Recently, the European Union (EU) signed an agreement with UNICEF that will bring sustainable and integrated water supply and sanitation as well as hygiene promotion to 200,000 people in rural communities in selected states and local governments.
The EU’s investment of 9 million Euros (1.9 billion naira), which will be funded under the Support to Reforming Institutions Programme, is to stimulate accountability and transparency in State and Local Government Area (LGAs) budgeting processes in six states: Anambra, Osun, Cross River, Kano, Jigawa and Yobe. UNICEF will implement the programme over the next two (2) years.
Speaking at the occasion, David MacRae, Ambassador/Head of the EU Delegation to Nigeria said “We at the EU believe that the provision of water and sanitation and the promotion of hygiene are essential public services. They protect populations from diseases that particularly affect children, including cholera and diarrhoea, and they help contain malaria. We will be pleased to support the state and local governments that are leaders in this area.”
The first phase of the agreement is for a public expenditure management and financial accountability review in the six states to assess their public finance management; the extent of their investment in water, sanitation and hygiene so far; and the activities required to bring water and sanitation to rural areas.
Only states and local governments that the review shows to have committed to and made progress on reform, particularly in public finance management, will win EU investments in the second phase. The second phase will comprise a series of activities in the selected local governments and states, including mobilizing schools, communities and local governments to develop community action plans for promoting sanitation and hygiene; building the capacity of communities and local governments for delivering sustainable water and sanitation services; establishing community-based water, sanitation and hygiene models in rural communities, including increasing access to improved source of water for about 200,000 rural people; raising awareness and visibility of accountability and transparency practices that contribute to good governance in the water and sanitation sector; strengthening monitoring and evaluation systems at community, local government and state levels.
For Suomi Sakai, Representative of UNICEF in Nigeria, “We are proud to partner with the EU on this innovative programme. Communities and governments that provide sanitation and safe water can promote good hygiene as well - save lives, particularly of children.”
Wednesday, October 20, 2010
Lagosians groan as hospital remains shut for over two months
…as Nigerians call for dialogue to resolve the impasse
Lagosians who think they will soon access medical care from any Lagos state owned hospital may have to wait longer as the payment of the Consolidated Medical Salary and Professional Allowance (CONMESS) by the Federal Government to doctors working in federal health institutions have caused ripples in the health sector as doctors under the employ of the state government have vowed to continue its 9 weeks old industrial strike over the non- payment of the CONMESS.
To any individual following the development, the industrial strike which began from August 12 2010 till date has no doubt brought untold hardship and misery to Lagosians thus leaving the clinics and wards of the state owned hospitals open with no doctor attending to any patient. Interestingly, most private hospitals, of which one may not be able to guarantee its operational ability, have now become the last resort of most people who believe are reaping the gains of the current strike action by charging exorbitant fees for medical care.
A visit to Lagos University Teaching Hospital (LUTH), the only functional health institution, within the last 2 weeks has witnessed large number of patients awaiting medical attention. Most wards like the Accident and Emergency session, Radiography, Olikoye Ransome Children Emergency Centre, to name but a few are filled to the bream with little or no space to admit more patients. Already, the hospital management expressed fears that the large number of people waiting for treatment might lead to the outbreak of an epidemic. However, this situation has also increased the hours patients have to wait before been attended to by a physician.
Lamenting his ordeal to BusinessDay, Ebele Enuani, a patient at LUTH said he had to wait for over an hour before doing his x-ray examination due to the large number of people waiting to be examined. He stated that this is has placed much pressure on facilities at the hospital as patients wait endlessly to be attended to.
“I can’t be able to afford the huge bills which private hospitals are currently charging. They are already making some fortune from the strike. Currently, I have to bear with the situation; it’s just that I have to wait for long hours and this is frustrating.”
For Amaka Okoye, she had to spend over three hours before she could do two medical tests and collect her drugs at LUTH. The same cannot be said of Taiwo Okundayo who lost the father due to late referral from a private hospital where he was receiving treatment.
In his words: “I took my father to one of the private hospitals at Apapa, Lagos where we were told a compulsory consultancy fee of five thousand Naira. We did as we were told. When his health worsened, the doctor never said referred us to LUTH till he was in a critical shape. En route LUTH, he died. While I was at LUTH to deposit his body at the morgue on Saturday last week, about eight bodies were deposited within a space of five hours with people wailing the loss of their loved ones.” And the list goes on and on.
In a bid to know current efforts made to resolve the strike action which has made patients pass through trying times, Ayobode Williams, Chairman, Medical Guild, which is the umbrella body for all doctors in the service of Lagos State with affiliates drawn from the Medical and Dental Consultants Association in General Hospitals along with the Association of Resident Doctors of LASUTH, said the Guild made only one demand to the Lagos State Government-the payment of the CONMESS with effect from August 2010 and their arrears withheld as from January to July this year.
Speaking to BusinessDay, he revealed that In September 2009, the Federal Government approved the payment of CONMESS package for medical and dental practitioners with effect from January 2010. According to him, in November 2009, the Medical and Dental Council of Nigeria (MDCAN) General Hospital wrote a letter to the Executive Governor of Lagos State Babatunde Fashola concerning the payment of the new salary.
“Currently, doctors in the service of Lagos State earn less than half of the monthly income of their colleagues in the Federal service despite the fact that they work more than their counterpart in the other states. We are ready for negotiation but the letter from the State Government stated that the government will pay us whatever it thinks fit and I am not sure we have asked for ‘whatever.’ Other requests include the reinstatement of our immediate past chairman, Ibrahim Olaifa, who was unlawfully dismissed, our union dues, and over taxation which we demand be corrected,” Williams disclosed.
With scores of people dying on a daily basis due to the inability of doctors to attend to them, calls have been made from several quarters towards seeking a lasting solution through effective dialogue between the Government and the doctors.
Executive Chairman, Yaba Local Council Development Area (LCDA), Jide Jimoh appealed to the striking doctors in Lagos to resume work as a matter of urgency in order to save the lives of patients who are dying in the hospitals. He stated this recently while donating an ambulance to the Harvey Health Centre in Yaba, Lagos.
According to Jimoh “It is unfortunate that doctors are on strike and patients in the hospitals are dying. This is the time for the state government and the resident doctors to dialogue and find a lasting solution to the incessant strikes. Though strike actions are bound to happen, the state government and the striking doctors should be considerate because they were playing with the lives of people.”
For Babatunde Fashola, Governor of Lagos state, while at the commissioning ceremony of the haemodialysis centre donated by MTN Foundation to Alimosho General Hospital within the week said appealed to doctors to come back to work as no amount of money paid to them can bring back those who have died during the strike action even as the government is open to dialogue with the doctors.
While Lagosians await the end of the strike which has crippled hospital activities, efforts should be made to resolve the various differences as more people are bound to lose their lives if nothing urgently is done.
Alexander Chiejina
Lagosians who think they will soon access medical care from any Lagos state owned hospital may have to wait longer as the payment of the Consolidated Medical Salary and Professional Allowance (CONMESS) by the Federal Government to doctors working in federal health institutions have caused ripples in the health sector as doctors under the employ of the state government have vowed to continue its 9 weeks old industrial strike over the non- payment of the CONMESS.
To any individual following the development, the industrial strike which began from August 12 2010 till date has no doubt brought untold hardship and misery to Lagosians thus leaving the clinics and wards of the state owned hospitals open with no doctor attending to any patient. Interestingly, most private hospitals, of which one may not be able to guarantee its operational ability, have now become the last resort of most people who believe are reaping the gains of the current strike action by charging exorbitant fees for medical care.
A visit to Lagos University Teaching Hospital (LUTH), the only functional health institution, within the last 2 weeks has witnessed large number of patients awaiting medical attention. Most wards like the Accident and Emergency session, Radiography, Olikoye Ransome Children Emergency Centre, to name but a few are filled to the bream with little or no space to admit more patients. Already, the hospital management expressed fears that the large number of people waiting for treatment might lead to the outbreak of an epidemic. However, this situation has also increased the hours patients have to wait before been attended to by a physician.
Lamenting his ordeal to BusinessDay, Ebele Enuani, a patient at LUTH said he had to wait for over an hour before doing his x-ray examination due to the large number of people waiting to be examined. He stated that this is has placed much pressure on facilities at the hospital as patients wait endlessly to be attended to.
“I can’t be able to afford the huge bills which private hospitals are currently charging. They are already making some fortune from the strike. Currently, I have to bear with the situation; it’s just that I have to wait for long hours and this is frustrating.”
For Amaka Okoye, she had to spend over three hours before she could do two medical tests and collect her drugs at LUTH. The same cannot be said of Taiwo Okundayo who lost the father due to late referral from a private hospital where he was receiving treatment.
In his words: “I took my father to one of the private hospitals at Apapa, Lagos where we were told a compulsory consultancy fee of five thousand Naira. We did as we were told. When his health worsened, the doctor never said referred us to LUTH till he was in a critical shape. En route LUTH, he died. While I was at LUTH to deposit his body at the morgue on Saturday last week, about eight bodies were deposited within a space of five hours with people wailing the loss of their loved ones.” And the list goes on and on.
In a bid to know current efforts made to resolve the strike action which has made patients pass through trying times, Ayobode Williams, Chairman, Medical Guild, which is the umbrella body for all doctors in the service of Lagos State with affiliates drawn from the Medical and Dental Consultants Association in General Hospitals along with the Association of Resident Doctors of LASUTH, said the Guild made only one demand to the Lagos State Government-the payment of the CONMESS with effect from August 2010 and their arrears withheld as from January to July this year.
Speaking to BusinessDay, he revealed that In September 2009, the Federal Government approved the payment of CONMESS package for medical and dental practitioners with effect from January 2010. According to him, in November 2009, the Medical and Dental Council of Nigeria (MDCAN) General Hospital wrote a letter to the Executive Governor of Lagos State Babatunde Fashola concerning the payment of the new salary.
“Currently, doctors in the service of Lagos State earn less than half of the monthly income of their colleagues in the Federal service despite the fact that they work more than their counterpart in the other states. We are ready for negotiation but the letter from the State Government stated that the government will pay us whatever it thinks fit and I am not sure we have asked for ‘whatever.’ Other requests include the reinstatement of our immediate past chairman, Ibrahim Olaifa, who was unlawfully dismissed, our union dues, and over taxation which we demand be corrected,” Williams disclosed.
With scores of people dying on a daily basis due to the inability of doctors to attend to them, calls have been made from several quarters towards seeking a lasting solution through effective dialogue between the Government and the doctors.
Executive Chairman, Yaba Local Council Development Area (LCDA), Jide Jimoh appealed to the striking doctors in Lagos to resume work as a matter of urgency in order to save the lives of patients who are dying in the hospitals. He stated this recently while donating an ambulance to the Harvey Health Centre in Yaba, Lagos.
According to Jimoh “It is unfortunate that doctors are on strike and patients in the hospitals are dying. This is the time for the state government and the resident doctors to dialogue and find a lasting solution to the incessant strikes. Though strike actions are bound to happen, the state government and the striking doctors should be considerate because they were playing with the lives of people.”
For Babatunde Fashola, Governor of Lagos state, while at the commissioning ceremony of the haemodialysis centre donated by MTN Foundation to Alimosho General Hospital within the week said appealed to doctors to come back to work as no amount of money paid to them can bring back those who have died during the strike action even as the government is open to dialogue with the doctors.
While Lagosians await the end of the strike which has crippled hospital activities, efforts should be made to resolve the various differences as more people are bound to lose their lives if nothing urgently is done.
Alexander Chiejina
Scaling up HIV/AIDS interventions in Nigeria through universal access and ART adherence
When antiretroviral drugs (ARVs) were introduced in Nigeria in the early 1990s, they were only available to those who paid for them. With calls towards achieving universal access to HIV/AIDS beyond 2010, Alexander Chiejina calls for renewed political and funding commitments in the wake of ART usage.
Over the years, Human immuno Virus (HIV) epidemic has continued to remain a major global public health challenge with a total of 33.4 million people living with HIV globally. In 2008 alone, 2.7 million people were newly infected with HIV globally.
Coming home, the 2007 National HIV/ AIDS and Reproductive Health Survey (NARHS Plus) in Nigeria showed that the national HIV prevalence of people living with HIV and AIDS is 3.6 percent (females 4.0 percent; males 3.2 percent with increasing cases in the rural areas in some parts of the country.
Although HIV prevalence is much lower in Nigeria than in other African countries such as South Africa and Zambia, the size of Nigeria’s population (around 150 million) meant that by the end of 2010, over 4.5 million people will be living with the virus. With AIDS claiming so many lives, Nigeria’s life expectancy has declined significantly with latest figures suggesting that the figures had fallen to 48 for women and 46 for men.
Inspite of this shortfalls, since 2006 when United Nations Member States committed to scaling up services and interventions towards the goal of universal access to HIV prevention, treatment, care and support by 2010, the World Health Organisation (WHO), United Nations Children Emergency Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) sought to monitor key components of the health sector response to the HIV epidemic worldwide.
The year 2009 saw continuing progress in expanding access to HIV testing, prevention, treatment and care in low- and middle-income countries. The report assessed HIV/AIDS progress in 144 low- and middle-income countries in 2009 stated the following: 15 countries, including Botswana, Guyana and South Africa, were able to provide more than 80 percent of HIV-positive pregnant women in need, the services and medicines to prevent mother-to-child HIV transmission; 14 countries, including Brazil, Namibia and Ukraine, provided HIV treatment to more than 80 percent of the HIV-positive children in need; and eight countries, including Cambodia, Cuba and Rwanda, have achieved universal access to antiretroviral treatment (ART) for adults.
Though the development of potent anti retroviral therapy (ART) has dramatically improved treatment of HIV, medical experts and stakeholders in the country have stressed the need delivering universal access must be scaled up even as strict adherence to ART medication is required.
Speaking at a recent program organised by Journalist against AIDS (JAAIDS) at Ikeja, Lagos, Deborah Igbokwe, a medical expert at APIN clinic, Nigerian Institute of Medical Research, NIMR, Yaba, Lagos said that adherence is a major issue in HIV treatment given the fact that it affects how well anti-HIV medications decrease the patient’s viral load as well as help prevent drug resistance.
Igbokwe stated that HIV treatment regimens can be complicated as most regimens involve taking multiple pills each day; some anti-HIV medications requires one to take medication on an empty stomach, while others must be taken with meals, and before or after doses of other medications.
In her words “This can be difficult for many people, especially for those who are sick or are experiencing HIV symptoms or negative side effects caused by their medications. Other factors that can make it difficult to adhere to an HIV treatment regimen include experiencing unpleasant side effects after taking one’s medications, travelling away from home, being too busy, forgetting to take medications just to name but a few.”
For Ogechi Onuoha, a member of JAAIDS, findings from an earlier project implemented in 2009 by JAAIDS with funding support from SIDACTION France revealed that people living with HIV/AIDS (PLWHA) faced challenges of long waiting time at clinics, inadequate doctor/client interaction, limited capacity of counselors and infrequent adherence counseling, as well as low knowledge level of the treatment received and how it works.
According to her “the project study which was carried out in Lagos and Oyo states in February 2010 revealed that only a few sites truly offer comprehensive ART services – all expense paid, some PLWH were sometimes unable to afford meals and transport to the clinic, some PLWH were deceived into abandoning their treatment to seek for “miracle cures” and positive mothers who are forced due to cultural influence to breast feed their infants and risk transmitting the virus to their babies and this seriously affected the treatment regimen spelt out by the physician.”
It is noteworthy to state that obstacles to scaling up HIV treatment include funding shortages, limited human resources, and weak procurement and supply management systems for HIV drugs and diagnostics and other health systems bottlenecks which persists in most countries. It is believed that one third of countries reported at least one or more cases when supply of HIV medicines had been interrupted in 2009.
In Nigeria, resources needed to provide sufficient treatment and care for those living with HIV in Nigeria are seriously lacking. A study of health care providers found many had not received sufficient training on HIV prevention and treatment and many of the health facilities had a shortage of medications, equipment and materials. The government's National HIV/AIDS Strategic Framework for 2005 to 2009 set out to provide ARVs to 80 percent of adults and children with advanced HIV infection and to 80 percent of HIV-positive pregnant women in 2010.
Currently, about 34 percent of people with advanced HIV infection are said to be receiving ARVs in the country this year. In the revised framework (from 2010 to 2015), the treatment goals were set back to 2015. Going further, availability and safety of blood and blood products continue to be a concern for HIV prevention. While 99 percent and 85 percent of blood donations in high- and middle-income countries respectively were screened in a quality-assured manner in 2009, in low-income countries the comparable figure was 48 percent. And the list is endless.
No doubt, steps towards achieving universal access beyond 2010 calls for a clear set of actions to be taken by Nigeria and the international community includes renewing political and funding commitments to achieve universal access to HIV/AIDS prevention, treatment and care; improving integration and linkages between HIV/AIDS and related services such as tuberculosis, maternal and child health, sexual health and harm reduction for drug users.
More importantly, special approaches remain necessary to address the particular circumstances and needs of those populations at greater risk for HIV infection. Programmes must be designed and delivered in ways that ensure equity in access, including for children and women. There is no gain saying that only such a combined commitment to programme planning and delivery, built upon a solid primary healthcare framework can fully capture synergies between interventions, ensure programmatic sustainability and maximize coverage and impact.
Over the years, Human immuno Virus (HIV) epidemic has continued to remain a major global public health challenge with a total of 33.4 million people living with HIV globally. In 2008 alone, 2.7 million people were newly infected with HIV globally.
Coming home, the 2007 National HIV/ AIDS and Reproductive Health Survey (NARHS Plus) in Nigeria showed that the national HIV prevalence of people living with HIV and AIDS is 3.6 percent (females 4.0 percent; males 3.2 percent with increasing cases in the rural areas in some parts of the country.
Although HIV prevalence is much lower in Nigeria than in other African countries such as South Africa and Zambia, the size of Nigeria’s population (around 150 million) meant that by the end of 2010, over 4.5 million people will be living with the virus. With AIDS claiming so many lives, Nigeria’s life expectancy has declined significantly with latest figures suggesting that the figures had fallen to 48 for women and 46 for men.
Inspite of this shortfalls, since 2006 when United Nations Member States committed to scaling up services and interventions towards the goal of universal access to HIV prevention, treatment, care and support by 2010, the World Health Organisation (WHO), United Nations Children Emergency Fund (UNICEF) and the Joint United Nations Programme on HIV/AIDS (UNAIDS) sought to monitor key components of the health sector response to the HIV epidemic worldwide.
The year 2009 saw continuing progress in expanding access to HIV testing, prevention, treatment and care in low- and middle-income countries. The report assessed HIV/AIDS progress in 144 low- and middle-income countries in 2009 stated the following: 15 countries, including Botswana, Guyana and South Africa, were able to provide more than 80 percent of HIV-positive pregnant women in need, the services and medicines to prevent mother-to-child HIV transmission; 14 countries, including Brazil, Namibia and Ukraine, provided HIV treatment to more than 80 percent of the HIV-positive children in need; and eight countries, including Cambodia, Cuba and Rwanda, have achieved universal access to antiretroviral treatment (ART) for adults.
Though the development of potent anti retroviral therapy (ART) has dramatically improved treatment of HIV, medical experts and stakeholders in the country have stressed the need delivering universal access must be scaled up even as strict adherence to ART medication is required.
Speaking at a recent program organised by Journalist against AIDS (JAAIDS) at Ikeja, Lagos, Deborah Igbokwe, a medical expert at APIN clinic, Nigerian Institute of Medical Research, NIMR, Yaba, Lagos said that adherence is a major issue in HIV treatment given the fact that it affects how well anti-HIV medications decrease the patient’s viral load as well as help prevent drug resistance.
Igbokwe stated that HIV treatment regimens can be complicated as most regimens involve taking multiple pills each day; some anti-HIV medications requires one to take medication on an empty stomach, while others must be taken with meals, and before or after doses of other medications.
In her words “This can be difficult for many people, especially for those who are sick or are experiencing HIV symptoms or negative side effects caused by their medications. Other factors that can make it difficult to adhere to an HIV treatment regimen include experiencing unpleasant side effects after taking one’s medications, travelling away from home, being too busy, forgetting to take medications just to name but a few.”
For Ogechi Onuoha, a member of JAAIDS, findings from an earlier project implemented in 2009 by JAAIDS with funding support from SIDACTION France revealed that people living with HIV/AIDS (PLWHA) faced challenges of long waiting time at clinics, inadequate doctor/client interaction, limited capacity of counselors and infrequent adherence counseling, as well as low knowledge level of the treatment received and how it works.
According to her “the project study which was carried out in Lagos and Oyo states in February 2010 revealed that only a few sites truly offer comprehensive ART services – all expense paid, some PLWH were sometimes unable to afford meals and transport to the clinic, some PLWH were deceived into abandoning their treatment to seek for “miracle cures” and positive mothers who are forced due to cultural influence to breast feed their infants and risk transmitting the virus to their babies and this seriously affected the treatment regimen spelt out by the physician.”
It is noteworthy to state that obstacles to scaling up HIV treatment include funding shortages, limited human resources, and weak procurement and supply management systems for HIV drugs and diagnostics and other health systems bottlenecks which persists in most countries. It is believed that one third of countries reported at least one or more cases when supply of HIV medicines had been interrupted in 2009.
In Nigeria, resources needed to provide sufficient treatment and care for those living with HIV in Nigeria are seriously lacking. A study of health care providers found many had not received sufficient training on HIV prevention and treatment and many of the health facilities had a shortage of medications, equipment and materials. The government's National HIV/AIDS Strategic Framework for 2005 to 2009 set out to provide ARVs to 80 percent of adults and children with advanced HIV infection and to 80 percent of HIV-positive pregnant women in 2010.
Currently, about 34 percent of people with advanced HIV infection are said to be receiving ARVs in the country this year. In the revised framework (from 2010 to 2015), the treatment goals were set back to 2015. Going further, availability and safety of blood and blood products continue to be a concern for HIV prevention. While 99 percent and 85 percent of blood donations in high- and middle-income countries respectively were screened in a quality-assured manner in 2009, in low-income countries the comparable figure was 48 percent. And the list is endless.
No doubt, steps towards achieving universal access beyond 2010 calls for a clear set of actions to be taken by Nigeria and the international community includes renewing political and funding commitments to achieve universal access to HIV/AIDS prevention, treatment and care; improving integration and linkages between HIV/AIDS and related services such as tuberculosis, maternal and child health, sexual health and harm reduction for drug users.
More importantly, special approaches remain necessary to address the particular circumstances and needs of those populations at greater risk for HIV infection. Programmes must be designed and delivered in ways that ensure equity in access, including for children and women. There is no gain saying that only such a combined commitment to programme planning and delivery, built upon a solid primary healthcare framework can fully capture synergies between interventions, ensure programmatic sustainability and maximize coverage and impact.
Wednesday, October 13, 2010
Over 2.5 million Nigerians aged 40 blinded by glaucoma in Nigeria---Stastitics
...as the world celebrate 'Sight Day'
The eyes no doubt are one of the numerous organs in the human body, whose function is very vital given its role of providing sight. Sadly, many people pay little attention to eye health, let alone eye exam. Hence, protecting it from developing any impairment is one issue "Vision 2020: The Right to Sight", is a global advocacy effort to prevent blindness which was created by the World Health Organisation (WHO) and the International Agency for the Prevention of Blindness (IAPB) is built on. This call is coming at a time as Nigeria joins the rest of the world to mark World Sight Day (held on second Thursday in October).
In the light of this, medical experts in the country have called on Nigerians to visit their physician frequently to avoid developing one form of visual impairment or the other as global attention on blindness, visual impairment and rehabilitation of the visually impaired is brought to the fore.
In an interview with BusinessDay, Adeola Onakoya, Consultant Ophthalmologist, college of medicine, Lagos University Teaching Hospital (LUTH), said that the global target was to ultimately reduce blindness prevalence to less than 0.5 percent in all countries in keeping with the Vision 2020; The Right to Sight.
Onakoya disclosed that the new data based on the world population of 2002 showed a reduction in the number of people who are blind or visually impaired, in particular, those who are blind because of infectious causes. However, there is an increase in the number of people who are blind or visually impaired due to increasing longevity and the increase of non-communicable chronic diseases.
According to the Consultant Ophthalmologist, “the main causes of visual impairment include cataract, glaucoma, refractive errors and low vision, childhood blindness, diabetic retinopathy, age related macular degeneration, genetic eye diseases as well as trachoma (which is caused by Chlamydia trachomatis and is spread by direct contact with eye, nose, and throat secretions from affected individuals, or contact with inanimate objects such as towels and/or washcloths) and Onchocerciasis (river blindness).”
She revealed that the increase of diabetes among many population groups has caused diabetic retinopathy to be added to the priority list while glaucoma, an eye disease of the nerves known for centuries, remains on the public health agenda due to difficulties in its early diagnosis and frequent necessity of lifelong treatment as well as uncorrected refractive errors which is now an emerging important cause of visual impairment.
For Kunle Hassan, National President, Ophthalmological Society of Nigeria (OSN), much advocacy is made on glaucoma because it causes progressive damage of the optic nerve at the point where it leaves the eyes which carries visual information to the brain affected. Hassan stated that glaucoma is the second cause of irreversible blindness globally and the main cause of blindness in Nigeria progresses without warning or obvious symptoms to the patient.
In his words: “Certain factors such as high intraocular pressure (IOP), family history, ethnic background (mostly blacks), age or optic nerve appearance, have been implicated in people who develop glaucoma. However, most Nigerians who visit eye centres for screening more often than not present the later stage.”
According to a survey conducted in Nigeria in 2007, over 16.7 percent (over 2.5 million) of Nigerians aged 40 years were suffering from glaucoma and more Nigerians at present are predisposed to the disease giving lack of awareness of the disease. Already, an estimated 80 million people is anticipated to suffer from glaucoma globally by the year 2020 if awareness and continuous eye screening is not done. In addition, approximately 314 million people worldwide live with low vision and blindness. Of this number, 45 million people are blind and 269 million have low vision.
Giving these alarming figures, there is no gain saying that periodic eye and vision examinations are an important part of preventive health care. Many eye and vision problems have no obvious signs or symptoms. As a result, individuals are often unaware that problems exist.
Forging a way forward for Nigerians, Onakoya stated that for Nigerians who have no family history of eye defect/ disease, they should visit an optometrist /ophthalmologist at least once a year so as to detect any eye disease which may further lead to visual impairment if not detected in time.
In her words “Some problems might not be easily found until they come to late stage. But they can be easily detected through certain eye checks. In other words, most of these eye problems can be well prevented or slowed down if detected at early stage. On the whole, regular eye exam can do people a lot of benefits. But what should the frequency be. People who are younger than forty should get one eye exam at least annually as annual check is needed as they age.”
BY Alexander Chiejina
The eyes no doubt are one of the numerous organs in the human body, whose function is very vital given its role of providing sight. Sadly, many people pay little attention to eye health, let alone eye exam. Hence, protecting it from developing any impairment is one issue "Vision 2020: The Right to Sight", is a global advocacy effort to prevent blindness which was created by the World Health Organisation (WHO) and the International Agency for the Prevention of Blindness (IAPB) is built on. This call is coming at a time as Nigeria joins the rest of the world to mark World Sight Day (held on second Thursday in October).
In the light of this, medical experts in the country have called on Nigerians to visit their physician frequently to avoid developing one form of visual impairment or the other as global attention on blindness, visual impairment and rehabilitation of the visually impaired is brought to the fore.
In an interview with BusinessDay, Adeola Onakoya, Consultant Ophthalmologist, college of medicine, Lagos University Teaching Hospital (LUTH), said that the global target was to ultimately reduce blindness prevalence to less than 0.5 percent in all countries in keeping with the Vision 2020; The Right to Sight.
Onakoya disclosed that the new data based on the world population of 2002 showed a reduction in the number of people who are blind or visually impaired, in particular, those who are blind because of infectious causes. However, there is an increase in the number of people who are blind or visually impaired due to increasing longevity and the increase of non-communicable chronic diseases.
According to the Consultant Ophthalmologist, “the main causes of visual impairment include cataract, glaucoma, refractive errors and low vision, childhood blindness, diabetic retinopathy, age related macular degeneration, genetic eye diseases as well as trachoma (which is caused by Chlamydia trachomatis and is spread by direct contact with eye, nose, and throat secretions from affected individuals, or contact with inanimate objects such as towels and/or washcloths) and Onchocerciasis (river blindness).”
She revealed that the increase of diabetes among many population groups has caused diabetic retinopathy to be added to the priority list while glaucoma, an eye disease of the nerves known for centuries, remains on the public health agenda due to difficulties in its early diagnosis and frequent necessity of lifelong treatment as well as uncorrected refractive errors which is now an emerging important cause of visual impairment.
For Kunle Hassan, National President, Ophthalmological Society of Nigeria (OSN), much advocacy is made on glaucoma because it causes progressive damage of the optic nerve at the point where it leaves the eyes which carries visual information to the brain affected. Hassan stated that glaucoma is the second cause of irreversible blindness globally and the main cause of blindness in Nigeria progresses without warning or obvious symptoms to the patient.
In his words: “Certain factors such as high intraocular pressure (IOP), family history, ethnic background (mostly blacks), age or optic nerve appearance, have been implicated in people who develop glaucoma. However, most Nigerians who visit eye centres for screening more often than not present the later stage.”
According to a survey conducted in Nigeria in 2007, over 16.7 percent (over 2.5 million) of Nigerians aged 40 years were suffering from glaucoma and more Nigerians at present are predisposed to the disease giving lack of awareness of the disease. Already, an estimated 80 million people is anticipated to suffer from glaucoma globally by the year 2020 if awareness and continuous eye screening is not done. In addition, approximately 314 million people worldwide live with low vision and blindness. Of this number, 45 million people are blind and 269 million have low vision.
Giving these alarming figures, there is no gain saying that periodic eye and vision examinations are an important part of preventive health care. Many eye and vision problems have no obvious signs or symptoms. As a result, individuals are often unaware that problems exist.
Forging a way forward for Nigerians, Onakoya stated that for Nigerians who have no family history of eye defect/ disease, they should visit an optometrist /ophthalmologist at least once a year so as to detect any eye disease which may further lead to visual impairment if not detected in time.
In her words “Some problems might not be easily found until they come to late stage. But they can be easily detected through certain eye checks. In other words, most of these eye problems can be well prevented or slowed down if detected at early stage. On the whole, regular eye exam can do people a lot of benefits. But what should the frequency be. People who are younger than forty should get one eye exam at least annually as annual check is needed as they age.”
BY Alexander Chiejina
Placing health research in Nigeria’s healthcare sector
Taking a cursory look at healthcare delivery across the globe, there is no gain saying that health research plays a pivotal role in the development of any nation. This is in view of its contribution to the provision of solutions to health problems, providing evidence for addressing communicable and non-communicable diseases, reducing health disparities, strengthening national health systems as well as deliver healthcare services. Little wonder the World Health Organisation (WHO) revealed that improvement in healthcare delivery has closely been associated with advances in medical research.
Sadly, with Nigeria not in the driving seat of health research in sub Saharan Africa let alone the entire globe, medical experts have called for the Government to provide the necessary leadership in the development and sustainability of health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in- country and at global levels.
Speaking recently at a program organised by the Nigeria Institute of Medical Research, (NIMR), Yaba, Lagos on the theme “Nigeria at 50; Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja said that till date, medical research has provided the strongest support for preventive and curative medicine.
Lecky revealed that medical research began to develop in Nigeria in 1920 when the Rockfeller Foundation established the Yellow Fever Commission and seminar initiatives like the International Conference on Health Research priorities for Nigeria in the 1990s, National seminar on Essential National Health Research (ENHR) etc. to name but a few were held but regretted that certain policy directives to champion health research in the country is still yet to be implemented thus stalling the advancement of medical research in Nigeria.
According to Lecky “The National Health Research Policy and the National Health Research Priorities, which were drafted in 2001 and revised in 2006, is still awaiting implementation into the mainstream of the nation’s health system. Although the National Ethical Research Committee is on place, there is poor adherence to ethical guidelines in medical research resulting probably from absence of ethical review boards in most states and higher institutions. Also, monitoring, and evaluation of research is limited and researchers are not adequately motivated.”
He added that factors responsible for the inadequacies in health research in nigeria includes lack of co-ordination, lack of regular forum to discuss health research, poor linkage between research and policy, dearth of research infrastructures, sub-optimal capacity building strategies, ineffectual documentation.
For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (such as Nigerian Institute of Medical Research and National Institute for Pharmaceutical Research Development NIPRD), human resources challenges, shortage of specialised expertise, inadequate prioritization by development partners and other funding bodies have negatively contributed in the relegation of medical research in the country
Nwanyanwu noted that currently, health research is not a priority of governments and most funding agencies, weak linkages with the academia, governance and industry even as health research is considered not attractive due to time constraints, bearing in mind the high technical expertise and a diversion of intervention resources.
He added that “there is the need to promote public-private partnerships, advocate improved funding for public health research, encourage philanthropy to invest in health research like Ford Foundation, Bill & Melinda Gates Foundation, partner to include research into all interventions and encourage the use of research findings in services”
It is worthy to state that the increased longevity of humans over the past century can be significantly attributed to advances resulting from medical research. Among the major benefits have been vaccines development for measles and polio, insulin treatment for diabetes, classes of antibiotics for treating a host of maladies, medication for high blood pressure, improved treatments for AIDS, statins and increasingly successful treatments for cancer and other emerging diseases.
Furthermore, research funding in many countries emanates from research bodies which distribute money for equipment and salaries. For instance, in the United Kingdom, funding bodies such as the Medical Research Council derive their assets from UK tax payers, and distribute this to institutions in a competitive manner.
In 2003, The National Institutes of Health and pharmaceutical companies in the United States collectively contributed 26.4 billion dollars and 27.0 billion dollars, respectively which constitute 28 percent and 29 percent of the total as at 2003 to medical research.
Other significant contributors included biotechnology companies, medical device companies, other federal, state and local governments as well as foundations and charities, led by the Bill and Melinda Gates Foundation.
With developed nations setting the pace globally, Nigeria can’t afford to lag behind bearing in mind its vision of becoming one of the twenty leading economies in the year 2020 as well as meeting with the Millennium Development Goals deadline of improved healthcare by 2015.
For Innocent Ujah, Director General, NIMR, “Key requirements for health research success include strategic research planning, sustainable funding of research, strengthening identifiable health research institutions at all levels such as NIMR, NIPRD, teaching hospitals, Federal Medical Centres, linking research to global and national initiatives and objectives, develop transparent approach for using research findings to aid evidence based policy at all levels and undertake research at critical areas already identified in different forums.”
More importantly, at the institutional level, there is the need to generate innovative development plan based on the National Strategic Health Development Plan (NSHDP- which is a heath component of Vision 20;2020) which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP. In addition, at the national level, it is eminent to progressively increase investment in health research, pursue the passage of the Health bill and approve Health Research Policy and priorities, and establish a robust database of health research for better co-ordination.
ALEXANDER CHIEJINA
Sadly, with Nigeria not in the driving seat of health research in sub Saharan Africa let alone the entire globe, medical experts have called for the Government to provide the necessary leadership in the development and sustainability of health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in- country and at global levels.
Speaking recently at a program organised by the Nigeria Institute of Medical Research, (NIMR), Yaba, Lagos on the theme “Nigeria at 50; Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja said that till date, medical research has provided the strongest support for preventive and curative medicine.
Lecky revealed that medical research began to develop in Nigeria in 1920 when the Rockfeller Foundation established the Yellow Fever Commission and seminar initiatives like the International Conference on Health Research priorities for Nigeria in the 1990s, National seminar on Essential National Health Research (ENHR) etc. to name but a few were held but regretted that certain policy directives to champion health research in the country is still yet to be implemented thus stalling the advancement of medical research in Nigeria.
According to Lecky “The National Health Research Policy and the National Health Research Priorities, which were drafted in 2001 and revised in 2006, is still awaiting implementation into the mainstream of the nation’s health system. Although the National Ethical Research Committee is on place, there is poor adherence to ethical guidelines in medical research resulting probably from absence of ethical review boards in most states and higher institutions. Also, monitoring, and evaluation of research is limited and researchers are not adequately motivated.”
He added that factors responsible for the inadequacies in health research in nigeria includes lack of co-ordination, lack of regular forum to discuss health research, poor linkage between research and policy, dearth of research infrastructures, sub-optimal capacity building strategies, ineffectual documentation.
For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (such as Nigerian Institute of Medical Research and National Institute for Pharmaceutical Research Development NIPRD), human resources challenges, shortage of specialised expertise, inadequate prioritization by development partners and other funding bodies have negatively contributed in the relegation of medical research in the country
Nwanyanwu noted that currently, health research is not a priority of governments and most funding agencies, weak linkages with the academia, governance and industry even as health research is considered not attractive due to time constraints, bearing in mind the high technical expertise and a diversion of intervention resources.
He added that “there is the need to promote public-private partnerships, advocate improved funding for public health research, encourage philanthropy to invest in health research like Ford Foundation, Bill & Melinda Gates Foundation, partner to include research into all interventions and encourage the use of research findings in services”
It is worthy to state that the increased longevity of humans over the past century can be significantly attributed to advances resulting from medical research. Among the major benefits have been vaccines development for measles and polio, insulin treatment for diabetes, classes of antibiotics for treating a host of maladies, medication for high blood pressure, improved treatments for AIDS, statins and increasingly successful treatments for cancer and other emerging diseases.
Furthermore, research funding in many countries emanates from research bodies which distribute money for equipment and salaries. For instance, in the United Kingdom, funding bodies such as the Medical Research Council derive their assets from UK tax payers, and distribute this to institutions in a competitive manner.
In 2003, The National Institutes of Health and pharmaceutical companies in the United States collectively contributed 26.4 billion dollars and 27.0 billion dollars, respectively which constitute 28 percent and 29 percent of the total as at 2003 to medical research.
Other significant contributors included biotechnology companies, medical device companies, other federal, state and local governments as well as foundations and charities, led by the Bill and Melinda Gates Foundation.
With developed nations setting the pace globally, Nigeria can’t afford to lag behind bearing in mind its vision of becoming one of the twenty leading economies in the year 2020 as well as meeting with the Millennium Development Goals deadline of improved healthcare by 2015.
For Innocent Ujah, Director General, NIMR, “Key requirements for health research success include strategic research planning, sustainable funding of research, strengthening identifiable health research institutions at all levels such as NIMR, NIPRD, teaching hospitals, Federal Medical Centres, linking research to global and national initiatives and objectives, develop transparent approach for using research findings to aid evidence based policy at all levels and undertake research at critical areas already identified in different forums.”
More importantly, at the institutional level, there is the need to generate innovative development plan based on the National Strategic Health Development Plan (NSHDP- which is a heath component of Vision 20;2020) which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP. In addition, at the national level, it is eminent to progressively increase investment in health research, pursue the passage of the Health bill and approve Health Research Policy and priorities, and establish a robust database of health research for better co-ordination.
ALEXANDER CHIEJINA
Wednesday, October 6, 2010
Kidney failure on the rise in Nigeria
...As calls have been made for regular medical check up
The human kidney is one essential organ responsible for the removal of waste products and excess fluids from the body. Aside this, the kidney helps in reabsorbing useful substances like glucose, protein and electrolysis into the body in precise levels needed for proper body functioning as well as produce hormones which help various organs carry out their specific functions.
Despite the critical role this organ plays, medical experts are worried on the increasing cases of kidney failure or end stage renal disease which is becoming a major issue in Nigeria giving the increasing incidence of the medical ailment.
Recent statistics indicate that kidney failure is increasing worldwide by approximately 7 to 8 percent annually even as incidence in Nigeria could be as high as 10 per million population. In addition, about 12 to 14 cases of patients aged between 20 and 50 years come for kidney dialysis in Lagos University Teaching Hospital (LUTH), idi-araba, Lagos on a weekly basis.
With a significant number of Nigerians who fall within the working population likely to be affected, medical experts have called for Nigerians to maintain healthy lifestyles, go for medical checkups giving the fact that the threat to the future of Nigeria’s economy is at stake.
Speaking at a Kidney Rejoice Program in Lagos recently, Toyin Amira, Consultant Nephrologist, Lagos University Teaching Hospital (LUTH), Idi-araba, Lagos, said that kidney failure results from damages to one or both kidneys giving rise to accumulation of waste and fluids in the body.
Amira stated that the damage to the kidneys can be sudden (as in acute failure) with adequate co-progressive and irreversible insult to the kidney, often referred to as End Stage Kidney Failure.
According to Amira: “Healthy kidneys work 24 hours a day to remove waste products from the blood that build up mainly from the food that we eat. These waste products include urea, creatinine, potassium, sodium, phosphorus and fluids. However, kidney failure may show no symptoms until it reaches an advanced stage. However, some identified causes include hypertension, diabetes, glomerulonephrities, HIV/AIDS, analgesic nephropathy, certain diseases like polycystic kidney diseases, to name but a few. “
She hinted that a failure of the kidneys could lead to so many negative complications and gradually affect the other organs of the body which may eventually make the patient succumb to death except treated by dialysis or transplantation.
For Hadunni Ogunjumelo, co-coordinator, Kidney Rejoice, a non-governmental organsation targeted at creating awareness of Kidney issues in Nigeria said that “Because hypertension-often referred to as a “silent killer”-cause no symptoms and medications are expensive and may cause unwanted side effects, many find compliance with required treatment difficult and this further compound the problem of hypertension related kidney disease.
In her words “Poverty has been identified as a major problem in the bid to reduce this casualty. In advanced countries, they have extensive prevention programmes on kidney while for us in Nigeria we need to depend even more on prevention modes. Unfortunately, quite a high number of patients in Nigeria end up with no treatment option. In other words, they just wait to die due to unawareness, inability to afford treatments and inaccessibility to good treatment modes. Don’t forget that a typical renal patient has a 3 to 5 hour dialysis treatment; three times per week. For instance, in Nigeria, each session of dialysis treatment will cost an average of N25, 000. 00 (twenty-five thousand naira) or over seventy–five thousand naira per week, a cost much more than the average Nigerian worker cannot bear.”
With the World Health Organization (WHO) statistics of 2002 which put death rate from intrinsic kidney and urinary tract disease at one million and the prevalence of impaired kidney function estimated to range between 10 percent and 20 percent of adult population in most countries worldwide, it is evident that urgent attention needs to be paid to the risk factors for chronic kidney disease and to instituting interventions to slow the progression of renal disease.
For Joe Okei-Odumakin, President, Women Arise for Change initiative, whose brother was diagnosed of kidney failure three months before he died, stated that since the kidney is a sensitive organ in the body, Nigerians should endeavour to consult their health care provider for prescription of drugs as unregulated across the shelf consumption of drugs could affect the kidney without the person knowing about that.
“Make efforts to check your blood pressure since chronic high blood pressure have been identified as one of the most common causes of acute kidney failure in adult men and women; quitting cigarette smoke lowers the blood pressure, which is important for preventing kidney failure; and maintaining healthy lifestyle by checking what you eat/ drink is also important. You can reduce the strain on your kidneys by cutting all alcoholic drinks out of your lifestyle. These drinks require that your kidneys work very hard and not drinking them can help prevent kidney problems,” Okei-Odumakin added.
alexander Chiejina
The human kidney is one essential organ responsible for the removal of waste products and excess fluids from the body. Aside this, the kidney helps in reabsorbing useful substances like glucose, protein and electrolysis into the body in precise levels needed for proper body functioning as well as produce hormones which help various organs carry out their specific functions.
Despite the critical role this organ plays, medical experts are worried on the increasing cases of kidney failure or end stage renal disease which is becoming a major issue in Nigeria giving the increasing incidence of the medical ailment.
Recent statistics indicate that kidney failure is increasing worldwide by approximately 7 to 8 percent annually even as incidence in Nigeria could be as high as 10 per million population. In addition, about 12 to 14 cases of patients aged between 20 and 50 years come for kidney dialysis in Lagos University Teaching Hospital (LUTH), idi-araba, Lagos on a weekly basis.
With a significant number of Nigerians who fall within the working population likely to be affected, medical experts have called for Nigerians to maintain healthy lifestyles, go for medical checkups giving the fact that the threat to the future of Nigeria’s economy is at stake.
Speaking at a Kidney Rejoice Program in Lagos recently, Toyin Amira, Consultant Nephrologist, Lagos University Teaching Hospital (LUTH), Idi-araba, Lagos, said that kidney failure results from damages to one or both kidneys giving rise to accumulation of waste and fluids in the body.
Amira stated that the damage to the kidneys can be sudden (as in acute failure) with adequate co-progressive and irreversible insult to the kidney, often referred to as End Stage Kidney Failure.
According to Amira: “Healthy kidneys work 24 hours a day to remove waste products from the blood that build up mainly from the food that we eat. These waste products include urea, creatinine, potassium, sodium, phosphorus and fluids. However, kidney failure may show no symptoms until it reaches an advanced stage. However, some identified causes include hypertension, diabetes, glomerulonephrities, HIV/AIDS, analgesic nephropathy, certain diseases like polycystic kidney diseases, to name but a few. “
She hinted that a failure of the kidneys could lead to so many negative complications and gradually affect the other organs of the body which may eventually make the patient succumb to death except treated by dialysis or transplantation.
For Hadunni Ogunjumelo, co-coordinator, Kidney Rejoice, a non-governmental organsation targeted at creating awareness of Kidney issues in Nigeria said that “Because hypertension-often referred to as a “silent killer”-cause no symptoms and medications are expensive and may cause unwanted side effects, many find compliance with required treatment difficult and this further compound the problem of hypertension related kidney disease.
In her words “Poverty has been identified as a major problem in the bid to reduce this casualty. In advanced countries, they have extensive prevention programmes on kidney while for us in Nigeria we need to depend even more on prevention modes. Unfortunately, quite a high number of patients in Nigeria end up with no treatment option. In other words, they just wait to die due to unawareness, inability to afford treatments and inaccessibility to good treatment modes. Don’t forget that a typical renal patient has a 3 to 5 hour dialysis treatment; three times per week. For instance, in Nigeria, each session of dialysis treatment will cost an average of N25, 000. 00 (twenty-five thousand naira) or over seventy–five thousand naira per week, a cost much more than the average Nigerian worker cannot bear.”
With the World Health Organization (WHO) statistics of 2002 which put death rate from intrinsic kidney and urinary tract disease at one million and the prevalence of impaired kidney function estimated to range between 10 percent and 20 percent of adult population in most countries worldwide, it is evident that urgent attention needs to be paid to the risk factors for chronic kidney disease and to instituting interventions to slow the progression of renal disease.
For Joe Okei-Odumakin, President, Women Arise for Change initiative, whose brother was diagnosed of kidney failure three months before he died, stated that since the kidney is a sensitive organ in the body, Nigerians should endeavour to consult their health care provider for prescription of drugs as unregulated across the shelf consumption of drugs could affect the kidney without the person knowing about that.
“Make efforts to check your blood pressure since chronic high blood pressure have been identified as one of the most common causes of acute kidney failure in adult men and women; quitting cigarette smoke lowers the blood pressure, which is important for preventing kidney failure; and maintaining healthy lifestyle by checking what you eat/ drink is also important. You can reduce the strain on your kidneys by cutting all alcoholic drinks out of your lifestyle. These drinks require that your kidneys work very hard and not drinking them can help prevent kidney problems,” Okei-Odumakin added.
alexander Chiejina
Experts seek means to improve mental healthcare in Nigeria
…as the world celebrates World Health Day
To medical experts, physical and mental health is intertwined hence, mental health is seen as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Taking a cursory look at the Nigerian society, people with mental and psychosocial disabilities are among the most marginalized group. Even though development actors have pledged to focus their work on the most vulnerable in a community, many programmes continue to ignore and exclude this vulnerable group. Sadly, the treatment gap for mental, neurological and substance use disorders is alarming especially in poor resource countries with Nigeria not left out of this frame.
As Nigeria joins the rest of the world to celebrate World Mental Health Day every October 10- a day set aside to raise public awareness about mental health issues, promote more open discussion of mental disorders, and investments in prevention and treatment services, medical experts in the country have tasked the government on the need for availability and access to mental care to Nigerians.
Speaking recently to newsmen in Lagos, Olufemi Olugbile, Chief Medical Director, Lagos State University Teaching Hospital (LASUTH) said that it has been estimated that at least, about 90 percent of people with clear-cut mental health syndromes do not even get any treatment at all in Nigeria which is an atrocious figure and everybody knows the issue.
Olugbile, who is also a consultant psychiatrist stated that the specialists, such as psychiatrist nurses, social welfare officers, occupational therapists and all those who form members of the mental health team, are very few in numbers, grossly inadequate even as the number of hospital units available for the treatment of mental disorders is also very low.
According to him “Mental healthcare is supposed to be one of the elements of primary healthcare in Nigeria but that is only seen on papers. Most of the people at the level of the primary health care don’t know much about mental health, don’t have interest in it and don’t have facilities, including simple drugs for treating mental illness. We believe that if we reverse all these three things, giving them knowledge, facilities and supervision, mental healthcare would reach its optimal goal. Right now, there are more people outside the net than inside the net.
The problem is not all about non-availability of specialists but the way, services are organized currently do not make for appropriate coverage. Of course, when people do not have access to the so-called mental healthcare services, what are they supposed to do? They patronize people closer to them the traditional healers. What Lagos State has done is that, it has set up a body to coordinate the traditional healthcare and also to help standardize it so that they would be doing some kind of certification, inspecting what people are doing, checking both their environments and the details of their practice.”
He added that “In the United Kingdom and other nations of the world, mentally-ill people are actually not treated by mental health specialists but by General health Practitioners. Most illnesses are of such an order that they can actually be substantially treated and relieved by lower level of care, non specialized care, such as what is available in primary health care centres and in general practices.”
For Oye Gureje, President, Association of Psychiatrists in Nigeria (APN), mental health conditions are responsible for a great deal of mortality and disability, accounting for 8.8 percent and 16.6 percent of the total burden of disease due to health conditions in low and middle-income countries, respectively according to latest reports from the World Health Organsation (WHO).
Guruje disclosed that “this report calls for development actors to address the needs of people with mental and psychosocial disabilities in development work by: recognizing the vulnerability of this group and including them in all development initiatives, scaling up services for mental health in primary care; involving people themselves in the design of development programmes and projects; and improving social services for people with mental and psychosocial disabilities as the nation may not be able to achieve the lofty dreams of Millennium Development Goals (MDGs) if proper attention is not paid to the burning issue of mental welfare of the nation.”
It is eminent to state that In Africa, less than 50 percent of countries have a mental health policy. In Nigeria, the progressive 1991 primary health care policy states that mental health should be integrated at the primary care level but this is still yet to be implemented.
However, the most severe mental illnesses require long-term treatment. Although this treatment when given in the community is not expensive, the system of paying out-of-pocket means that many families find it hard to afford the care their loved ones need month after month. It is unclear whether the National Health Insurance Scheme will adequately cover mental ill health.
Some schools of thought believe that monies expended by the Federal government for mental health is what is being used to run the eight psychiatric hospitals that the Federal government has. If this is what it really is, it means there may be insufficient funds for programmes such as initiative and public education, as well as the scourge of debilitating mental disorder in our nation.
No doubt, to revamp mental healthcare in Nigeria, there must be equal attention, even more attention, paid to advocacy and programmes meant to change the pattern and reverse the statistics which suggest that about 90 percent of people lack access to mental care. This is a paradigm shift which the government has to make.
Alexander Chiejina
To medical experts, physical and mental health is intertwined hence, mental health is seen as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community.
Taking a cursory look at the Nigerian society, people with mental and psychosocial disabilities are among the most marginalized group. Even though development actors have pledged to focus their work on the most vulnerable in a community, many programmes continue to ignore and exclude this vulnerable group. Sadly, the treatment gap for mental, neurological and substance use disorders is alarming especially in poor resource countries with Nigeria not left out of this frame.
As Nigeria joins the rest of the world to celebrate World Mental Health Day every October 10- a day set aside to raise public awareness about mental health issues, promote more open discussion of mental disorders, and investments in prevention and treatment services, medical experts in the country have tasked the government on the need for availability and access to mental care to Nigerians.
Speaking recently to newsmen in Lagos, Olufemi Olugbile, Chief Medical Director, Lagos State University Teaching Hospital (LASUTH) said that it has been estimated that at least, about 90 percent of people with clear-cut mental health syndromes do not even get any treatment at all in Nigeria which is an atrocious figure and everybody knows the issue.
Olugbile, who is also a consultant psychiatrist stated that the specialists, such as psychiatrist nurses, social welfare officers, occupational therapists and all those who form members of the mental health team, are very few in numbers, grossly inadequate even as the number of hospital units available for the treatment of mental disorders is also very low.
According to him “Mental healthcare is supposed to be one of the elements of primary healthcare in Nigeria but that is only seen on papers. Most of the people at the level of the primary health care don’t know much about mental health, don’t have interest in it and don’t have facilities, including simple drugs for treating mental illness. We believe that if we reverse all these three things, giving them knowledge, facilities and supervision, mental healthcare would reach its optimal goal. Right now, there are more people outside the net than inside the net.
The problem is not all about non-availability of specialists but the way, services are organized currently do not make for appropriate coverage. Of course, when people do not have access to the so-called mental healthcare services, what are they supposed to do? They patronize people closer to them the traditional healers. What Lagos State has done is that, it has set up a body to coordinate the traditional healthcare and also to help standardize it so that they would be doing some kind of certification, inspecting what people are doing, checking both their environments and the details of their practice.”
He added that “In the United Kingdom and other nations of the world, mentally-ill people are actually not treated by mental health specialists but by General health Practitioners. Most illnesses are of such an order that they can actually be substantially treated and relieved by lower level of care, non specialized care, such as what is available in primary health care centres and in general practices.”
For Oye Gureje, President, Association of Psychiatrists in Nigeria (APN), mental health conditions are responsible for a great deal of mortality and disability, accounting for 8.8 percent and 16.6 percent of the total burden of disease due to health conditions in low and middle-income countries, respectively according to latest reports from the World Health Organsation (WHO).
Guruje disclosed that “this report calls for development actors to address the needs of people with mental and psychosocial disabilities in development work by: recognizing the vulnerability of this group and including them in all development initiatives, scaling up services for mental health in primary care; involving people themselves in the design of development programmes and projects; and improving social services for people with mental and psychosocial disabilities as the nation may not be able to achieve the lofty dreams of Millennium Development Goals (MDGs) if proper attention is not paid to the burning issue of mental welfare of the nation.”
It is eminent to state that In Africa, less than 50 percent of countries have a mental health policy. In Nigeria, the progressive 1991 primary health care policy states that mental health should be integrated at the primary care level but this is still yet to be implemented.
However, the most severe mental illnesses require long-term treatment. Although this treatment when given in the community is not expensive, the system of paying out-of-pocket means that many families find it hard to afford the care their loved ones need month after month. It is unclear whether the National Health Insurance Scheme will adequately cover mental ill health.
Some schools of thought believe that monies expended by the Federal government for mental health is what is being used to run the eight psychiatric hospitals that the Federal government has. If this is what it really is, it means there may be insufficient funds for programmes such as initiative and public education, as well as the scourge of debilitating mental disorder in our nation.
No doubt, to revamp mental healthcare in Nigeria, there must be equal attention, even more attention, paid to advocacy and programmes meant to change the pattern and reverse the statistics which suggest that about 90 percent of people lack access to mental care. This is a paradigm shift which the government has to make.
Alexander Chiejina
Subscribe to:
Posts (Atom)