The need to restore confidence and hope in the healthcare system while focusing on other key areas within the sector, is at the front burner of the Lagos State government policy.

In a chat with Chioma Obinna, the Commissioner of Health, Dr. Jide  Idris who is staging a comeback, deliberated on the four cardinal points of his tenure.

Among these are revitalisation of Primary Health Care, institution of a quality care at all levels, healthcare financing and shortage of human resources.

Idris asserted that building a strong health system that would ensure better referral would help achieve the primary goals of ensuring that every Lagosian has access to unfettered healthcare in the state.

Excerpts:

In every health system, behaviour has remained a major problem and if you are able to change behaviour it will definitely reduce the frequency of visits to hospitals.

In the past the ministry had carried out projects and programmes to address these issues.   We have done all these including free health missions to take care of the health needs of Lagosians who cannot afford to pay for their health needs.

This time around, we are going to address key areas that essential for any popular health system Some of these areas include; Primary Healthcare, healthcare financing, quality of care and human resources.

• Dr. Jide Idris

We will also address the issue of behaviour, the issue of behaviour in terms of the people themselves who are the beneficiaries of the health services and the people providing services. It is a two way thing.

Again, anybody who believes that once you set up hospitals that is the end of health sector, it is wrong because the truth is that clinical care only caters for 20-25 percent in the health sector and if you look at the health sector globally, there are other areas of health sector we have to address for us to have a holistic view of the system.

If only 20 per cent population is addressed in the hospitals, a huge population is left out. But if you change behaviour,  if you change the environment of where they live, then you will impact positively on their health, therefore reducing the chances of people going to the hospitals.

Primary Health Care

Primary heath care is the bedrock of any health system. It is the first point of contact to people in any health system. It is closet to the people.

Over the years, it is has been the sole responsibility of the local government.  There are number of things that are necessary to be handled at that level.  But because that level is not being adequately addressed, we are beginning to see the effect at that tertiary an secondary levels.

People who ordinary should not visit the tertiary and secondary are doing so now. This is not largely their fault because people can only visit anywhere they feel they will get service and that is why our General and Teaching hospitals are overwhelmed by people.

This is the major reason why we have made it as on one of the things we are going to address vigorously this time around.

To address primary health care issues, we are establishing flagship Primary Healthcare Centre (PHCs) in each local government in the state. Each of the PHCs will have a doctor, nurse, pharmacists and other professionals.

The centres are also expected to work 24 hours. These centres will also boast referral system in the state. If we have all that ready and functioning, we will have the moral justification to tell people that you will not be seen in any of the tertiary health institutions without a proper referral.

We are also trying to ensure that we put in place proper referral system. With this in place, the burden will be less on these hospitals and the professionals at these institution will have time to do things that they were trained to do.

For instance, you can imagine a Cardiologist in LASUTH who should deal with the heart in a much higher level attending to  to malaria and pneumonia cases. You are wasting his time and talents and at the end of the day we are not getting value for money.

A lot of cases we treat there are not supposed to be treated there. It should be sub-speciality care but malaria cases are seen there. A doctor in Lagos state is seeing three times the patients a doctor in otherstates are seeing.

Primary health care is our major priority. We need to address the problems properly. If we don’t address the issue of primary health care, will continue to encounter these problems at the tertiary level and secondary levels

Health Financing

Financing basically covers areas like; what are the resources, how do you raise resources, what do you use those resources for or how efficiently are you going to use the resources.  One of the goals of the Lagos State gogernment is to assure access to health for all.

Every Lagosian must have unfettered access to healthcare. Barriers in the form of poor health facilities, though high in numbers but are not properly equipped, they may not be adequate which is the situation right now.

That is a physical barrier. Barriers can also be geographical and financial. If the people don’t have what it takes to pay for health, it is a major cause of poverty and unfortunately, from a research work we have done,  over 50 to 70 percent of people pay out of pocket.

Majority of the patients are people who do not have money. Paying out of pocket has been found as a major problem in this environment. Most countries that have made progress have structures to reduce the out of pocket payments. We must be able to protect the poor and the vulnerable and this is where health financing comes in.

Health Insurance

We need to fashion out our own health insurancesystem to reflect to our environment. Unfortunately we have shortage of human resources. It is not peculiar to Nigeria. And because of our population, Lagos State in particular, we are having an unfair share of the burden.

If you are going to provide health to a population of over 18 million people there must be adequacy in number and for you to have quality, certain issues have to be taken care of. The welfare issues of health workforce must be taken care of.

Quality care

If you have done all these things and if the people are not satisfied, you will have problems.  Quality of care has different dimensions. The quality of infrastructure, services and equipment also reflection of quality. The people who work there, their attitude is also a reflection of quality.

We also going to change attitudes. Attitude is not something you can do over night. People in the health sector need to be reoriented. Human resource is a major issue

. We are aware of them and it is something we have discussed on all levels. It is a conscious effort. Sometimes these attitudes could be as a result of pressure of work. This is why we must address the issue of shortage of human resource.

 External monitors

Apart from putting in place external monitors, what we are trying to put in place is that each hospital must have a monitoring unit to address the quality of care. We are also going to form other bodies to take up issues concerning negligence and others.

Emergency response:We are going to provide all the necessary things to ensure that the lives of patients are saved. That is why we have invested enough resources to the train of personnel and this is why we procured all the ambulances and right now we are expecting delivery of more ambulances and we are also going to train the people that are going to be man them We are working towards expanding the programme.

we going to build another emergency centres at Badagry and one around Lekki corridor. We are also purchasing more ambulances in other to take more people.

Industrial peace

Without industrial peace, you will achieve nothing. We have establish some degree of harmony and rapour which we tend to sustain. In the last one or two weeks we have held meetings with doctors and nurses.

We are also planning to hold meetings with other categories of health workers and after that we are going to bring all of them together to form harmony within them.

Disharmony among healthcare workers have been a very serious problem in the sector. If they can’t form harmony among themselves their won’t be peace.  We will be engaging ourselves constantly to nip any problem in the bud.