your injury and equity stands the medical doctor and allied clinicians who will examine your injuries, causes and possible cost to repair the injury if possible.

     

    Areas where personal injuries are applicable:

    Areas where personal injury claims are commonly made include road traffic accidents in which the accident causing the injury is the fault of another, work place accidents, tripping accidents at work whereby a member of the public or worker gets injured as a result of the negligence of the contractor.. Assault claims such as rape can both lead to personal injury claims and criminal prosecutions. Defective product leading to harm of the consumer or causing accidents (product liability) can lead to personal injury claims. The term personal injury also incorporates medical and dental accidents (which lead to medical negligence claims). Cases classified as industrial disease cases such as asbestosis, chest diseases (e.g., emphysema, bronchitis, asthma, chronic obstructive pulmonary disease, and chronic obstructive airways disease), vibration white finger, occupational deafness, occupational stress, contact dermatitis, and repetitive strain injury cases are all forms of personal injuries.

    Though specific data are lacking, looking at the cause of death, coroner and personal injury cases in Nigeria, accidents, product liability and automobile collisions, will probably be amongst the highest causes of injuries. Personal injury cases may also include toxic torts, in which a contaminant transmitted by air or water causes illness, injury, or death. Death of a relative can also lead to claim of personal injury by those concerned who suffered the loss (say spouses, parents, children and close relatives). Such an event of death may also be a cause of criminal prosecution in which case a coroner and or forensic examination would take place.

     

    The benefits

    The pursuit of personal injury claims is not a child’s play. It may be tortuous and painful. It may take a long time to arrive at a resolution and requires expensive investigations. In general, the society is better off as the parties that are involved will take caution not to cause similar injuries in the future. Suffice it to say that government at various levels and big corporations are not immune to personal injury claims.

     

    Forensic medicine and personal injuries:

    Forensic medical practitioners including coroners are specialty workers that determine the cause, nature and extent of injuries to a person. As I stated earlier, these professionals work along lawyers in resolving death and injury issues so that justice can be obtained for the victims. When the injuries does not involve death, clinical physicians will work with or without lawyers to resolve the matter.

     

  • Consumer Protection: Healthcare as a Case Study: 1

    n the next couple of weeks, we will deal with consumer protection issues. In so doing, we will use healthcare industry as our example to illustrate key issues concerning consumers of products and services.
    Note: The excerpts culled from the book: “Personal Injury & Clinical Negligence: Consumer Rights & Provider’s Responsibilities” which will be published in this column in the coming weeks was granted with the kind permission of the publisher, Strategic Insight Publishing. The author of the book is Dr. Joel Akande. The book being sold in Nigeria for N2500, went on sale worldwide on 4 September 2018.

    Introduction.
    Fundamentally, this book is about the rights of the consumers of products and services in Nigeria. The right to have the opportunity to consume products and services that are safe and free of harms. This right which is enshrined in law in Nigeria as in many other countries includes a situation which, when harm does occur, the right of the consumer to expect apologies and appropriate restitution when applicable. The legal right of the consumer extends the responsibility of the provider of the good or service to ensure that the consumer is not injured. It’s immaterial where such products and services are originating from in so far as the provider of a good or service has as we shall see later on, a duty to care (formally called duty of care) for the consumer of such products and services. The product or service may be from individual medical doctors, lawyers, accountants or teachers and or from the owners of such enterprises. Such products or services provider, (so long as the provider holds the responsibility of duty of care, may be an agency of the government at any level: be it Federal, State or Local Government. In the end, injuries that are caused will lead to involvement of medical doctors who will care for the injured and treat the injury that is sustained by faulty products and services provided by someone else. Thus, although this book aims at helping the consumer to understand his rights as a consumer, it pinpoints the need for the provider of goods and services to appreciate the imperative of avoiding consequences that involve injury to the consumer, resulting from the use of the product or service. By implication, this book promotes the wellbeing, primarily of the consumer of products and services, and the overall welfare of Nigeria and Nigerians:
    This book has introduced two seemly reinforcing perspectives to the fundamental issues that form the central points of this book, which are personal injury and clinical negligence. These are the legal and the medical perspectives to personal injury and clinical negligence. These separate but related areas of professional endeavour will be discussed separately with the aim that both will be referred to as we go along. Towards the end of the book, they will be combined to form a whole. For emphasis and with the clear intention not to be misread, once again, the principles and practice that are discussed in this book are applicable to all areas of human endeavour where one person holds the responsibility or duty of care for another: be it government at any level, agencies of government, private citizens, registered or unregistered businesses, manufacturers, professionals such as lawyers, physicians, dentists, accountants, mechanical engineers, civil engineers, farmers, parents and so forth. And where such duty is breached and an injury results from the consumption of the product or use of the service, a form or forms of restitution may be demanded or provided without any demand.
    In the clinical negligence that is discussed in this book, clinical issues pertaining to healthcare professionals have been used as a case study on one hand, to illustrate the various principles discussed in the book and in particular, the doctrine of duty of care, and on the other hand, as a matter of convenience. The principles of duty of care, standard of care, resulting injuries and the need for restitutions are all applicable across different sectors though the applicable laws are different to make the said law suitable to the specific industrial sector. That is, the duty of care is the same in civil construction as it is in healthcare sector. The standard of care in accounting is similar to that of military officers though the measure of such standard are different for variety of reasons. Let us now take a look at each of personal injury and clinical negligence in turn. Continue next week…

  • Kano to provide good healthcare

    Kano State Governor Abdullahi Ganduje has reiterated his government’s commitment to provide quality, available and affordable healthcare for the people.

    Ganduje spoke at the opening of the DFID/EU Solar project at Gwagwarwa Primary Health Centre in Nassarawa Local Government Area, and the inauguration of 83 TED microscopes, donated to the government by National Tuberculosis Programme/Global Fund.

    He said: “One of the cardinal principles of this administration is to improve the people’s health because we believe that a healthy society is a wealthy and productive one.”

    Ganduje maintained that through community mobilisation and evidence-based interventions, such as recruitment of health personnel, community midwifery program, training, upgrade and renovation of health facilities, as well as sustainable health financing, a revolution has begun in the health sector.

    He added: “Projects, such as the solar power in health facilities, and other EU interventions in education, will standardise health services and consolidate what our government is doing to expand access to education.”

    The governor lauded development partners like the EU for supporting the government in its quest to ensure the people have unhindered access to quality health care irrespective of their socio-economic status. He hoped the trend would be maintained.

    The EU representative, Nadia Kanada, said the project would help the government channel money spent on diesel for health centres to other positive endeavours.

    DFID’s Head of Mission for Nigeria, Debbie Palmer, hoped that EU interventions would change social services in Kano, stressing that “the EU/Kano state government partnership would be transformative for the people”.

  • Elumelu seeks passage of healthcare bill

    Chairman of Heirs Holdings Tony Elumelu has called for urgent passage of the healthcare bill into law to alleviate the health challenges in the country.

    Speaking during the inauguration of the Avon Dialysis Centre in Lagos yesterday, the Heirs Holdings boss said with a proper health insurance scheme, more people would easily access healthcare.

    He argued that passing the bill into law would give affordable healthcare to Nigerians, promote tourism and increase the enormous potentials in the sector.

    Elumelu lamented that less than five per cent of the population had signed up to the National Health Insurance Scheme (NHIS)

    He added: “We need the legislature to pass the bill, and that will change the health sector.

    “As more people cannot pay for medical services, hospitals cannot invest more.”

    The chief executive officer of Avon Medical Services Limited, Dr. Awele Elumelu, said Avon Dialysis Centre was a response to the increased rate of diabetes, as reports show Nigeria as having the highest number of diabetic patients in Sub-Saharan Africa.

     

     

     

  • Cement, healthcare companies to raise N240b new capital

    THE country’s largest cement and healthcare manufacturing companies are planning to raise N240 billion new capital to grow their businesses.

    The two largest cement companies – Dangote Cement Plc and Lafarge Africa Plc – and two leading healthcare companies – Fidson Healthcare Plc and May & Baker Nigeria Plc – have launched the new capital raisers. They are expected to conclude the supplementary issue by the fourth quarter of the year.

    Dangote Cement, Nigeria’s most capitalised quoted company and Africa’s largest cement producer, is raising N150 billion in debt capital.

    The company has concluded the first tranche of the N150billion, raising N50 billion in new debt capital.Dangote Cement issued commercial papers of 180 days and 270 days’tenors with effective yields of 13.21 per cent and 13.96 per cent.

    According to the company, the net proceeds from the deal would be used to finance capital expenditure, working capital and  corporate purposes.

    Lafarge Africa Board has also approved a right issue of up to N82 billion to reduce the company’s leverage as well as strengthen its profitability.

    Earlier, Lafarge Africa shareholders approved a resolution authorising the company to raise more capital of up to N100 billion as the cement group continues to optimise its balance sheet.

    Lafarge Cement shareholders mandated the  Board to raise more capital through an offer of debt or equity or a combination of the two  from local or international capital market. Last year, the cement company raised N131.6 billion from a rights issue, which was oversubscribed.

    Fidson Healthcare is raising N4.5 billion new capital from new ordinary shares to its shareholders.

    The Nigerian Stock Exchange (NSE) has approved the rights issue, paving the way for the company to open application list for the offer.

    Fidson Healthcare will issue 900 million ordinary shares of 50 kobo each to shareholders at N5 per share. The rights issue will be pre-allotted on the basis of three new ordinary shares for every five ordinary shares held as at the close of business on July 5.

    Shareholders of Fidson Healthcare last year approved a plan to raise N6 billion to boost its working capital and support its expansion. Shareholders had authorised the board of directors of Fidson Healthcare to “raise further capital of up to N6 billion through an offer whether by way of public offering, rights issue, private and special placement of shares”.

    Shareholders also authorised the directors to absorb oversubscription and to convert existing loans due to any person from the company towards payment for any rights or shares subscribed for. Shareholders increased the authorised share capital from N1.2 billion to N1.5 billion by the creating more 600 million shares of 50 kobo each.

    Fidson Healthcare Plc Chairman, Mr. Felix Ohiwerei, said the new capital would be used to boost working capital that had been negatively impacted by the depreciation of Naira.

    He noted that the company’s new factory had come on stream and that it needed more capital to realise the full potential and utilise the new factory to full capacity.

    Sources confirmed to The Nation  that May & Baker Nigeria has advanced discussions on its much-awaited rights issue.

    Its shareholders earlier this year voted to increase the company’s share capital from N1.9 billion of 3.8 billion ordinary shares of 50 kobo each to N3 billion of six billion ordinary shares of 50 kobo each. It has a subsisting shareholders’ approval to raise N3.2 billion.

    Earlier this year, May & Baker Nigeria Chairman Lt.-Gen. Theophilus Danjuma (rtd), told shareholders that company’s directors believe that the time was right to raise the funds to enable the company harness new opportunities.

    “Therefore, our rights issue will soon open and I hope shareholders will take up their rights to support our company in achieving its new vision. We shall all reap the rewards in the immediate future and beyond,” Danjuma said.

  • Way forward for the health sector

    Sir: It is the duty of the government to make healthcare services available and affordable to those who truly need them. Denying citizens healthcare services to the point of abrogation is as good as denying them their right to life. Nigeria’s statistics for maternal mortality ratio, infant mortality ratio and life expectancy are very scary. The pattern of financing healthcare in Nigeria will determine if and when Nigeria will attain universal health coverage.

    The annual appropriation to the Federal Ministry of Health in the 2014, 2015, 2016 and 2017 budgets amounts to 5.63%, 5.78%, 4.13% and 4.17% respectively of the overall budgets. The total allocation of ¦ 356,450,966,085 to the Federal Ministry of Health in the 2018 budget is commendable but can also be improved upon. If the Abuja Declaration benchmark of 15% cannot be met because of other competing needs, the federal government should allocate about 7.5% of its annual budget representing half of the Abuja Declaration benchmark to its commitment towards meeting acceptable health standards. Upon attaining 7.5% budgetary allocation to healthcare, it can then progressively increase the budgeted amount up until a time when we will be able to meet the benchmark of the 2001 Abuja Declaration. Beyond increasing the budgetary allocation to healthcare, there is need to also ensure that the bulk of the allocation goes to capital expenditure. In the 2018 budget of the Federal Ministry of Health, 24.26% of the allocation went to capital expenditure while 75.74% of the allocation went to recurrent expenditure. This has also been the trend in previous years.

    Going forward, it will be in the best interest of the nation to increase the percentage allocation to capital expenditure.

    In order to make more money available for the health sector, the National Health Insurance Scheme Act should be amended to make health insurance compulsory and universal. New funding sources like a minimal surcharge on imports, a special sin tax on alcohol and tobacco, and minimal tariff on telecommunication services could be explored to fund healthcare services. The Federal Government should also consider the establishment of a Health Bank of Nigeria. The Health Bank of Nigeria will provide long term loans at single digit interest rates to healthcare infrastructure, human resources and healthcare institutions. Regional and international development partners should be encouraged to support the mandate of the Health Bank of Nigeria. The Central Bank of Nigeria should provide long term bailout funds for the health sector.

    In line with the provisions of the 2014 National Health Act, the recent decision of the federal government to allocate one percent of the consolidated revenue fund amounting to ¦ 55.150 billion to basic healthcare provision fund is commendable. However, all hands must be on deck to ensure that the appropriated ¦ 55.150 billion is fully released, cash-backed and judiciously utilized. Going forward, the dedicated amount of the consolidated revenue fund for basic healthcare should be domiciled in the statutory transfers of the annual budget rather than the service wide votes of the annual budget where it is currently domiciled in the 2018 budget.

    All ongoing efforts towards local vaccine production and sustainable immunization financing should be strengthened. Bi-annual funding for the procurement of vaccines should be encouraged in order to reduce delays due to procurement bottlenecks, partial releases, cash-backing and utilization of funds. Ongoing efforts geared towards nationwide revitalization of Primary Healthcare Centres must seek the support of state and local governments.

    Worthy of note is the fact that the federal government pays more attention to the construction of Primary Healthcare Centers than it does on provision of resources for the daily administration and management of the Centers. This implies that any effort towards construction of Primary Healthcare Centers that does not get the collaboration, commitment and support of the States and Local Governments will likely lead to fully constructed but non-operational Primary Healthcare Centers. What is the utility provided by a fully constructed Primary Healthcare Centre that is under lock and key? The National Primary Healthcare Development Agency should develop a smart tool for functionality assessment to determine the degree of funding each Primary Healthcare Center will receive. Also, the National Assembly is encouraged to elevate Primary Healthcare to justiciable fundamental human rights as enshrined in chapter four of the 1999 constitution of the Federal Republic of Nigeria. This will go a long way to promote transparency and accountability in the sector

     

    • Martins Eke,

    Centre for Social Justice, Abuja. 

  • We have failed Nigerians on healthcare delivery, says NHIS boss

    The Executive Secretary of National Health Insurance Scheme (NHIS), Prof. Usman Yusuf, on Wednesday in Kano admitted that the Scheme has committed a lot of mistakes in its operation to better the health of Nigerians.

    Yusuf who spoke to Reporters during and interactive session, after the launching of seven health sector projects initiated by Governor Abdullahi Umar Ganduje at Muhammadu Specialist Hospital (MDH) Gingiyu, said the Scheme has already taken measures to correct the anomalies.

    According to him, “In fact, our mistakes are many! And I am forced to say it because if you do not admit what your mistakes are, you will continue to make such mistakes. We are the regulators of health insurance in this country, and a lot of what you see have been from our mistakes; and we have owned up to that and said we have done mistakes in the past, and we want to tell people we will correct those mistakes and do the right thing.

    “What are the mistakes: we have not been holding ourselves accountable, that is number one. Number two, we have not been holding hospitals we give people’s money to accountable. Number three, we have not been holding HMOs we give people’s money to accountable.

    “We are saying this time around, it is going to be different, we have to hold ourselves accountable, we have to hold the hospitals we give people’s money to accountable and we have to hold HMOs accountable. Now those hospitals and HMOs we give money to, we will go and ask them—what did you do with that money.

    “In Abuja, what we have done in NHIS is that I have deployed Desk Officers to major hospitals in Abuja. They are there to act as advocates for patients. When our patients go to hospitals, and then they said no, your bills are not covered by NHIS, whereas it is, or they don’t get treated well, they go to this Desk Officers and complain to them and the Desk Officers go and advocate for them.

    “We want to replicate that across the six geo-political zones in major hospitals. We are going to be enrollee-centric rather than HMO-centric. Many of hospitals get a lot of money from us and they never held anybody accountable, but this time around, it is going to be different.”

    He added that, “NHIS has been going round the country interacting with states governments, Commissioners of Health and Governors, and encouraging them to create their own health insurance agencies. So far, we have only 19 of such agencies in the country. Our goal is that by the end of this year, we should be where we need to be. “Our call to them is that if you don’t create your own health insurance agency, they will not enjoy these basic healthcare provisions. So, here we are, we are working with them and we will get there.”

    Yusuf also noted that, “people do not know about National Health Insurance Scheme (NHIS), I agree, but that is the reason that we are here having this interaction.

    “The misconception is always NHIS is only for Federal Government employees. Again, we are guilty as charged, we have not gone to talk to people; that is why we have this engagement. And now, our goal is aggressively advocating and telling people what NHIS is about.

    “Essentially, the largest pool is Federal Government employees, but it doesn’t mean that is we take care of. We have the organized private sector.”

    He stated that HNIS has come up with a programme that can take care of the health needs of the Nigerian masses, pointing out that, “there is this programme called Vital Contributors’ Social Health Insurance Programme (VC-SHIP), for N15, 000 yearly anybody can enjoy healthcare as I would. You pay N15, 000 a year, you can go to a hospital and they will send us a bill up to N300, 000 and NHIS will pay.

    “The whole idea is that we are able to do that because the Federal Government has put this large pool into the formal sector. Our goal is to have a large economy upscale.

    “The more people contribute into this, (and forget about the sentiment of I contribute, but I probably will not use it) but the whole idea is for the healthy to pay for the sick; the strong to pay for the weak; and the young to pay for the aged.

    “This is what we encourage, unless you have a very large number, you are not going to be able to subsidize that. Let us all think about this—I mean, all of us, from the president to the peasant—we all go back to our villages, there are always people coming to us to ask us about going to hospital; and more often than not, you end up spending more than N15, 000. So, you pay N15, 000 and anyone of us can enjoy healthcare delivery as we can pay for every other person.

    “So, VC-SHIP is what we want to aggressively advocate and sale to people as part of our outreach for the informal sector; because in the Federal Government, the formal sector is for sure because the Federal Government is now employing more people; but the informal sector is where the future is and that is where about 99 per cent of our people are. We will see how we will connect with the states and do the right thing for our people.”

  • Family physicians urge govt on healthcare

    private medical practitioners have called for collaboration between them and the government to save the ailing health system.

    Association of General and Private Medical Practitioners of Nigeria (AGPMPN) President, Dr Ugwu Odo, who made the call at a news conference organised by the association and the World Organisation of Family Doctors (WONCA), in Lagos, said the government’s collaboration with private medical practitioners is the only assurance for Nigerians to have affordable and accessible quality health care for all.

    The conference is to commemorate the World Family Doctor’s Day (WFDD), marked annually on May 19, to acknowledge the role and contributions of family physicians in health care delivery.

    The 2018 WFDD theme is: “Family Doctors: Leading the Way to Better Health’’.

    He said:“Family doctors are a very special group of doctors because they provide the most essential daily health care needs to the highest number of the population.

    “They are also the longest serving, as well as the longest staying doctors in the lives of people, especially because they provide comprehensive and continuous care.

    “On a day like this, family doctors across the world mark their great work in advocacy, clinical governance, health care development and promotion by way of corporate social responsibility to the society.”

    He continued:“We are all encouraged to replicate this at state and individual hospital levels. We commend our governments at the Federal, state and local levels for what they have done in articulating a health system for Nigeria.

    “However, a lot still needs to be done in the health sector because our health care institutions are still very weak and unsustainable.

    “The determinants and indicators of a functional primary health care system, which account for over 80 per cent of the needs of the population, are not strongly in place.

    “Governments must budget more for health, at least 17 per cent of the annual budget is expected to go to the health sector but it gets less than five per cent presently.

    “Our health insurance scheme must be transformed by transparency, accountability and professional diligence, to enthrone universal coverage.’’

    Odo urged governments at all levels to invest in and also grow the private health sector by policy shift and system restructuring that are investment friendly.

    Chairman, AGPMPN, Lagos State Chapter, Dr Tunji Akintade, drew attention to the need for private/public collaboration, which could help to deliver good health services to the people.

    “Public/private collaboration would address the challenges of lack of health personnel and brain drain in the health system.

    “Our major plan is to have a meaningful impact on health but governments need to employ more manpower than just restructuring health facilities.

    “There is a gap in human resource for health in Nigeria that is why we have doctor/patient ratio at one to 5,000.

    “We do not have more than 40,000 doctors in Nigeria; the main reason it is important for government to partner private sector to improve primary health care services,’’ he said.

    Akintade said there was need for an inclusive health insurance system. “Health insurance scheme can also be used to improve the health system in both public and private sectors.

    “That is why we want government to consider the private health sector during budgeting and also reduce multiple taxation in the health system,’’ he said.

    Former World Organisation of Family Africa president, Dr Sylvester Osinowo, also said it was important to put the health sector in the right perspective.

    The only way this could be achieved, according to him, is by planning and ensuring that every individual contributes to health according to their income.

    “This can be done through telecommunications, which is a meaningful way of funding health. The government needs to establish a health bank to manage such funds, which will help everybody to access health,’’ Osinowo said.

    AGPMPN offers free medical services to over 150 residents in Lawanson, Surulere, Lagos.

    The outreach comprises tests, which included malaria, diabetes and cholesterol level checking.

     

  • Prioritising healthcare delivery

    SIR: In 2001 Nigeria voluntarily made a commitment along with other African countries under the auspices of AU in what was tagged ‘Abuja Declaration’ to set aside 15 percent of her annual budget to finance health-care development.

    Sadly, 17 years on, no administration has gone near half of that commitment. In fact, the proposed budgetary allocation for the Ministry of Health in 2018 annual budgetary estimates is a little above N340.40 billion, representing 3.9 percent of the N8.6 trillion budgetary estimates. This breaks down toN1,888 for the healthcare needs per capita of citizens. With that percentage, allocation for health comes 12th on the country’s scale of priority.

    Ironically, Nigeria spends over N359.2 billion annually on medical tourism. This huge capital flight from Nigerians seeking medical attention abroad leaves much to be desired. The few privileged Nigerians in government would not mind spending thousands of dollars to seek foreign medical attention for ailments as minor as headache, dislocation or even cough. What message are they trying to pass by this action? Are the services providers in that sector no more capable of handling the nation’s healthcare needs?

    Health is on concurrent list, which implies that, the three tiers of government should be involved. While local governments provide primary healthcare at that level, state governments handles the secondary healthcare needs in general hospitals and the federal government takes care of tertiary healthcare in teaching and specialist hospitals. The sign that all is not well in that sector is the apparent collapse of this structure as we often see teaching hospitals being inundated by patients with minor cases which should have been handled at lower levels.

    The recent survey by WHO shows that Nigeria is rated 187th out of 191 countries, in terms of world health system. And this assessment took consideration of efficiency of healthcare delivery services in those countries examined. Similarly, the world body has disclosed that the country’s life expectancy is now 54 years. The report also places Nigeria in not too enviable position on infant mortality rate, where it comes as third worst performing in that area. Some preventable diseases are still life-threatening in the country. With obsolete, inadequate or damaged health facilities, only a declaration of a state of emergency in the sector can bring the much needed succour.

    When lives of hapless citizens are lost because of absence of appropriate drugs or inability of citizens to afford the cost of such treatment; it only smacks of government’s blithe insensitivity to the plight of the citizens. While this writer is not advocating for free medical service to citizens, the cost of this would certainly be too much for government. The effective implementation and expansion of the scope of National Health Insurance Scheme (NHIS) to capture more Nigerians would neither be a bad suggestion nor an indictment on government.

    It is often said that the primary purpose of government is the protection of lives and property of its citizens but of most fundamental is the preservation of life. If life is not preserved how can be it protected?

    But the reactive instead of proactive approach to healthcare issues is worrisome here. It is for this concern that one applauds the recent assurance by Minister for Health, Prof. Isaac Odewale that the government has decided to adopt preventive rather than curative medical approach to address myriads of diseases threatening the country. Nigeria is always seen as a reactive country, unfortunately, this culture had also permeated the health ministry. While the baleful effect of this attitude may not be immediately noticed in other sectors, but such is dangerous here as it has led to untimely death of both health workers and patients alike.

    For government to be seen as serious in healthcare development, genuine effort must be put in place to permanently resolve incessant labour issues in the health sector. This development, which often leads to frequent industrial disputes and brain drains of health professionals, does no one any good.

    Invasion of various outbreaks of infectious diseases in the country last year was a clarion call for all stakeholders to rise to the occasion, and bring issues of health to the national front burner. The overall country’s health architecture should be restructured and repositioned to better address emerging health challenges using modern day technology.

     

    • Itaobong Offiong Etim, Calabar.