It has become a ritual to welcome every new-year with exciting celebrations. Of course, partakers of the cultural/ religious event are those healthy enough to scale through the hurdles of the previous and out gone year.
People with failing health merely breeze through the celebration without really feeling that they are part of it as other things weigh heavily on their minds.
Against the background of high hospital bills facing most patients and increased cost of medications occasioned by the current recession, there are fears that these will further weigh heavily on those seeking care in the prevailing year 2017 and may dash their hope to attain good health.
Highlighting some of the issues that bedeviled the health sector during previous years, some stakeholders listed them as poor health budgets, non-implementation of the 2014 National Health Act, NHA, the lack of expansion of the National Health Insurance Scheme, NHIS, to cover more Nigerians, the non-actualisation of the Universal Health Coverage, UHC, which is recommended by the World Health Organisation, WHO, as a strategy to bring care closer to the door steps of global communities, lack of strengthening of Primary Health Care, PHC, system, poor disease surveillance system, which is driving the emergence/ re-emergence of new infectious diseases, among others.
According to the stakeholders, many of the problems that rocked the health sector in the past years are largely blamed on these factors which they advocate must be effectively addressed to improve the worsening health indices of the country.
Poor budget
Giving an insight into how persistent poor health budget have become the bedrock of problems in the health sector, Vice President of Commonwealth Medical Association, CMA, Dr. Osahon Enabulele lamented that the 4.16 per cent voted for health in the 2017 Budget “is a far cry from where we were coming from”.
The previous administration under President Goodluck Jonathan voted 3. 6 per cent for health in the 2016 Budget. Enabulele who was a former President of the Nigeria Medical Association, NMA, said the ruling party, the All Progressives Congress, APC, had promised Nigerians that it would earmark 15 per cent of Budget to health but has failed to do that.
“There is no excuse for failing to do that because anybody that aspires to come into office must have known what was on ground.
“Even if the Federal Govern ment cannot meet the 15 per cent target, it should meet some commendable milestone,” he noted.
Besides, Enabulele observed, “that the 2017 Health Budget does not incorporate the basic health care consolidated fund that is expected to be sourced from the National Health Act, NHA, is not inspiring because this is not the promise made by the ruling government.”
As provided for in Section 10 of the National Health Act, 2014, one per cent of consolidated revenue should be allocated to health.
However, going by the reality, he noted: “There is no excuse whatsoever that in two budget circles – 2016 and 2017, we are not going to see any form of additional funding from the consolidated revenue as provided for in the NHA.”
Again, Health care services, especially primary health care services, PHC, are again missing in the 2017 Budget, Enabulele lamented.
Speaking further, he urged Nigerians to take government to account on these in term of its inability to give expressions to its own obligations to Nigerians.”
However, the vice president of the CMA, said the Federal Government has more major obligations on this issue of financial requirement to boost the health care sector and access for Nigerians especially in rural communities.
Hence, Enabulele challenged the government to be sincere, forthright and forthcoming in terms of its plans to ensure the provision of the one per cent of consolidated revenue to advance health care in the country.
Polio
With the current successes recorded in the war against terrorism in Borno State and its environs by the Federal Government, it is expected that there would be re-stabilisation of health care facilities in those communities that would guarantee improved access to immunisation services, Enabulele reasoned, adding, “With all these in place we can get back on track towards de-listing Nigeria from polio endemic countries.
This means that the three tiers of government have to invest massively in immunisation.” He said a situation where foreign donors were still subsidising polio eradication for Nigeria was unacceptable.
“Nigeria should get to that level where we should produce our vaccines in order to eliminate most vaccine-preventable diseases.” Corroborating the views of En-abulele, a Fellow of the Pharmaceutical Society of Nigeria, PSN, and the Programme Director (Strategy), PSN/ Partnership For Advocacy in Child and Family Health (PACFaH) Project, Remi Adeseun said the Federal Government should have a clear strategy to source local funding for immunisation activities.
He reasoned that manufacturing vaccines and other health care products were national security issues.
Furthermore, Adeseun noted: “If we quarrel with America or Europe and health products were restricted from coming into Nigeria, we will all be in trouble.”
Non implementation of agreements
So many agreements have been signed in the health sector since 2009 but have not been implemented.
Delayed implementations are causing many agitations, according to some stakeholders. Some unimplemented agreements include Adjusted Consolidated Health Salary Structure for Health Care Professionals, a court judgment that favours the payment of specialist allowance to health workers, the appointment of some health workers that are qualified for consultancy status, the elongation of working service to 65 years as it has been done for universities and polytechnics, an agreement to implement Skipping Policy for medical and dental practitioners, among others.
Reacting, Enabulele asserted that the way forward was for government to play its own part by implementing whatever was collectively agreed with particular unions/associations.
“Government having signed an agreement with whosoever person or organisation should be willing to play its own part while the other side should also be willing to play their own part,” he said.
Highlighting another factor that could pave way for quality health care provision, immediate past Chairman of the Association of General Private Medical Practitioners of Nigeria, AGPMPN, Lagos State Branch, Dr. Adeyeye Arigbabuwo said the immediate implementation of the NHA should be a priority.
It will be recalled that the NHA was passed into law in 2014, and has since been in limbo. However, Arigbabuwo asserted that implementing the NHA would go with the Universal Health Coverage, UHC, and the National Health Insurance Scheme, NHIS.
The goal of UHC is to ensure that all people obtain the health services they need without suffering financial hardship when paying for them.
The UHC is a strategy of the World Health Organisation, WHO, to ensure access to health care for global communities.
On the issue of unpaid salaries, a major problem behind persistent strikes in the health sector, National President, Nigerian Union of Allied Health Professionals, NUAHP, Comrade (Dr.) Obinna Ogbonna who is also the National Vice-Chairman, Joint Health Sector Unions, JOHESU presented the background of the situation.
He said some federal hospitals were yet to pay several months of salaries. According to him, staff of the “University College Hospital, UCH, Ibadan have not received their November and December salaries and employees of the Iruah Specialist Hospital in Edo State have similarly not received salaries since September up till date.”
Others facilities affected by unpaid salaries are the National Orthopaedic Hospital Dala, Kano State involving October, November and December 2016 salaries; the Jos University Teaching Hospital, JUTH, (November and December 2016 salaries) and the Federal Medical Centre in Owerri, (October, November and December 2016 salaries).
Ogbonna therefore urged President Muhammadu Buhari to release some money to settle these salaries by early January so as to prevent new spate of strikes that could result.
In his reaction, a Professor of Community Medicine and Public Health at the College of Medicine, University of Lagos, CMUL, and Vice Chairman, Association of Public Health Physicians of Nigeria, Bayo Onajole called for the strengthening of the Primary Health Care, PHC, system, because it is the entry point into the health system.
According to him, the control of locally endemic diseases like Lassa and Dengue fevers as well as the Zika virus were critical.
Data issued by the Nigeria Centre for Disease Control, NCDC, shows that between 2015 and 2016, Nigeria recorded one of the largest outbreaks of Lassa fever in its history- reporting 273 cases, including 149 deaths.
Of these, 165 cases and 89 deaths have been confirmed through laboratory testing. The cases were reported from 23 states in Nigeria.
However, Onajole stressed, “We need to strengthen our disease surveillance and notification system so that we can nip in the bud most of these epidemics that are coming up.
We also need to look at environmental pollution as it will further strengthen the health system.” Onajole explained that pollution is a problem.
“We have pollution of the air, the soil, and that of the water system due to indiscriminate disposals of waste. Another area of health care that needs attention is the management of cancers.
Cancer rates could further increase by 50 per cent to 15 million new cases in the year 2020, according to the World Cancer Report.
However, the report also provides clear evidence that healthy lifestyles and public health action by governments and health practitioners could stem this trend, and prevent as many as one third of cancers worldwide. Nigeria records 100,000 new cancer cases yearly.
On what should be done to achieve effective control of cancers, a Professor of Radiation therapy and Chairman, National Consultative Committee on Cancer Control in Nigeria, Francis Abayomi Durosinmi-Etti recommended that emphasis must be placed on cancer prevention “Prevention is cheaper and better than focusing on treatment,” he added. Similarly, he urged every Nigerian to encourage early cancer diagnosis.
“Affected persons must report early to ensure early diagnosis,” he stressed. Furthermore, Durosinmi-Etti urged cancer treatment facilities to provide needed equipment and materials to make proper diagnosis especially for common cancers.
Although, breast cancers are a common cancer in this environment, there are many variants, he noted and reasoned that facilities must install treatment equipment that will determine the type of cancer and treatment protocol to adopt.
Although, an estimate by the international Atomic Energy Agency, IAEA, suggests that Nigeria requires 200 cancer treatment facilities, available machines are about 20 only.
To this end, the Professor of Radiation Therapy called for increase in the number of radiotherapy centres in the country, while calling for the involvement of public private partnership to boost treatment equipment.
“Government alone cannot do it,” he added. Furthermore, Durosinmi-Etti called for the training of staff on modern cancer treatment techniques as well as the establishment of a task to oversee cancer equipment in various centres.
“Members of the task force can monitor cancer treatment centres and do preventive maintenance,” he added.
By: Appolonia Adeyemi
The Newtelegraph News
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