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Nigeria at 50: Milestones in healthcare

By Sola Ogundipe, Chioma Obinna, Victoria Ojeme & Rosemary Duru
First description of Lassa fever – as an acute viral haemorrhagic fever was  in 1969 in the town of Lassa, in Borno State.

• Eradication of smallpox in 1970 in line with the rest of the world.

• Establishment of health policy with Federal charater by Nigerian Constitution which prescribes responsibility for three tiers of Government on Health Care services.

•  Marked improvement in diagnosis and treatment of non-communicable disorders (NCDs)

• Development of a mechanism of drug production, procurement and distribution and remarkable improvement in regulation of food, drugs and other regulated products through the National Agency for Food & Drug Administration and Control (NAFDAC) set up by Decree No. 15 of 1993)

•  Former Minister of Health Prof. Olikoye Ransome Kuti enabled official acceptance of Policy document on Primary Health Care  by FG in 1988

• Establishment of the  National Primary Healthcare Development Agency (NPHCDA) in 1992 to support the Primary Healthcare level of care.

• Federal Government is responsible for Tertiary Health Institutions such as Federal Medical Centres and University Teaching Hospitals which serve as referrals.

• Realisation of the  National Health Insurance Scheme (NHIS). This is a programme that enables civil servants to access Healthcare services in easily through identified Health Care Providers

• Setting up of NIPRID, NIMR, FIRRO and other research centres and institutes that are concentrating on better ways of managing diseases and promoting healthcare

• Development of Niprisan for management of sickle cell disease

• Pioneering discovery of anti-snake venom from  local sources

•  Establishment of a National Tertiary Healthcare Commission and national Startegic Health Development Plan

• Federal government  supported initiative to  State governments in providing free antenatal care  free treatment to children less than five years through the NHIS.

• Introduction of Midwife Service Scheme in pursuit of attainment of owards achieving health related Millennium Development Goals. Through the  scheme Federal Government employs midwives, trains them and posts them to the rural areas to assist in handling pregnant women and providing skilled care to women in labour.

•  Initiation of a national malaria control programme which facilitates purchase and distribution of insecticide treated nets, provides ACT for treatment

• Engagement of traditional rulers to successfully aid fight against polio, and facilitate reduction of polio cases  by over 99 percent interruption of the wild polio virus

• Widespread acknowledgement of this landmark achievement.

• Notable pesonalities including Mr Bill Gates of the Bill & Melinda Gates Foundation; Dr. Bruce Alywald of the WHO Polio Eradication Initiative (PEI) and  WHO Regional Director, Dr. Margaret Chan.

• Modernisation and upgrading of nine Federal  Tertiary Health institutions  through VAMED Project with state-of- the–art facilities

• Recorded zero case of  guinea worm for the last 20months – a feat which puts the nation on the path of certification as a guineaworm free nation by WHO if the zero case status is sustained for 36 months

• Increased attention to cancer control. through partnering with Nollywood to create awareness and offer of free cancer screening to women.

Also modern equipments are available at our Tertiary Health facilities to treat cancer patient

• Integration of maternal and and newborn child health strategy (IMNCH)

• Establishment of a National Blood Transfusion Service

• Setting up of an effective HIV & AIDS Control Agency

We are below the UN standard, says Dr. Chukwunweike Ojeh

Talking about how we have fared, I would not know how to start. In terms of what we have achieved and using the United Nations standard, we are very much below par.  What the health budget is in Nigeria is nothing to right home about. When the UN said every nation should allocate 15 percent of its annual budget to health, Nigeria is allocating 5 percent. How can we expect much with one third of the expected budget and the issue of brain drain, every now and then, strike for the well fare of those working in the health sector.

We’ve not done badly, but…, says Dr. Olurotimi Akanbi Olojede,National President-elect, Nigeria Dental Association (NDA)

• Success in halting the spread of the wild polio virus through immunisation is one of the significant milestones in Nigeria’s health history since independence.

The health sector has done so well even though it could be better and for that, I want to appeal to all authorities concern to ensure that the maximise their resources no matter how little to the barest minium, that would indeed, increase and elevate and make our health sector to be what it ought to be.

Rome was not built in a day. I wouldn’t expect to get all the advancements and all that we need to get there in a day.  But if each government had done its bit, by now we should be far ahead by now.

We need to sit up and put things in the right perspective, so that the dividends of democracy would be felt among the Nigerian public.

Nigeria has not fared well, says TEMIYE
*Dr. Edamisan Temiye, Chairman Nigerian Medical Association, Lagos State branch

Nigeria has not fared very well as regards the healthcare delivery system in the country in the past 50 years. At  independence, there was a lot of hope for  as regards healthcare delivery.  We started having teaching hospitals and at that time, government was voting money for specialist training. Today no money is voted for specialist training again. This is creating problem.

At that time, the University College Hospital (UCH), Ibadan, was one of the best hospitals in the world.Today if you list 2,000 hospitals in the world, you will not find one in Nigeria. We have depreciated terribly. Most doctors trained here are now outside the country.

In terms of healthcare indices, we have moved away from the expected to a far low level. Our mortality rate is between 90-100 per ,1000 births. Today, we still have cholera outbreak in Nigeria. in many countries they only read about tetanus but in Nigeria babies are still suffering from tetanus and dying from it.

Nigeria is today one of the five countries that are still being ravaged by polio. To me, the reason for all these is because we have have government that has never taken  healthcare serious, rather they want people to take care of their health themselves. I can tell you  government has no health programme.  There is no primary healthcare in Nigeria. The system has been completely destroyed. No local government in this country has a health plan and primary healthcare that is the pivot has collapsed.

If a child develops cancer today, that child would most likely die because there is no plan by government to take care of the disorder. How many people can afford N3-5 million to treat cancer in their children? But in many  other countries treatment for cancer is free. Children under 18 years get free  health treatment. The way forward is  political reorientation. People should be made to hold political position with trust.

Kufeji calls for change in medical education

To meet the challenges of advancement  in health care delivery globally, President of the National Postgraduate Medical College of Nigeria, Dr. Leonard Idowu Kufeji has called for a paradigm shift in the country’s medical education, saying as medical education should change as knowledge base changes

Speaking during the 2010 Train- The-Trainers’ workshop  last week in Lagos Kufeji said “Ideally,  medical education should change as knowledge base changes and as perceived needs of patients, medical practitioners, society and new disease change.”

He said it is time trainers in the various medical schools in Nigeria set an enviable standard for trainees to ensure that Nigerian doctors have very good overall standards of practice to be able to define good clinical care, make explicit expectations about clinical judgement and patent’s rights to be treated even if they post a risk to the doctor amongst others.

Kufeji stated that trainers and trainees should maintain good medical practice and performance, set out conditions for good relationship with patients in the areas of consent, trust and confidentiality.

“We have 37 teaching hospitals and there is obviously no uniformity in the works of these directors/chairmen, residency training. We have evaluated what had been on ground and found the need to review our methods of training. Medical educator have professional and ethical obligation to meet the needs of their learners, patients and society and they should be held accountable for the outcome of their interventions.”

He explained that the workshop which was attended by over 350 medical professionals from all fields was to deliberate on new modern methods of training and examination.

“We want to highlight what we expect from the trainers in the areas of assessing research proposals, assessing the residents amongst others. All these affect the quality of training and the products of the college. We need to examine areas of the college is in marketing its products, responding to inquiries, amongst others.”

Continuing, the president who stressed the need for continuing medical education for fellows and indeed for different levels of doctors in the private and public sector noted that the public need to be confident that award of fellowship indicates that a fellow has completed training to a satisfactory and programmed standard.

The profession has the duty to ensure that each specialities’s portfolio contains unequivocal evidence of this and t develop training structure that supports the doctor in completing his or her training. we should therefore not allow extraneous factors to influence the training programme.”

Stillbirth coverage still low, says NPHCDA

The National Primary Health Care Development Agency has directed all  Chief Medical Directors in the States to hand over official ambulances to appropriate channels for hospital usage, even as Director,  Primary Health Care System Development, Dr. Mohammed Abdullahi noted during a two weeks training at Gwagwalada Teaching Hospital, Abuja, that stillbirth coverage is low in the country.

Abdullahi said  Federal government is determined to continue with positive movement to improve the survival of women and children in order to safeguard the human capital of Nigeria. “We have noticed that still birth is still very low in the country and we need to seriously do something about it, we have also sent some ambulances to some States not just that but we have also hard that most of this ambulances are been use by the chief medical directors in the states.

He saidover 2800 midwives have been deployed to various general primary health care centres  in the States and we are also calling on doctors and midwives to join hands in making maternal and mortality rate a success “All hands must be on deck to ensure maternal survival is maximized in our country we are committed to doing that.”


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