Tag: Healthcare

  • Council chair seeks partnership on healthcare

    The Executive Chairman Yaba Local Council Development Area (LCDA), Kayode Adejare Omiyale, has appealed to philanthropic organisations to partner the council on free health programmes.

    He made the appeal while opening the free cancer screening.

    According to him, the government alone cannot provide healthcare services to the people.

    He said: “We seek the assistance of kind-hearted organisations like the Sahara Foundations. The scourge of cancer is prevalent in our society today; the only solution to this deadly scourge is early detection so that appropriate actions could be taken.”

    Omiyale also appealed to mothers to get their children immunised against measles. “Measles is deadly but it is preventable when our children, between nine months and five years, are immunised appropriately,” he said.

  • Afe Babalola urges Nigerians to invest in education, healthcare

    Legal luminary and founder of Afe Babalola University in Ado-Ekiti (ABUAD), Aare Afe Babalola (SAN), has urged well-meaning Nigerians to join him in promoting quality and functional education, industry, service and character as well as discipline in humanity.

    He said this would leave the society better than they met it.

    Babalola spoke yesterday at the brief ceremony that heralded the beginning of operation at the 400-bed ABUAD Multi-System Hospital in Ado-Ekiti, the Ekiti State capital.

    The eminent lawyer noted that if more well-to-do Nigerians channel their resources towards the establishment of quality universities and health facilities, there would be no reason for people to send their children to foreign lands for education or medical service.

    According to him, with the modern equipment in his nine-year-old university and the state-of-the-art equipment at his Multi-System Hospital, which was inaugurated on October 21, last year, the university has been rated Number One Private University in Nigeria by Webometrics, while the hospital has been primed to provide quality health care that would end medical tourism outside Nigeria.

    Babalola opened the doors of the hospital, which is managed by ABUAD and Aster DM Healthcare of Dubai, for a four-day procedures at discounted rates and free consultation from yesterday till March 24.

    He said: “I must make it clear that this hospital is open to everyone – the rich and the not-so-rich alike. We will run this place like we run our chambers where we handle the cases of the not-so-rich at minimal charges while those who can pay are made to pay.

    “In the short and long run, the rich and the not-so-rich will be happy. The rich will pay less than they would have paid going abroad for the same treatment, while we will be able to subsidise the cost for people on the lower rung of the ladder.”

    Those at the ceremony included Babalola’s wife, Yeye Aare Modupe; ABUAD’s Vice Chancellor Prof. Michael Ajisafe; his two deputies – Prof. Yekini Lawal (DVC Academic) and Prof. Smaranda Olarinde (DVC Administration); some members of the Board of Trustees (BoT) of the university; Dr. Gboyega Babalola, a member of the Governing Council of the university and the Catholic Bishop of Ekiti Diocese, Bishop Felix Ajalaiye.

  • NSIA okays $20m for three healthcare facilities

    The Nigerian Sovereign Investment Authority (NSIA) has set aside $20 million to develop three healthcare facilities in three states.

    The NSIA Healthcare Development and Investment Company (NHDIC), an NSIA company, in collaboration with Federal Ministry of Health yesterday announced the execution of joint venture and other project agreements for investments in three  federal healthcare institutions in Nigeria.

    The benefiting healthcare institutions are, the Lagos University Teaching Hospital (LUTH, Lagos), the Aminu Kano Teaching Hospital (AKTH, Kano) and the Federal Medical Centre Umuahia (FMCU, Abia).

    Following from these agreements, funds will be deployed to build, equip, maintain and operate a private cancer centre for advanced radiotherapy treatment at the Lagos University Teaching Hospital (LUTH) and to also build, equip, maintain and operate private modern medical diagnostic centres at the Aminu Kano Teaching Hospital (AKTH) and the Federal Medical Centre Umuahia (FMCU).

    Under the agreements, the cancer centre at LUTH will be upgraded to provide specialist care for cancer treatment while AKTH and FMCU will focus on diagnostics providing medical microbiology services, routine chemical pathology,  haematology tests and advanced radiography including MRI and CT services.

    The investment is expected to upgrade these institutions to modern medical centres and significantly enhance Nigeria’s ability to treat non-communicable diseases (NCDs).

    The NSIA said: ”The investments will assist in bridging the infrastructure gap in the healthcare sector and help reduce the burden of medical tourism which is estimated to drain over $1 billion in foreign exchange annually.

    “Similarly, the investment is intended to provide access to advanced healthcare services for the benefit of lower income families many of whom have limited access to care.”

    As part of the programme, NHDIC has procured the services of internationally renowned equipment vendors, including Varian (Switzerland), Siemens (Germany), JNC International (Nigeria) and Fuji Films (Japan) to provide turnkey services including civil works, design, equipment installation and maintenance services for the centres.

    Each centre will run as a joint venture between NSIA and the respective tertiary hospital to ensure timely and efficient delivery of services.

    Speaking at the agreement signing ceremony yesterday, Mr. Uche Orji, MD/CEO of NSIA stated that “Investing in healthcare remains a vital component of the Nigerian Infrastructure Fund strategy. The enhancement of healthcare infrastructure in these institutions will contribute towards raising the quality and standard of care in Nigeria with outcomes which are consistent with the 2030 agenda for sustainable development. In addition, it will demonstrate the economic potential of healthcare nvestments in Nigeria and catalyse private sector participation”

    The Chairman of NSIA, Mr. Jide Zeitlin said the NSIA’s pursuit ”in this phase of our healthcare strategy is to focus on non-communicable diseases and provide treatment for cardiovascular, renal, orthopedic and oncological conditions.

  • Kogi to get $1.6m FG grant for healthcare delivery —Minister

    Kogi to get $1.6m FG grant for healthcare delivery —Minister

    For judicious utilization of previous grant, Kogi state will receive $1.6 million (N576m) from the Federal Government for health care, the Minister of Health, Professor Isaac Adewole has said.

    The grant is from the Saving One Million Lives(SOML) counterpart fund to Kogi State government  as “an incentive  to do more’’ towards improving healthcare delivery in the state.

    The state’s qualification for the extra grant is due to its judicious use of the previous $1.5m granted the state last year, according to Adewole.

    The Minister stated this at the Flag-off ceremony of “Health Care Plus’’  intervention programme and the unveiling of delivery kit, post-partum haemorrhage pack and hypertensive pack, held yesterday in Lokoja.

    Adewole called on other state governments to emulate the Kogi state government’s commitment  by investing in health programmes that touch their citizens’ lives.

    He also commended the Kogi governor, Yahaya Bello, for his impressive response, initiative and commitment towards the improvement of the well-being of the citizenry as demonstrated through the investments and several rehabilitation projects recorded in the health sector across the state.

    In his response, Governor Bello, said the ‘Health care Plus’ project was launched to further stem the tide of maternal and child mortality in Kogi state because of the benefit the citizens stood to gain.

    The Governor added that the project was also a fulfillment of the pledge he made to the people when he assumed office two years ago.

    He explained that the package would create a niche for itself in Nigeria as it comprises many positive peculiarities compared with similar projects across the country.

  • NESG canvasses reforms to improve access to education, healthcare

    The Nigerian Economic Summit Group (NESG) has said reforms in key sectors of the economy, accompanied by strategic investments, are necessary to improve quality of life and obtain better educational outcome.

    The group stated this in its 2018 Macroeconomic Outlook titled: “Will Nigeria’s growth be inclusive in 2018 and beyond?”

    The outlook, obtained by The Nation, indicated that development of human capabilities, access to quality education and healthcare are basic rights of citizens.

    The NESG advised that government policies should be tailored to significantly support both sectors to improve standard of living in the country. “The relevance of education remains unclear, as it is apparent that the educational system is raising graduates that find it difficult to fit into the workplace, even as innovation and entrepreneurship learning are not picking up as expected.

    “Healthcare in Nigeria is in a dire strait; this is evident in the high infant and under-five mortality rate.”

    According to NESG, growth in population, which is expected to reach 399 million by 2050, will increase the demand for jobs and social services.

    It indicated that there was an urgent need to up-scale job creation to salvage current unemployment and underemployment situation.

    The group revealed that the social sector could help in filling the job gap through skills development to boost productivity and reduce number of unemployed citizens.

    It indicated that government spending and urgent reforms must support the development of the social sectors to improve literacy rates; learning outcomes; access to quality health education and gender equality.

    “ Interestingly, the Economic Recovery and Growth Plan (ERGP) recognises the importance of developing these sectors and outlines several reforms to be implemented by the government.”

    The NESG also recommended the provision of socio-economic data to measure progress recorded in the country. “The government should provide frequent and timely data on poverty, learning outconmes, out-of-school, mortality rates, unemployment rates to track Nigeria’s performance on improving quality of life,”it said.

    It also suggested the enactment of a national skills development policy and programme to address skills and capability challenges across all sectors in Nigeria.

    “In the light of this, we propose that the Graduate Internship Scheme (GIS) needs to be reviewed and implemented to encourage synergies between the private sector and the fresh graduates.

    “Nigeria needs holistic structural reforms for the education sector; the purpose of education in Nigeria needs to be clearly defined, while issues of accountability and governance of the sector must be given utmost attention.

    “Nigeria’s curriculum must be up-to-date with the rapidly changing skills-need of the country. To achieve this, the Nigerian government must strengthen public-private approaches in the review of the curricula at different levels.”

  • Healthcare service delivery in Kuje Area Council: The challenges and hope

    The residents of Kuje have, on many occasions, expressed concern about what they describe as poor healthcare system that has been the residents’ major challenge.

    Most of them call on stakeholders in health sector to raise the hope of the residents in 2018 by ensuring robust healthcare service delivery.

    They identified poor access road network, under equipped primary healthcare centres and overstretching of medical equipment at hospitals located in the community as some of the challenges hindering proper healthcare services.

    Others explained that the community dwellers mostly travelled long distances just to access basic healthcare services at better equipped hospitals located in other neighbouring communities.

    Some residents, health workers and ante-natal patients, also called for improvement in the healthcare delivery in the community.

    They, nonetheless, commended the intervention of non-governmental organisations that they claimed to have been providing free medical services and training for health workers in the community.

    Mr Abraham Isa, a resident of the community, observed that Rije community that is five-kilometre distance from the council headquarters had a dilapidated primary healthcare centre.

    He blamed the government for neglecting the facilities in the healthcare centre for so long a time.

    “The journey to Kuje General Hospital is dangerous and the road is so bad that during the rainy season they are almost unusable.

    “The issue of healthcare centres has been bordering us in this community for a very long time. I am pleading with the council to come to our aid and improve the primary health centre in the area,’’ he said.

    Recently, Mr Haruna Agwai, the Health Care Coordinator of the Council, said inadequate vaccines, bad roads even affected immunisation in the area.

    He said in spite of the challenges, the health workers vaccinated children of zero month to 59 months against oral polio vaccines and children from one year to 29 years against meningitis.

    He also said more than 7,763 children were immunised against these diseases out of more than 17,000 children population in the area council.

    “We area vaccinating the children and taking precautions against the outbreak of meningitis in some parts of the country as well.

    In spite of these challenges, the health workers vaccinated children against meningitis and oral polio vaccines,’’ Agwai said.

    He urged the government to collaborate with the private sectors on funding to improve the healthcare system in the six area councils of the Federal Capital Territory, Abuja.

    He said the private sector had a major role to play in driving and improving healthcare services in FCT.

    Mrs AJara Sani, an ante-natal patient in Kuje General Hospital, said high cost of child’s delivery and attitude of health personnel were some of the challenges facing healthcare delivery.

    “The cost of child’s delivery and access to drugs is very high, especially when you are to be operated to be delivered of a baby.

    “Some women even give birth on their way before they get to the general hospital due to bad road,’’ she said, calling the government to subsidise the cost of healthcare services in the area.

    To address some of the challenges, Women Friendly Initiative, a non-governmental organisation, said it had recently trained health workers for comprehensive sexual reproductive health services in the area.

    Dr Francis Eremutha, Chief Executive Officer of the organisation, said the training was aimed at reducing maternal morbidity and mortality in the area.

    According to him, it will also check life-threatening complications arising from pregnancy.

    He said the training emphasised, among others, the benefits of contraception, ante-natal attendance, supervised delivery, infection prevention and immunisation services for mother and child.

    “Women and girls face enormous challenges in accessing services, especially in relation to sexual and reproductive health for fear of condemnation.

    “They also face stigmatisation by the society and the negative attitude of some health workers, ’’ he observed.

    He also said the training would help in deepening and sustaining community health-provider’s adherence to guidelines and standards of practice.

    Apart from this, he said the training would facilitate supervision and routine monitoring of trained providers and health facilities.

    “We aim to strengthen local institutions, structures and entities that enhance communities’ health. We are also building the capacity of health service providers for quality comprehensive sexual reproductive health services,’’ he said.

    He, therefore, called on ministries of health and relevant bodies to equip primary health centres with medical equipment.

    However, Mr Abdullahi Galadima, Chairman, Kuje Area Council, said the challenges of healthcare delivery were inherited by his administration but promised that measures had been put in place to tackle them.

    “We are aware that most of the primary healthcare centres are dilapidated and some are out of drugs. I want to assure the people of Kuje Area Council that we are moving on and certainly, will be paying attention to health facilities,’’ he promised.

    Galadima further called on residents to be patient as efforts were ongoing to resolve some of the problems facing the healthcare system in the community.

    All in all, residents of the community insist that concerned authorities ought to make pragmatic efforts at making healthcare delivery service worthwhile in all its 10 electoral wards to ease their sufferings on health issues.

    • Tadanyigbe is of the News Agency of Nigeria (NAN)
  • Health experts urge govts to focus on primary healthcare

    Health experts urge govts to focus on primary healthcare

    To improve quality and reduce cost of accessing healthcare, federal and state governments should direct reforms and policies to deliver primary healthcare, provide health insurance for the poor and allow for private sector actors to handle tertiary and emergency healthcare.

    This was the submission of experts during the plenary on social welfare targeted at healthcare at the Alaghodaro Investment Summit, organised at the weekend by the Edo State Government, in Benin City.

    The Minister of State for Health, Dr. Osagie Ehanire, who was the discussion leader at the plenary, said that the Edo State government is on the verge of domesticating the National Health Act, noting that the move will greatly improve healthcare delivery in the state.

    According to him, “Not only is the Edo State government on the verge of domesticating the National Health Act, it is also working to have a health insurance scheme that will cover all. The state will also serve as a pilot for the implementation of the primary healthcare programme.”

    Former Chief Medical Director at the University of Benin Teaching Hospital (UBTH), Prof. Michael Ibadin, said that there was need for more private sector participation in healthcare delivery.

    Arguing that the dominance of government in health sector has stifled growth, he said, “We can improve healthcare delivery when we get more private sector participation. When we do this, we would have less incessant strikes. There is evidence that private hospitals are delivering good services. But most people have been left to suffer because a lot of people depend on service in public hospitals. We need this trend to change.”

    Dr. Christopher Otabor of Alliance Hospital, Abuja, said that Governor Godwin Obaseki’s experience in the private sector is one of the greatest assets he is bringing to governance, noting that government should provide guarantees that will allow people access healthcare cost-efficiently.

    “When it appears healthcare is anchored on private sector investment and accessing services is hard for the poor, government can provide insurance. The stage is being set in Edo State for this. Government doesn’t necessarily have to bring money to fund hospitals. It can provide guarantees and ensure that there is a stable environment for hospitals to thrive,” he said.

    Prof. Jonny Ikimalo of Prime Hospital said that the reason for poor health indices in Nigeria is due to poor budgetary allocations, condemning the fact that a lot of people have to pay for services out of their pockets when they are already in hospitals.

    According to him, “Healthcare is expensive and I have a problem when people talk about health insurance for the poor. People think that anything that relates with insurance is expensive because what we ordinary associate with insurance are cars, life and the likes. We should rather call it health plans. Healthcare is a social responsibility. So, much as we suggest that government should allow private investment, it should also provide cover for the poor.

    “What I understand from the visionary stance of the state governor, is that the state is already putting in place a health insurance scheme which will provide health coverage for everybody, including the underprivileged. I think it is work in progress and it is expected that this summit will make input into it.”

    Rev. Fr. Anslem Adodo of Pax Herbal Clinic noted that there was need to promote traditional medicine in the quest to attain universal health coverage, noting, “One of the surest means to provide healthcare to the people is to recognise the place of traditional healthcare. But to do this, we must reform and integrate traditional medicine in our health system in Edo State.”

  • ‘We are pursuing basic healthcare through PHCs’

    ‘We are pursuing basic healthcare through PHCs’

    The Minister of Health, Prof. Isaac Adewole, spoke with select reporters in Ibadan, and talks about how the ministry is pursuing a comprehensive health project to revamp a minimum of one Primary Health Centre in every political ward across the country. Bisi Oladele was there

    HEALTHCARE delivery looks poor in this country. What is your ministry doing to revamp, particularly about the Primary Healthcare Centres (PHCs)?

    I think we should start by saying upfront that primary health or primary care is not direct responsibility of federal government. But as I have said often and often, our job is to look at the entire healthcare architecture and make sure that we get it right. What we have today is a situation whereby the primary health care is dysfunctional and the secondary is begging for help. The only one that is actually doing good work is the tertiary. People now abandon primary and secondary and work straight to tertiary and this is why we have the problem we have on ground – a situation in which a large majority of our people visit tertiary care is not good. So, what we are trying to do, because we are in charge of policy, is to reverse this unfortunate and unacceptable trend by making sure that we reposition the healthcare system in a way that 85 per cent of our people would go to primary health care rather than going to a teaching hospital and that’s why we have taken the initiative to flag off the programme of revitalization of PHCs and it has become a cardinal programme of this administration.

    There was a time primary education was also in total crisis and the federal government came up with an idea that up till today, teachers were rescued. Is it not possible for the Federal Ministry of Health to also come up with that kind of idea that will rescue primary health care because that is the closet hospitals to the people?

    That is exactly the same reason that necessitated our focusing on PHCs. It has become the cardinal programme of Mr. President and he personally flagged off the Kuchingoro model PHC on January 10 to really demonstrate his commitment to revitalizing PHCs. PHC is the healthcare facility that is the closest to the people. And if you look at the All Progressives Congress’ (APC) manifesto, it identifies healthcare system that is affordable, accessible and of good quality and within 3-5 kilometres to the people and that is why we are focusing on PHCs. And we looked at what we have on ground. We have about 30, 000 PHCs for now but only about 20 per cent of them are working. So we said if we can make one in every political ward function, we would reach about 100 million people. Each political ward has about 10,000 people. So, if we have about 10,000 PHCs we would reach about 100 million people. The National Health Act passed in 2014 has given the Ministry of Health the authority to define what basic healthcare is all about. And for me, the basic healthcare package includes ante-natal care, delivery, treating malaria, checking blood pressure, giving vaccines to young ones and treating other basic problems, testing them for HIV and TB.

    You mentioned affordable healthcare as being part of the APC manifesto. But today, if we go to tertiary health institutions, because of shortage of funds, they look inward to generate additional revenue to plug short fall in their expenses and the implication is that they pass on a lot of expenses to poor patients. Don’t you think that this is contrary to the promise to offer affordable health?

    Well, let me assure you that good care and affordable care do not necessarily imply free care. There is nowhere in the manifesto of APC where we talked about free health care but what I can assure you is that when we say it is affordable, that means those who can afford will pay and then we pay for those who cannot. And that is why we are promoting health insurance, encouraging states to set up health or contributing scheme and we are also looking into setting up a National Health Insurance Commission that will make health insurance compulsory and universal in the country. When you have that, you will be able to put together resources to take care of health. Anywhere health is free, some people must be paying for it. In the United Kingdom (UK), the National Health Service depends on taxation. So what we are currently looking into in the context of Nigeria is how can we put resources together that will afford us the opportunity to take care of health? And one basic provision in the national health care is the prescription giving at least one per cent of the consolidated revenue fund to health to fund basic healthcare and that money will go straight to primary health care. For the first time the PHCs will get money direct from the federal. If we get that right, then this country has actually arrived at what we call a comfortable stage where we can deliver basic healthcare to our people. For now, we have not succeeded. We are talking to our colleagues in the Ministry of Budget and Planning and that of Finance and I have also approached Mr. President to ensure that we put the one per cent in it. We have assurances from the National Assembly that if the Executive contributes that one per cent, they will protect it. So we are quite optimistic that very soon we would have that one per cent. But pending the time that we would have the one per cent, we are doing what we call a scale-up project in three states: Abia, Niger and Osun where we would pilot basic healthcare provision fund, where money directly will flow from central to each of the PHCs. We would open account at the local facility and also engender ownership because the people must own it. We don’t want a situation where federal government will own the facility. It must belong to the people. We would then partner with the states to set up a state primary healthcare development board and a ward development committee so that the people can own the facility.

    The Chief medical Director (CMD) of University College Hospital (UCH), Ibadan, Prof. Temitope Alonge, recently suggested the idea that the federal government can make an arrangement for tertiary health institutions to adopt a number of PHCs within their locality to be able to mentor them since they have enough manpower and better facilities. Why can’t this happen?

    We are on the same page with the CMD. I have discussed with him how we can get this done. It is actually a two-phased process. The first thing is to partner with the state to also support their secondary facility. We have more than enough human resources in our teaching hospitals. For example, you get to Sokoto Teaching Hospital there are over 500 doctors there. But if you go to the state hospital, I am sure they have less than 100. Zamfara is a case in point with 122 doctors in the Federal Medical Centre in Gusau. But here are less than 24 doctors in the state hospitals. So, one of the things we are trying to build is a partnership between federal and the states so that they can oversee. In the example in Sokoto, the teaching hospital will also oversee the local government and if we do that, each of our teaching hospitals or medical centres will then supervise the PHCs and it will be good for them for training. It will be good in terms of supervision and we can ensure that the people get good healthcare. The federal system will also be strengthened because if a case cannot be managed at a PHC, that case will immediately leave the PHC. We expect that normal delivery should take place at PHC but if we have complications, hypertensions, convulsion, and baby lying across in the tummy, multiple pregnancy, baby coming by the buttock; those cases should moved to a higher level because we don’t want to risk the lives of women at that level.

    Sir, in medical practice generally or health sector generally, it is believed that prevention is actually better than cure. Do you think government is doing enough in running campaigns to help people embrace practices that prevent sickness?

    This is where we all got it wrong. Health is on the concurrent list. One of the things we want to do is change the perception that the federal government must do everything. That is where we got it wrong. Federal government took over everything; that was okay when we had enough resources. Now that we do not have enough resources we need to share the resources with the states. We are only in charge of policy. States must take care of the people in their states. We cannot have cholera in Kwara and say federal should come and look after them. No, that is the responsibility of Kwara State Government. Kwara must provide water for the citizens because water is what you need to prevent cholera and also ensure that we mange waste properly so that they will not defecate along streams that people will drink. What we are doing at the federal is to change the way and manner we allocate resources. Before we came on board, 80 per cent of the resources at federal level were into curative care. The first we have done now is to change the allocation to preventive care. If you look at the 2016/2017 budget, a large chunk of our capital allocation now is into preventive. We have also given approval for the National Centre for Disease Control that is out to work with states. The disease control centres have trained surveillance officers; these are disease detectives. We have posted them to all the states; we are working with the states so that if there is an outbreak we can quickly nip it in the bud.

    Before now we use to think that VVF is a thing that is restricted to the northern states but now we are talking of VVF in the Southwest and other places…

    There are many southerners who also share that wrong impression or perspective. When we flagged off the VVF repair at Wesley Hill Hospital Ilesa, Osun Sate, the Deputy Governor came and was shocked. In fact, I did not realize why she was asking for the name of the patient we operated on. In one week, we operated about 25 patients. And the Deputy Governor said what is your name? Where are you from? And they said Ikire, Lagos, Osogbo, she was shocked. She said I thought VVF was confined to the North and I said that VVF is all over Nigeria. But what we are doing now is to set up more VVF hospitals, train more people, increase awareness, actively campaign against child marriage and also promote ante-natal care and supervise delivery. Both must work together. If a girl of seven years old gets pregnant and is managed properly, that girl won’t develop VVF. So, we need to combine good care with advocacy and education.

    How would you rate the advocacy of VVF from your ministry so far?

    We are doing well and as I told you, we are not only working alone, we are working with states and we are being supported by the United States government. The USAID has a good programme to engender health working together to improve advocacy. We are working with the Ministry of Women Affairs to improve education of young girls, delay marriage and also make sure that where you get pregnant you go for ante-natal care and supervised delivery.

    As the Minister of Health, what is that one thing that will make you feel fulfilled if your ministry is able to push through today?

    The basic healthcare provision fund.

    What is it about?

    It is one per cent of the consolidated revenue funds going to PHCs because that is the only thing that will make the PHCs survive.

    What is your ministry doing to address this huge shortage of fund for tertiary health institutions?

    Well, I think we must look at the situation from two perspectives. The first thing is to move patients away from the tertiary and that’s why taking care of primary healthcare is good. When I trained in the UCH, you can’t just walk in to the UCH and say I have fever, cough. No. You must come with a referral. If you fail to come with a referral they will send you to the Out-patient Department where someone will see you and may send you back to state hospital or treat you there and say ‘Go away’ or ‘this is a complex case, go and see a consultant.’ When you do that, the consultants in UCH will have more time for those complex cases. There will be enough materials for them, and no one will complain. So that is why it is important to make sure the PHC and secondary healthcare are working. Secondly, we need to put more resources in the tertiary. No doubt about that. We need to upgrade the condition, make sure their water and electricity are efficient, upgrade their equipment and upgrade the skills of the health professionals working there. That is the only thing we can do correctly to stop people from going out and we can save a lot of money. We estimate that we can save up to $1 billion a year if we upgrade our tertiary care centres and government is committed to doing that. In our 2017 budget appropriation, we have money allocated for that strategic investment in tertiary hospitals. We are going to upgrade eight of our facilities – one in each geo-political zone, including the National Hospital, Abuja and LUTH.

  • ‘We are pursuing basic healthcare through PHCs’

    ‘We are pursuing basic healthcare through PHCs’

    The Minister of Health, Prof. Isaac Adewole, spoke with select reporters in Ibadan, and talks about how the ministry is pursuing a comprehensive health project to revamp a minimum of one Primary Health Centre in every political ward across the country. Bisi Oladele was there

    Healthcare delivery looks poor in this country. What is your ministry doing to revamp, particularly about the Primary Healthcare Centres (PHCs)?

    I think we should start by saying upfront that primary health or primary care is not direct responsibility of federal government. But as I have said often and often, our job is to look at the entire healthcare architecture and make sure that we get it right. What we have today is a situation whereby the primary health care is dysfunctional and the secondary is begging for help. The only one that is actually doing good work is the tertiary. People now abandon primary and secondary and work straight to tertiary and this is why we have the problem we have on ground – a situation in which a large majority of our people visit tertiary care is not good. So, what we are trying to do, because we are in charge of policy, is to reverse this unfortunate and unacceptable trend by making sure that we reposition the healthcare system in a way that 85 per cent of our people would go to primary health care rather than going to a teaching hospital and that’s why we have taken the initiative to flag off the programme of revitalization of PHCs and it has become a cardinal programme of this administration.

    There was a time primary education was also in total crisis and the federal government came up with an idea that up till today, teachers were rescued. Is it not possible for the Federal Ministry of Health to also come up with that kind of idea that will rescue primary health care because that is the closet hospitals to the people?

    That is exactly the same reason that necessitated our focusing on PHCs. It has become the cardinal programme of Mr. President and he personally flagged off the Kuchingoro model PHC on January 10 to really demonstrate his commitment to revitalizing PHCs. PHC is the healthcare facility that is the closest to the people. And if you look at the All Progressives Congress’ (APC) manifesto, it identifies healthcare system that is affordable, accessible and of good quality and within 3-5 kilometres to the people and that is why we are focusing on PHCs. And we looked at what we have on ground. We have about 30, 000 PHCs for now but only about 20 per cent of them are working. So we said if we can make one in every political ward function, we would reach about 100 million people. Each political ward has about 10,000 people. So, if we have about 10,000 PHCs we would reach about 100 million people. The National Health Act passed in 2014 has given the Ministry of Health the authority to define what basic healthcare is all about. And for me, the basic healthcare package includes ante-natal care, delivery, treating malaria, checking blood pressure, giving vaccines to young ones and treating other basic problems, testing them for HIV and TB.

    You mentioned affordable healthcare as being part of the APC manifesto. But today, if we go to tertiary health institutions, because of shortage of funds, they look inward to generate additional revenue to plug short fall in their expenses and the implication is that they pass on a lot of expenses to poor patients. Don’t you think that this is contrary to the promise to offer affordable health?

    Well, let me assure you that good care and affordable care do not necessarily imply free care. There is nowhere in the manifesto of APC where we talked about free health care but what I can assure you is that when we say it is affordable, that means those who can afford will pay and then we pay for those who cannot. And that is why we are promoting health insurance, encouraging states to set up health or contributing scheme and we are also looking into setting up a National Health Insurance Commission that will make health insurance compulsory and universal in the country. When you have that, you will be able to put together resources to take care of health. Anywhere health is free, some people must be paying for it. In the United Kingdom (UK), the National Health Service depends on taxation. So what we are currently looking into in the context of Nigeria is how can we put resources together that will afford us the opportunity to take care of health? And one basic provision in the national health care is the prescription giving at least one per cent of the consolidated revenue fund to health to fund basic healthcare and that money will go straight to primary health care. For the first time the PHCs will get money direct from the federal. If we get that right, then this country has actually arrived at what we call a comfortable stage where we can deliver basic healthcare to our people. For now, we have not succeeded. We are talking to our colleagues in the Ministry of Budget and Planning and that of Finance and I have also approached Mr. President to ensure that we put the one per cent in it. We have assurances from the National Assembly that if the Executive contributes that one per cent, they will protect it. So we are quite optimistic that very soon we would have that one per cent. But pending the time that we would have the one per cent, we are doing what we call a scale-up project in three states: Abia, Niger and Osun where we would pilot basic healthcare provision fund, where money directly will flow from central to each of the PHCs. We would open account at the local facility and also engender ownership because the people must own it. We don’t want a situation where federal government will own the facility. It must belong to the people. We would then partner with the states to set up a state primary healthcare development board and a ward development committee so that the people can own the facility.

    The Chief medical Director (CMD) of University College Hospital (UCH), Ibadan, Prof. Temitope Alonge, recently suggested the idea that the federal government can make an arrangement for tertiary health institutions to adopt a number of PHCs within their locality to be able to mentor them since they have enough manpower and better facilities. Why can’t this happen?

    We are on the same page with the CMD. I have discussed with him how we can get this done. It is actually a two-phased process. The first thing is to partner with the state to also support their secondary facility. We have more than enough human resources in our teaching hospitals. For example, you get to Sokoto Teaching Hospital there are over 500 doctors there. But if you go to the state hospital, I am sure they have less than 100. Zamfara is a case in point with 122 doctors in the Federal Medical Centre in Gusau. But here are less than 24 doctors in the state hospitals. So, one of the things we are trying to build is a partnership between federal and the states so that they can oversee. In the example in Sokoto, the teaching hospital will also oversee the local government and if we do that, each of our teaching hospitals or medical centres will then supervise the PHCs and it will be good for them for training. It will be good in terms of supervision and we can ensure that the people get good healthcare. The federal system will also be strengthened because if a case cannot be managed at a PHC, that case will immediately leave the PHC. We expect that normal delivery should take place at PHC but if we have complications, hypertensions, convulsion, and baby lying across in the tummy, multiple pregnancy, baby coming by the buttock; those cases should moved to a higher level because we don’t want to risk the lives of women at that level.

    Sir, in medical practice generally or health sector generally, it is believed that prevention is actually better than cure. Do you think government is doing enough in running campaigns to help people embrace practices that prevent sickness?

    This is where we all got it wrong. Health is on the concurrent list. One of the things we want to do is change the perception that the federal government must do everything. That is where we got it wrong. Federal government took over everything; that was okay when we had enough resources. Now that we do not have enough resources we need to share the resources with the states. We are only in charge of policy. States must take care of the people in their states. We cannot have cholera in Kwara and say federal should come and look after them. No, that is the responsibility of Kwara State Government. Kwara must provide water for the citizens because water is what you need to prevent cholera and also ensure that we mange waste properly so that they will not defecate along streams that people will drink. What we are doing at the federal is to change the way and manner we allocate resources. Before we came on board, 80 per cent of the resources at federal level were into curative care. The first we have done now is to change the allocation to preventive care. If you look at the 2016/2017 budget, a large chunk of our capital allocation now is into preventive. We have also given approval for the National Centre for Disease Control that is out to work with states. The disease control centres have trained surveillance officers; these are disease detectives. We have posted them to all the states; we are working with the states so that if there is an outbreak we can quickly nip it in the bud.

    Before now we use to think that VVF is a thing that is restricted to the northern states but now we are talking of VVF in the Southwest and other places…

    There are many southerners who also share that wrong impression or perspective. When we flagged off the VVF repair at Wesley Hill Hospital Ilesa, Osun Sate, the Deputy Governor came and was shocked. In fact, I did not realize why she was asking for the name of the patient we operated on. In one week, we operated about 25 patients. And the Deputy Governor said what is your name? Where are you from? And they said Ikire, Lagos, Osogbo, she was shocked. She said I thought VVF was confined to the North and I said that VVF is all over Nigeria. But what we are doing now is to set up more VVF hospitals, train more people, increase awareness, actively campaign against child marriage and also promote ante-natal care and supervise delivery. Both must work together. If a girl of seven years old gets pregnant and is managed properly, that girl won’t develop VVF. So, we need to combine good care with advocacy and education.

      How would you rate the advocacy of VVF from your ministry so far?

    We are doing well and as I told you, we are not only working alone, we are working with states and we are being supported by the United States government. The USAID has a good programme to engender health working together to improve advocacy. We are working with the Ministry of Women Affairs to improve education of young girls, delay marriage and also make sure that where you get pregnant you go for ante-natal care and supervised delivery.

    As the Minister of Health, what is that one thing that will make you feel fulfilled if your ministry is able to push through today?

    The basic healthcare provision fund.

    What is it about?

    It is one per cent of the consolidated revenue funds going to PHCs because that is the only thing that will make the PHCs survive.

    What is your ministry doing to address this huge shortage of fund for tertiary health institutions?

    Well, I think we must look at the situation from two perspectives. The first thing is to move patients away from the tertiary and that’s why taking care of primary healthcare is good. When I trained in the UCH, you can’t just walk in to the UCH and say I have fever, cough. No. You must come with a referral. If you fail to come with a referral they will send you to the Out-patient Department where someone will see you and may send you back to state hospital or treat you there and say ‘Go away’ or ‘this is a complex case, go and see a consultant.’ When you do that, the consultants in UCH will have more time for those complex cases. There will be enough materials for them, and no one will complain. So that is why it is important to make sure the PHC and secondary healthcare are working. Secondly, we need to put more resources in the tertiary. No doubt about that. We need to upgrade the condition, make sure their water and electricity are efficient, upgrade their equipment and upgrade the skills of the health professionals working there. That is the only thing we can do correctly to stop people from going out and we can save a lot of money. We estimate that we can save up to $1 billion a year if we upgrade our tertiary care centres and government is committed to doing that. In our 2017 budget appropriation, we have money allocated for that strategic investment in tertiary hospitals. We are going to upgrade eight of our facilities – one in each geo-political zone, including the National Hospital, Abuja and LUTH.

     

  • Reducing inequality in healthcare system

    SIR: Inequality in healthcare in Nigeria can be defined as discrimination or imbalance in the medical care of individual citizens of Nigeria. It can also be defined as the unfair share of the medical provisions made available for Nigerian citizens through the Federal Ministry of Health and other department and agencies.

    Nigeria has experienced a great deal of inequality in the healthcare of its citizens whereby certain class of people especially the politicians in Nigeria will spend almost the annual budget of the health sector in medical treatment overseas whereas some people may not have access to the local or domestic medical treatment in the same country. This is as a result of practical application of the policy and system of governance adopted from the 7th commandment of George Orwell’s “Animal Farm” by majority of Nigerian leaders, administrators, executive and legislators manning the affairs of our country and health sector in particular. Thus recently, President Muhammadu Buhari spent more than 100 days in an undisclosed hospital in the United Kingdom whereas so many Nigerians with greater and worse health conditions are left unattended to in government hospitals and some have nobody to assist them to gain admission in the hospitals let alone being attended to by our medical practitioners.

    The Constitution of the Federal Republic of Nigeria 1999 (as amended), which is the grundnorm made provision in section 33 to protect the individual lives of its citizens. Basically, the right to life cannot be said to be complete if healthcare or equal access to medical treatment among citizens is undermined or relegated to the background. Thus, the challenges of the health sector are aptly described in the National Health Policy 2016 (pages xiii and xiv) respectively as follows: “…the Nigerian health system is weak and, hence, underperforming across all building blocks. Health system governance is weak. There is an almost total absence of financial risk protection and the health system is largely unresponsive. There is inequity in access to services due to variations in socioeconomic status and geographic location. For instance, 11% of births to uneducated mothers occur in health facilities while 91% of births to mothers with more than secondary education occurs in health facilities; 86% of mothers in urban areas receive Ante Natal Care (ANC) from skilled providers, compared to only 48% of mothers in rural areas; and ANC coverage in the North West is 41% compared to 91% in the South East. Other problems related to health services include: curative-bias of health services delivered at all levels; inefficiencies in the production of services; unaffordability of services provided by the private sector to the poor; limited availability of some services, including Voluntary Counselling and Testing(VCT), Prevention of Mother To Child Transmission(PMTCT) and Anti-Retroviral Therapy  ART; low confidence of the consumers in the services provided, especially in public health facilities; absence of a minimum package of health services; lack of proper coordination between the public and private sectors; and poor referral systems”.

    There is urgent need to strengthen the health sector in Nigeria through adequate provision, release and implementation of the annual budget to meet the medical need of every Nigerian and shun inequality in healthcare.

     

    • Gregory T. Okere Esq.

    Centre for Social Justice (CSJ), Abuja