PROTOCOL.
Your Excellency, permit me to congratulate you in advance as your administr.ation looks forward to marking one year in office. Your victory at the 2015 presidential pools is a testimony of the confidence Nigerians have in you that you can be trusted to lead us out of the doldrums especially at a time like now. We pray the Almighty Allah to guide and guard you throughout your stay in office to deliver those changes our nation needs so that Nigeria could be great again!.
The Nigerian Medical Association (NMA), as a body commends' and associates with your administration's spirited fight against corruption, insecurity and spirited efforts at revamping the economy. We pray that your dream of changing and repositioning our country from the list of nations with despicable socio-economicand health indices, to a position that engenders national pride and dignity.
The NMA acknowledges with great delight your undisguised commitment in associating with healthcare delivery since your assumption of office. You have led by example by publicly immunizing children even your own grand daughter, thereby publicly teaching and converting many in the public that immunization against child killer diseases is not harmful but life-saving. You have also been campaigning for donor assistance and partnerships to aid healthcare delivery in our country having hosted a number of world renowned donors, funding partners and international health agencies at the State House. We also note with great pleasure the prompt responsiveness of your government through the federal ministry of health against the current outbreak of Lassa fever, more especially with the proposal to increase the number of level 4 laboratories that could diagnose Lassa virus infection as well as other exotic infectious diseases.
We are deliqhted too about the plan to revitalize? 10,000 primary health care centres in the country by 2017.
Furthermore, that you've made a written commitment tolaunch the gazette of the National Health Act 2014 signifying the flag off ofthe implementation of the historic legislation receives NMA commendation.
Most recently sir, you listed healthcare delivery as one of the five strategic target areas for revamping our country's ailing economy. That realisation and your call on the NMA to partner with the federal ministry of health to sanitize the profession and the practice of medicine in Nigeria is not lost on us. The NMA promises not to fail you.
All the examples mentioned above represent a fitting illustration of the Political Will that shall underpine Health care delivery for Nigerians during your tenure. Thank you, sir.
Your Excellency, the health sector you inherited is one fraught with many challenges, which if tackled with focus and determination can maximize the great potentials for restoring the sector to become the pride of our nation:
These challenges range from inadequate funding and investments commensurate with needs of the sector; infra structural deficiencies; unreliable utilities such as power and potable water; poor governance of the sector due (until recently) to lack the enabling Law; absence of appropriate reward and sanctions mechanism; interprofessional disharmony and lack of trust between government and health workers leading to industrial disputes and strike action; and under-development of other social determinants of health including, potable water, decent housing, food security, public environmental sanitation, safe transportation, poverty, etc which could have promoted better health of the populace.
These have led to the poor health and other socio demographic indices, poor confidence in the sector leading to and a chaotic national health system; costly spate of foreign medical treatments (medical tourism).
Your Excellency, -as medical doctors, we are here to recommend practical solutions which if implemented, would enhance healthcare delivery outcome for all Nigerian:
THE NATIONAL HEALTH ACT 2014 The National Health Act 2014 is historic and provides Nigeria with a veritable and equitable platform to launch a truly National Health Service. Its implementation should not be delayed for whatever reason because Nigerians are keenly waiting to benefit from an integrated health system that guarantees that every citizen irrespective of where they live and work receive equivalent quality and safe health care. Full implementation ofthe Act shall give Nigerians a health service that is integrated and linked by effective two way referral from primary health care to secondary and then tertiary tiers of the system. At full operation, such a National Health system will save costs, save lives and assure quality.
UNIVERSAL HEALTH COVERAGE (UHC)
The greatest obstacle to unfettered access to health care for most Nigerians is inability to pay at the point of need.
By some reports up to 70% of the Nigerian population suffer lack of availability, accessibility and affordability of efficient healthcare services, especially when needed in life threateninq situations. In addition, up to 70% of medical services are still paid for by patients and families as out-of-pocket expenditure. The best antidote to this malady is social health insurance program. The NHIS was flagged off in 2005, but less than 10% of the populace have been captured under this scheme. NMA notes with great delight the news of your acceptance to publicly flag off the implementation of the National Health Act which provides for the establishment of a Basic Healthcare Provision Fund powered by not less than 1 % of the consolidated revenue fund and other sources, primarily directed towards the Provision of Basic Healthcare pakage for all Nigeria at primary care level.
The Nigerian Medical Association hereby recommends that you use your good offices to make Health Insurance mandatory for all Nigerians, direct the NHIS to achieve this in a given time period, using various mechanisms including Community based Health insurance program (CBSHIP), augmenting available funds through a Special Health Fund (similar to TETFUNO) from compulsory levy from the PROFIT of selected companies such as Oil and Gas, GSM, Air travel, manufacturers ofTobacco and Alcohol, ete. as a tool for actualising Universal Health Coverage in Nigeria. NMA is ready to provide further details of how and where this model has worked.
Your Excellency, without UHC it is impossible to achieve our nations vision and mission for Health for Nigerians which includes reducing maternal and child mortality, treat common illnesses, arrest infectious diseases before they escalate as epidemics, optimally manage chronic non communicable diseases, to improve family and social wellbeing of the people.
ENTRENCHING A HARMONIOUS INDUSTRIAL ENVIRONMENT IN THE HEALTH SECTOR:
Your Excellency, the NMA calls on you to order the immediate release and implementation of the White Paper on the Alhaji Mahmud Yayale Ahmed committee report on this subject matter.
The previous administration empaneled a wide array of eminent citizens- with track record of excellence in public service across various professional leanings chaired by Alh. Mahmud Yayale Ahmed to understudy the issues of contention and proffer solutions. The committee traveled round the country, and even outside the shores of Nigeria to the countries with efficient health sector, interact with relevant stakeholders, observe the health care delivery " environment and other necessary modalities before producing its Report. It is our patriotic conviction that the recommendations would go a long way in addressing the disharmony in the health sector.
EFFECTIVE REGULATORY FRAMEWORK FOR THE PRACTICE OF MEDICINE IN NIGERIA AND THE URGENT NEED TO RECONSTITUTE THE MEDICAL AND DENTAL COUNCIL OF NiGERIA (MDCN) BOARD.
Your Excellency no modern state operates its health sector without a Regulatory Medical and Dental Council full consitituted! It is a grievious anomaly to dissolve the Council and leave a void for even one day!.
The enabling Law of The MDCN as set up by law (Cap M8 at LFN), is explicit enough on the 4 year tenure of the board after inauquration.
With all sense of responsibility, The NMA most humbly appeals that the MOCN be reconstituted without further delay so as to continue the regulation of medical practice as enacted. It is only with a Council as properly constituted that NMA can legally carry out the assignment you gave us in fighting quackery and other unwholesome practices.
The same prayer goes for other Boards of Regulatory Agencies in the Health sector In all countries, Doctors, Dentists and all other health workers are regulated by their Councils without interruption in the interest of the Public.
2016 BUDGETARY ALLOCATION TO HEALTH, PRIMARY HEALTH CARE ADMINISTRATION & FREQUENT DISEASE OUTBREAKS INCLUDING LASSA FEVER & others:
Your Excellency, the NMA applauds your Administration's commitment to prudent and transparent utilization of the funds available to the Federation. However, the facts remain that Global reports from WHO, UNICEF and others have it that Nigeria accounts for 2% of the world population but contributes 10% of global maternal and child deaths. Nigeria ranks third in the HIV / AIDS scale after India arid South Africa. Nigeria is 187 out of 191 countries in the Global Human development Index. None of these appalling statistics can be reversed without adequate resources for Health. Proportionately, the Health sector deserves sustained and adequate allocation in the budget.
Therefore, without prejudice to the current drop in federation revenue, the allocation of 3.65% in the 2016 Appropriation is significantly less than the 15% minimum agreed by African Heads of State and Government in the 2001 Abuja Declaration of African Heads of State and Government. The NMA seeks that your administration takes the facts into serious consideration in subsequent budgets and commit to year to year increase of allocation to the health sector, if Nigeria is not to continue to suffer the effects ofa failing health system. A health nation becomes socio-economically and militarily strong.
OTHER OUTSTANDING ISSUES IN THE REMUNERATION OF DOCTORS·SKIPPING ALLOWANCE.
Mr President, please permit us to bring to your attention for clear and effective solutions:
NMA notes with great delight the news of your acceptance to publicly flag off the implementation of the National Health Act which provides for the establishment of a Basic Healthcare Provision Fund powered by not less than 1 % of the consolidated revenue fund and other sources, primarily directed towa rds the provision of basic healthcare package for all Nigerians at primary care level On "Skippinglf came into existence in 1998, after harmonization of salary and emoluments, excluding only Medical Doctors in the entire health sector. The NMA pleads. that you direct the Budget Office of the Federation (BOF) and FMOH to comply with the Head of Civil Service of the Federation (HOCSF) circular on skipping for medical doctors and that enough fund is provided for personnel emoluments to capture this allowance in the budget.
In 2012, National Industrial Court gave a judgement that skipping of CONHESS/CONTISS 10(GL 12) should I continue. This led to the release of circular no. HCSF/EPOI EIR/63755/T1/192 of 4th of November 2013. However, another circular no. HCSF IEPO/EIR/637551T1/195 of 19th of December 2013 was released by the HOCSF which extended skipping ofCONHEgS 10 (CONMES'S 2) to medical doctors after signing a collective bargaining agreement with the Federal Government. It is a fact that the Nigerian Medical Association accepted the position of government through circular no. (2262/t/111 DATED 29TH July 2015 that uninterrupted implementation would commence for medical doctors as from January, 2016 laterally as it was done for other health workers. Based on this, NMA through her Committee on Doctors' Remunerations calculated the cost implication and submitted to the Budget Office of the Federation and the Federal Ministry of Health to guide budgetary propositions for federal I tertiary institutions hospitals. It beats our i magination , then that the breakdown of the budget of the FMoH did not capture it.
UNIVERSAL APPLICABILITY OF CIRCULARS ON DOCTORS' WELFARE.
One of the strongest factors contributing to the skewed distribution of human health manpower in the country today is the unattractiveness of rural practice leading to drifting of health care workers to urban centres especially to the federal health institutions. This scenario is internal brain drain, leaves the state and local government-owned health facilities under-staffed, ill equipped and erratic power.
NMA has identified that it is only the adoption and implementation of similar or even better conditions of service at all the tiers of healthcare delivery- by both state and local governments that could revise the tide.
This is obtainable in the security agencies- armed forces, police, civil defence; judiciary and even with political office holders despite the yawning difference in the finances of the different states. We strongly believe that I your grand paternal influence and impeccable reputation could and would assist in bringing this to bear through the various modalities including intervention of the National Economic Council, Governors' forum and more especially with constitutional amendment.
COORDINATION OF PUBLIC HEALTH EMERGENCIES AND THE RE-ESTABLISHMENT OF THE OFFICE OF THE I SURGEON GENERAU CHIEF MEDICAL OFFICER OF NIGERIA.
The office of Surgeon General or Chief Medical Officer of Health was in existence before independence and shortly after. The NMA calls on Your Excellency to appoint a Chief Medical Officer of the Federation.
Experience from the recent public health emergencies in the recent past have shown the indispensability of a central coordinating authority empowered by law and equipped with knowledge and resources to mobilise the nation in a coordinated response to disease outbreaks. The statutes establishing this office is explicit enough on the roles assigned to it. We hereby make a passionate appeal to you sir to reconsider the re-establishment of this office that also exists in the countries that Nigerians patronise for overseas medical treatment. The return In these other countries, the offices of the minster/secretary of health exist. With proper delineation of roles, there would be no conflicts.
INCENTIVISING HEALTHCARE INVESTMENTS IN NIGERIA: IMPLEMENTATION OF INNOVATIVE FINANCING OPTIONS IN THE PUBLIC HEALTH SECTOR.
NMA agrees that government in the presence of existing realities cannot singlehandedly fund the health sector.
This reality led the nation to adopt the options of targeted public private Partnerships (ppn concessioning and out sourcing of some services in order to promote efficiency availability and effectiveness while preventing job losses and protecting the citizens from being ripped off by the investors. We- encourage this government not to look back in implementing targeted PPP options in order to attract investments in the sector. NMA notes with pride that the largest sectoral growth in the Nigerian economy with declining oil revenue according to the National Bureau of Statistics is in the health sector. With a ready market guaranteed by a huge population of 170 million people, fast tracking NHIS reforms with the entrenchment of compulsory social health insurance program would We have also brought campaign advocacy materials to be used during our AGC/DM in Sokoto later this month for your kind blessing. We request you to and them out promote investments in healthcare infrastructure and ensure that no matter how remote, every part of the country would be equitably supported with health services. This is a potential booming market which could surpass the gains countries like India has made in relation to contributions of the health sector to their GDP if well harnessed. Incentives like simplifying the acquisition of land titles, waving of duties on medical appliances, guaranteeing investment security and provision of interest free or even single digit credits as has been done in agriculture (rice, cocoa, cassava, sorghum, poultry, etc), Aviation, Energy, Banking and Solid mineral sectors are what we a re asking for. Your Excellency, Nigeria under your watch can afford to grant this to the health sector. Africa is waiting for this market to explode which will surpass oil boom. This is the reason. we conjecture, why you said healthcare delivery is one of the five few sectors with the potentials of a quick-win investment returns that could lead to the recovery of Nigeria's economy in the nearest future. Let's take the chance and do the needful.
WORLD HEALTH DAY 2016 : ITS MESSAGE AND IMPLICATIONS
Today, April 7, is marked globally as the world health day set aside by the WHO to use the occasion of the anniversary offounding ofthe WHO to raise awareness of health issues of global concern. The theme for this year is Diabetes- Halt the rise.
Please, graciously permit me sir, the NMA came here with some equipment to check the blood glucose level of officers of state here present in order to demonstrate the spirit of the Theme: Halt the rise of Diabetes through health promotion.
We have also brought campaign advocacy materials to be used during our AGC/DM in Sokoto later this month for your kind blessing. We request you to nand them out to members of the Federal Executive CounCil as the no. health worker/promoter in Nigeria.
Finally, we appeal in this regard for your administration to adopt a national consciousness day for health awareness and medical check-ups in which the ideals of healthy living including healthy nutrition, regular physical exercises, good environmental sanitation and personal hygiene practices, campaign for drug abuse, etc, would be re-enforced in the polity.
APPRECIATION'
Mr President, Sir, we can't appreciate you enough for the confidence you reposed on the medical profession by appointing four of her members into your cabinet. It is our prayer that they shall, all, deliver on their respective assignments.
We also appreciate YQu for granting us audience at such a time when every sector of the country is demanding your attention. While eagerly waiting for the unveiling of the Change agenda in the Health Sector, please consider us as your loyal partners in the arduous task of rebuilding Nigeria, Here are we; send us, use us! God willing, Nigeria will be great again under your leadership.
Long live Federal Republic of Nigeria.
Thank you.
Signed:
DR. KAYODE OBEMBE
President,
Nigerian Medical Association.
ABUJA: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
PORTHARCOURT: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
LAGOS: Training Schedule for Basic Life Support BLS, Pediatric Advanced Life Support (PALS), Advanced Cardiovascular Life Support ACLS, First Aid, CPR, AED
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