There is no gain saying that Sickle Cell Disorder (SCD), is a global health problem with psychosocial implications. This is due to the fact that despite the large number of people with SCD, the Nigerian society in general still has a negative image of SCD and reported negative perceptions and attitudes. This has in turn, created a scenario whereby those who cater for sufferers are faced with the burden of providing adequate care and support.
However, with the incidence of sickle cell anaemia in the country which is estimated at 150,000 births annually, survival of Nigerian children beyond childhood have largely depended on their access to appropriate care. And because most of them are born into poor under-privileged families, very few of them survive childhood.
In view of this starring reality, health experts in the country have tasked health authorities in the country to develop a well-resourced national policy and increased awareness which is believed would curtail the dissemination of unbiased public information and education about the disorder.
In a recent interview with BusinessDay, Olu Akinyanju, Chiarman, Sickle Cell Foundation revealed that the nation has the nation has no exact record of citizens suffering from the disorder in contrast to advanced countries of the world like the United States of America and United Kingdom.
This, according to him, has made it impossible for the country to provide for the needs of the patients in spite of the fact that the nation has the largest burden of the disorder in the world. Akinyanju stated that those with the disease suffer a higher than average frequency of illness and premature death, especially in infancy.
In his words “some of the challenges facing sickle cell patients in the country include the absence of dedicated sickle cell clinics in many hospitals across the federation, lack of funding for provision of healthcare to indigent patients, poor funding for capacity building, research and patient care as well as deployment of appropriate personnel and facilities in the nation’s infrastructures.”
He maintained that the Nigerian Sickle Cell Expert Advisory Committee has made important recommendations for improving the uniformity and standard of care delivered to patients, saying the implementation of the recommendations should significantly reduce avoidable illness and deaths among the affected people and thus, improve their quality of lives and average life expectancy.
For her part, Torinola Femi-Adebayo, Senior Medical Officer, Sickle Cell Foundation, noted that low level of awareness on SCD is fueling the misinformation, inappropriate treatment, frustration and stigmatisation. Femi Adebayo stated that the reason is that the affected children rarely survived childhood, and were, therefore, less likely to be encountered in secondary schools, universities and in the workplace.
According to her “having sickle cell disease means a lifelong battle against the health problems it can cause, such as pain, infections, anemia, and stroke. But many people are able to have a very good quality of life by learning to manage the disease. The sickling occurs because of a mutation in the haemoglobin gene.
“The most common signs and symptoms are linked to anaemia and pain while other signs and symptoms are linked to the disease’s complications. The pain from sickle-cell crisis can be acute or chronic, but acute pain is more common. Almost all people who have sickle-cell anaemia have painful crisis at some point in their lives. Your risk for a sickle-cell crisis increases if you are dehydrated, when your body does not have enough fluid. Drinking plenty of fluids can lower your risk for a painful crisis.
With SCD been a genetic disorder associated with excruciating pain, which occurs in different periods, there is the need for proper medical interventions in place to ensure sufferers don’t pass through trying times before accessing medical attention.
For Akinyanju, “The recommendations include the introduction of newborn, or at least, infant to screening for sickle cell disorder to enable early diagnosis. This is done in England and America not only for sickle cell, but also for other conditions. It also includes the training and development of a cadre of sickle cell specialist nurses in order to increase access to well-informed health workers.”
“Don’t forget that the average life expectancy of sickle cell patients in America rose to 53 with commensurate improvement in their quality of life due to their greater annual investment in sickle cell care which is higher than the average life expectancy of all Nigerians which currently stood at 47,” He concluded.
Lending his view, Olarewanju Ekujimi, National President, Association of Resident Doctors added that “regular checkups are an important part of life with this disease. People with sickle cell disease need a good working relationship with a doctor who is an expert in treating it. This is borne out of their painful episodes which sets off occasioned by high altitude, cigeratte smoke, etc. Also, since people with sickle cell disease and their families face ongoing stress, a support network can help ease stress and worry.”
Alexander Chiejina
Friday, January 21, 2011
Monday, January 17, 2011
School closure: Sure end towards getting a credible voters’ registration in Nigeria?
Recently, the Federal Government announced the closure of schools across the Federation for a month over voters’ registration exercise. This has been greeted with mass protests from stakeholders as they ponder whether this would ensure an obstruction in the entire exercise writes Alexander Chiejina
In recent times, the issue that has dominated the print and electronic media in the country has been whether the Independent National Electoral Commission (INEC) would come to terms with the aspiration of Nigerians at home and Diaspora to conduct a free and fair election. This apprehension is as a result of electoral processes in the past which has been greeted with ill-will, rancor and violence.
Faced with this daunting challenge, the electoral body on its part are geared towards the forthcoming elections with the recent training of ad hoc staffs including corps members nationwide that will serve as electoral officers even during the voters’ registration exercise, procuring the Data Direct Capturing (DDC) machines as well as setting machineries on ground which would ensure a smooth electionary process.
However, in readiness for the voters’ registration exercise, the Federal Government recently announced the postponement of resumption date of all schools (primary and secondary) across the federation by one month. This move the FG say is to enable INEC, conduct a smooth voters’ registration exercise. The closure of schools was set to begin from January 10th and last till January 29th 2011.
Following this pronouncement to postpone school resumption, mixed reactions have been trailing the decision. While some schools are waiting to see the outcome of the directive before opening their gates, some are still holding meetings to decide on the next line of action. However, some school owners who may not come to terms with the disruption that the directive will unleash on their time-table are threatening to commence resumption formalities.
Just last week, school owners, under the aegis of National Association of Proprietors of Private Schools (NAPPS), protested the FG’s decision to close schools for the voters’ registration which began at the weekend.
The proprietors, who stormed the office of Lagos State Governor Babatunde Fashola at Alausa, Ikeja, carried placards with inscriptions like: Why close all?”; “Open our schools - they cost money”; “Education in Nigeria is injured already”, etc to name but a few. While frowning at the decision of the government, they appealed to the governor to prevail on the government to reopen schools.
Speaking to newsmen at Ikeja, NAPPS president, Elizabeth Kufeji, said that the closure was improper. Kufeji stated that it was necessary for the government to intervene since private schools in Ogun State would be opened during the exercise. According to her, besides the fact that NAPPS members were not privy to the decision, the exercise could be held on weekends.
While disclosing that for the three weeks the schools will be closed, the proprietors will pay workers’ salaries, Kufeji added that parents will not take the matter.
According to her “As educators, we are not going to sit back and let the future of our children be ruined. When is there no bomb blast? Was it during the voter registration that we will begin to have bomb blasts? As far as we are concerned, the security system in Lagos State is well structured. This is not the first time in Nigeria that private schools were on and public schools were shut down.
They know how to adjust the academic calendar. The Federal Government should not disturb the academic session because it is organising voter registration. The first 400 universities were shortlisted recently; no Nigerian university was listed. All these were due to frequent distortions of our academic calendar. Other private schools in neighbouring states did not close down their schools. There is no good reason schools in the country should be closed. This is not the first time we are organising voter registration in Nigeria.”
Also in disagreement with the decision to close down schools for a month due to political reasons is the Association for Formidable Educational development (AFED). Joe Ejenavi, President AFED said that those who conceived the idea didn’t have the interest of the Nigerian children at heart. Ejenavi noted that since they are not using teachers for the exercise and none of the students were eligible to vote, so why the decision to close down all the schools?
“Their children are not in Nigeria. They are all attending schools abroad, so why would they care about the poor? Right now, we are still looking at the issues involved before we take a stand. We insist that the decision is not in the best interest of the masses. The education sector is very critical to national development and subjecting it to any form of interference has to be reconsidered.”
Prior to the pronouncement, some school of thought are of the view that security of pupils was the major consideration for the extension of resumption for public and private schools in the country.
Only recently at a joint media briefing held in Abuja, INEC’s Chairman, Attahiru Jega and the Minister of State for Education, Kenneth Gbagi, attributed the growing but disturbing “do or die” attitude to politics in the country as a major reason for the extension.
The INEC boss said that the electoral body assessed the entire situation with regard to the preparations for the conduct of the registration, and requested the intervention to have schools closed within this period, in order to enable us have a successful voters’ registration exercise.
According to the INEC boss “The justifications for these are there are close to 120,000 polling units. We have done a thorough verification of the polling units, and as at the moment we know that for a fact, 119, 976 polling units are spread in public schools. In fact, in many schools, there are three to 10 polling units. Indeed, about 70 per cent of our public schools are either used as polling units or are going to be used as registration centres.
“Where we are going to store the equipment, such as DDC machines throughout the duration of the exercise and where we are going to count some of the personnel that are going to participate in the exercise. Obviously, in each school where these activities are going to take place, there is possible disruption of school activities, because thousands of people will be going into these schools to be registered and we felt that it is important that in order to avoid these disruptions, it is better that the schools are closed down during the period,” Jega stated.
No one can downplay the importance of the upcoming voter's registration. However, it is believed that INEC can achieve a successful voters' registration without closing down schools and disrupting the academic calendar.
There had been voters' registration exercises in the past and the organizers of those exercises did not have to use school premises. If such exercises were deficient in any way it was not because school compounds did not serve as venues but because the operators were insincere in the handling of the assignments.
There are civic centers, town halls and open spaces across the country where INEC can mount canopies and use as venues for the registration exercise. Even, if using schools is the only option available to the Commission, are they going to use all the classrooms in all the private and public primary and secondary schools in the country? In communities that have many schools, is the registration going to take place in all of them?
We do not see how students being at home will ensure the safety of registration materials unless the electoral body and the Federal Government are afraid that under age pupils and students in primary and junior secondary schools respectively could be, or have been, responsible for stealing election materials.
If the closure is on security grounds, it is amazing that government has assured that it will guarantee the security of students in the senior class three and cannot extend such protection to those at the lower levels.
In recent times, the issue that has dominated the print and electronic media in the country has been whether the Independent National Electoral Commission (INEC) would come to terms with the aspiration of Nigerians at home and Diaspora to conduct a free and fair election. This apprehension is as a result of electoral processes in the past which has been greeted with ill-will, rancor and violence.
Faced with this daunting challenge, the electoral body on its part are geared towards the forthcoming elections with the recent training of ad hoc staffs including corps members nationwide that will serve as electoral officers even during the voters’ registration exercise, procuring the Data Direct Capturing (DDC) machines as well as setting machineries on ground which would ensure a smooth electionary process.
However, in readiness for the voters’ registration exercise, the Federal Government recently announced the postponement of resumption date of all schools (primary and secondary) across the federation by one month. This move the FG say is to enable INEC, conduct a smooth voters’ registration exercise. The closure of schools was set to begin from January 10th and last till January 29th 2011.
Following this pronouncement to postpone school resumption, mixed reactions have been trailing the decision. While some schools are waiting to see the outcome of the directive before opening their gates, some are still holding meetings to decide on the next line of action. However, some school owners who may not come to terms with the disruption that the directive will unleash on their time-table are threatening to commence resumption formalities.
Just last week, school owners, under the aegis of National Association of Proprietors of Private Schools (NAPPS), protested the FG’s decision to close schools for the voters’ registration which began at the weekend.
The proprietors, who stormed the office of Lagos State Governor Babatunde Fashola at Alausa, Ikeja, carried placards with inscriptions like: Why close all?”; “Open our schools - they cost money”; “Education in Nigeria is injured already”, etc to name but a few. While frowning at the decision of the government, they appealed to the governor to prevail on the government to reopen schools.
Speaking to newsmen at Ikeja, NAPPS president, Elizabeth Kufeji, said that the closure was improper. Kufeji stated that it was necessary for the government to intervene since private schools in Ogun State would be opened during the exercise. According to her, besides the fact that NAPPS members were not privy to the decision, the exercise could be held on weekends.
While disclosing that for the three weeks the schools will be closed, the proprietors will pay workers’ salaries, Kufeji added that parents will not take the matter.
According to her “As educators, we are not going to sit back and let the future of our children be ruined. When is there no bomb blast? Was it during the voter registration that we will begin to have bomb blasts? As far as we are concerned, the security system in Lagos State is well structured. This is not the first time in Nigeria that private schools were on and public schools were shut down.
They know how to adjust the academic calendar. The Federal Government should not disturb the academic session because it is organising voter registration. The first 400 universities were shortlisted recently; no Nigerian university was listed. All these were due to frequent distortions of our academic calendar. Other private schools in neighbouring states did not close down their schools. There is no good reason schools in the country should be closed. This is not the first time we are organising voter registration in Nigeria.”
Also in disagreement with the decision to close down schools for a month due to political reasons is the Association for Formidable Educational development (AFED). Joe Ejenavi, President AFED said that those who conceived the idea didn’t have the interest of the Nigerian children at heart. Ejenavi noted that since they are not using teachers for the exercise and none of the students were eligible to vote, so why the decision to close down all the schools?
“Their children are not in Nigeria. They are all attending schools abroad, so why would they care about the poor? Right now, we are still looking at the issues involved before we take a stand. We insist that the decision is not in the best interest of the masses. The education sector is very critical to national development and subjecting it to any form of interference has to be reconsidered.”
Prior to the pronouncement, some school of thought are of the view that security of pupils was the major consideration for the extension of resumption for public and private schools in the country.
Only recently at a joint media briefing held in Abuja, INEC’s Chairman, Attahiru Jega and the Minister of State for Education, Kenneth Gbagi, attributed the growing but disturbing “do or die” attitude to politics in the country as a major reason for the extension.
The INEC boss said that the electoral body assessed the entire situation with regard to the preparations for the conduct of the registration, and requested the intervention to have schools closed within this period, in order to enable us have a successful voters’ registration exercise.
According to the INEC boss “The justifications for these are there are close to 120,000 polling units. We have done a thorough verification of the polling units, and as at the moment we know that for a fact, 119, 976 polling units are spread in public schools. In fact, in many schools, there are three to 10 polling units. Indeed, about 70 per cent of our public schools are either used as polling units or are going to be used as registration centres.
“Where we are going to store the equipment, such as DDC machines throughout the duration of the exercise and where we are going to count some of the personnel that are going to participate in the exercise. Obviously, in each school where these activities are going to take place, there is possible disruption of school activities, because thousands of people will be going into these schools to be registered and we felt that it is important that in order to avoid these disruptions, it is better that the schools are closed down during the period,” Jega stated.
No one can downplay the importance of the upcoming voter's registration. However, it is believed that INEC can achieve a successful voters' registration without closing down schools and disrupting the academic calendar.
There had been voters' registration exercises in the past and the organizers of those exercises did not have to use school premises. If such exercises were deficient in any way it was not because school compounds did not serve as venues but because the operators were insincere in the handling of the assignments.
There are civic centers, town halls and open spaces across the country where INEC can mount canopies and use as venues for the registration exercise. Even, if using schools is the only option available to the Commission, are they going to use all the classrooms in all the private and public primary and secondary schools in the country? In communities that have many schools, is the registration going to take place in all of them?
We do not see how students being at home will ensure the safety of registration materials unless the electoral body and the Federal Government are afraid that under age pupils and students in primary and junior secondary schools respectively could be, or have been, responsible for stealing election materials.
If the closure is on security grounds, it is amazing that government has assured that it will guarantee the security of students in the senior class three and cannot extend such protection to those at the lower levels.
How mismanagement disrupts poverty alleviation efforts
There is yet no respite for the nation's teeming poor as the coordinating agency of the federal government's poverty eradication activities remains embroiled in a controversy over alleged misappropriation of funds writes Alexander Chiejina
As another year begins with high hopes of deepening growth, the worry of economic planners would be how to improve on the prevailing high levels of poverty in the country.
Sadly, it is estimated that about 70 percent of Nigerians live below poverty line of less than a dollar a day. This is according to recent reports from the United Nations Programme (UNDP) and the World Bank.
This estimate is believed to make up more than the combined population of Ghana, Togo, Sierra Leone, Benin Republic, Liberia, Gambia, and Cote D'Ivoire which is about 67.3 million. It is on this premise that the federal government under the Olusegun Obasanjo's administration in 2001, in recognition of the economic woes of Nigerians, came up with an idea to eradicate poverty which according to analysts is caused by high levels of corruption that has dogged the nation since independence in 1960. The idea thus gave birth to the National Poverty Eradication Programme (NAPEP).
As the coordinating agency of the federal government for all poverty eradication activities in the country, NAPEP's key strategy is to ensure that strong winning partnerships are forged in the country so that well synergised and sustainable programmes could be implemented for the benefit of the people.
Other duties of the agency include assisting state and local governments develop direct anti-poverty programs that include micro-credit and micro-finance as well as building strategic public and private sector partnerships that should empower the disadvantaged.
However, while the people continue to wait for NAPEP to deliver on this mandate, the agency has of late remained embroiled in controversy, mostly bothering on corruption.
For instance, a deepening crisis in the management of the poverty alleviation instruments has so far attracted the attention of many government agencies including the Economic and Financial Crimes Commission (EFFCC), a Senate investigative committee and internal panels of inquiry that had all probed allegations of corruption in the agency. The issues had centred on mismanagement, especially in the alleged diversion of N417 million of NAPEP fund as well as setting up of parallel phoney companies to ape and appropriate the functions of the agency for the benefit of few corrupt officials.
Early 1999, some officials of the agency had appeared before the Senate Committee on Public Accounts to account for how the N2.4 billion contract awarded by it for the supply of 5, 000 tricycles (KEKE NAPEP) and spare parts in 2003 was executed.
The Senate investigation followed an audit query by the Auditor-General of the Federation over disbursement of the agency's fund.
"From investigations, said the Senate report: "it is established that despite the sum of N1.850 billion provided between 2006 and 2008 on Monitoring and Evaluation, this aspect of the programmes was very weak and ineffective."
It added that most of the anomalies identified in various states of the federation were as a result of the nonchalant attitude of the Monitoring Unit of NAPEP at the National and State levels".
The Senate report further accused the Magnus Kpakol-led NAPEP leadership of funds misapplication, adding that some decisions taken affected Nigerians negatively. According to the report: "the committee established that relationships between NAPEP and Intercontinental Bank Plc and Oceanic International Bank Plc were skewed in favour of the banks.
"It is observed that the funds meant for Village Economic Development Solution (VEDS) and cope programmes- Five billion (N5bn) and two billion two hundred and sixty-five million (N2.265m) naira respectively were managed to the disadvantage of NAPEP and poor Nigerians. The banks in collaboration with NAPEP officials left the fund idle in various accounts with no interest paid by the banks. It also equally established a situation where one of the banks charged commission on turnover (COT) on NAPEP (Government) accounts against the directives of the central Bank of Nigeria."
It especially pointed out the lack of proper monitoring and evaluation despite the availability of N1.8billion provided between 2006 and 2008 for that purpose as well as poor management of funds by NAPEP.
The senate Committee also observed that NAPEP officials in their submission to the committee provided fake names and unverifiable addresses of beneficiaries, ostensibly to cover their tracks.
With poverty still endemic and with no clear programme for lifting the millions of Nigerians trapped in its bosom, it will be merely stating the obvious to say that those who conceived the idea would be hugely disappointed by the failure of the managers of the programme to interpret the poverty alleviation vision in a manner that would benefit the targeted poor.
A recent visit of an internal NAPEP panel to the offices of Autobahn Techniques and Keke Owners and Riders Association of Nigeria (KORAN) which is the official distributor of the tricycles also revealed more sordid details of official corruption going on in the entire NAPEP establishment.
Besides discovering the alleged diversion of N417million belonging to the Agency the visitation panel also observed the clandestine setting up of a parallel company that hides under the cover of an authorised agency to assemble and deliver the tricycles to its own unofficial clients.
The panel said in their report: "Another observation of the team was that, this new company, Trimidan Limited was currently assembling KEKE tricycles, painted them in national colours and entitled it as KEKE NAPEP, yet NAPEP as a government agency was not aware of such assemblage…"
While many continue to point accusing fingers on NAPEP management for the failure of the poverty alleviation programme, the agency had dismissed the claims as 'unnecessary diversion.'
NAPEP's Publicity Secretary, Phil Oshodin in a statement which was recently made available to journalists stressed that NAPEP was on course towards realising its mandate.
Attributing the problems of the agency to the ploy of some of its stakeholders with 'self-serving interests', Oshodin warned that distracting the agency would keep the country and its poor in the middle of nowhere.
According to her "Recently, vituperative attacks have been directed at the NAPEP and its National Coordinator and Senior Special Assistant to the President, Magnus Kpakol, with the usual call for his removal."
Business Day gathered that Ofili Okonkwo, the chief executive officer of Autobahn Technique suppliers of the tricycle had tried to exonerate his firm from any blame in the problems of NAPEP claiming that Autobahn has fulfilled its side of the bargain, having supplied 4,000 units in the first two phases of the contract. He however blamed the failure to deliver all the tricycles on the third phase of the project on schedule to logistics problems and delayed payment on the part of NAPEP.
In disagreeing with this claim, Oshodin argued that the firm had no reason to default despite having been paid fully by NAPEP. She said: "Regrettably, this is happening even when Autobhan Techniques Limited, the defaulter in a contract that was signed on February 16, 2007 to supply 5, 000 units of three wheeler tricycles called "Keke NAPEP" to NAPEP for distribution to various states for a hefty sum of N2.4 billion has brazenly failed to deliver 1,310 units of the tricycles worth N589, 500, 000 till today despite full payment made and the long expiration of the last delivery date on August 21, 2008."
A National Assembly member who pleaded anonymity wants the government to immediately set up a panel to "review and advise it on the findings of the two available Reports by the Visitation Panel and the Senate Committee on National Planning and Poverty Eradication."
As another year begins with high hopes of deepening growth, the worry of economic planners would be how to improve on the prevailing high levels of poverty in the country.
Sadly, it is estimated that about 70 percent of Nigerians live below poverty line of less than a dollar a day. This is according to recent reports from the United Nations Programme (UNDP) and the World Bank.
This estimate is believed to make up more than the combined population of Ghana, Togo, Sierra Leone, Benin Republic, Liberia, Gambia, and Cote D'Ivoire which is about 67.3 million. It is on this premise that the federal government under the Olusegun Obasanjo's administration in 2001, in recognition of the economic woes of Nigerians, came up with an idea to eradicate poverty which according to analysts is caused by high levels of corruption that has dogged the nation since independence in 1960. The idea thus gave birth to the National Poverty Eradication Programme (NAPEP).
As the coordinating agency of the federal government for all poverty eradication activities in the country, NAPEP's key strategy is to ensure that strong winning partnerships are forged in the country so that well synergised and sustainable programmes could be implemented for the benefit of the people.
Other duties of the agency include assisting state and local governments develop direct anti-poverty programs that include micro-credit and micro-finance as well as building strategic public and private sector partnerships that should empower the disadvantaged.
However, while the people continue to wait for NAPEP to deliver on this mandate, the agency has of late remained embroiled in controversy, mostly bothering on corruption.
For instance, a deepening crisis in the management of the poverty alleviation instruments has so far attracted the attention of many government agencies including the Economic and Financial Crimes Commission (EFFCC), a Senate investigative committee and internal panels of inquiry that had all probed allegations of corruption in the agency. The issues had centred on mismanagement, especially in the alleged diversion of N417 million of NAPEP fund as well as setting up of parallel phoney companies to ape and appropriate the functions of the agency for the benefit of few corrupt officials.
Early 1999, some officials of the agency had appeared before the Senate Committee on Public Accounts to account for how the N2.4 billion contract awarded by it for the supply of 5, 000 tricycles (KEKE NAPEP) and spare parts in 2003 was executed.
The Senate investigation followed an audit query by the Auditor-General of the Federation over disbursement of the agency's fund.
"From investigations, said the Senate report: "it is established that despite the sum of N1.850 billion provided between 2006 and 2008 on Monitoring and Evaluation, this aspect of the programmes was very weak and ineffective."
It added that most of the anomalies identified in various states of the federation were as a result of the nonchalant attitude of the Monitoring Unit of NAPEP at the National and State levels".
The Senate report further accused the Magnus Kpakol-led NAPEP leadership of funds misapplication, adding that some decisions taken affected Nigerians negatively. According to the report: "the committee established that relationships between NAPEP and Intercontinental Bank Plc and Oceanic International Bank Plc were skewed in favour of the banks.
"It is observed that the funds meant for Village Economic Development Solution (VEDS) and cope programmes- Five billion (N5bn) and two billion two hundred and sixty-five million (N2.265m) naira respectively were managed to the disadvantage of NAPEP and poor Nigerians. The banks in collaboration with NAPEP officials left the fund idle in various accounts with no interest paid by the banks. It also equally established a situation where one of the banks charged commission on turnover (COT) on NAPEP (Government) accounts against the directives of the central Bank of Nigeria."
It especially pointed out the lack of proper monitoring and evaluation despite the availability of N1.8billion provided between 2006 and 2008 for that purpose as well as poor management of funds by NAPEP.
The senate Committee also observed that NAPEP officials in their submission to the committee provided fake names and unverifiable addresses of beneficiaries, ostensibly to cover their tracks.
With poverty still endemic and with no clear programme for lifting the millions of Nigerians trapped in its bosom, it will be merely stating the obvious to say that those who conceived the idea would be hugely disappointed by the failure of the managers of the programme to interpret the poverty alleviation vision in a manner that would benefit the targeted poor.
A recent visit of an internal NAPEP panel to the offices of Autobahn Techniques and Keke Owners and Riders Association of Nigeria (KORAN) which is the official distributor of the tricycles also revealed more sordid details of official corruption going on in the entire NAPEP establishment.
Besides discovering the alleged diversion of N417million belonging to the Agency the visitation panel also observed the clandestine setting up of a parallel company that hides under the cover of an authorised agency to assemble and deliver the tricycles to its own unofficial clients.
The panel said in their report: "Another observation of the team was that, this new company, Trimidan Limited was currently assembling KEKE tricycles, painted them in national colours and entitled it as KEKE NAPEP, yet NAPEP as a government agency was not aware of such assemblage…"
While many continue to point accusing fingers on NAPEP management for the failure of the poverty alleviation programme, the agency had dismissed the claims as 'unnecessary diversion.'
NAPEP's Publicity Secretary, Phil Oshodin in a statement which was recently made available to journalists stressed that NAPEP was on course towards realising its mandate.
Attributing the problems of the agency to the ploy of some of its stakeholders with 'self-serving interests', Oshodin warned that distracting the agency would keep the country and its poor in the middle of nowhere.
According to her "Recently, vituperative attacks have been directed at the NAPEP and its National Coordinator and Senior Special Assistant to the President, Magnus Kpakol, with the usual call for his removal."
Business Day gathered that Ofili Okonkwo, the chief executive officer of Autobahn Technique suppliers of the tricycle had tried to exonerate his firm from any blame in the problems of NAPEP claiming that Autobahn has fulfilled its side of the bargain, having supplied 4,000 units in the first two phases of the contract. He however blamed the failure to deliver all the tricycles on the third phase of the project on schedule to logistics problems and delayed payment on the part of NAPEP.
In disagreeing with this claim, Oshodin argued that the firm had no reason to default despite having been paid fully by NAPEP. She said: "Regrettably, this is happening even when Autobhan Techniques Limited, the defaulter in a contract that was signed on February 16, 2007 to supply 5, 000 units of three wheeler tricycles called "Keke NAPEP" to NAPEP for distribution to various states for a hefty sum of N2.4 billion has brazenly failed to deliver 1,310 units of the tricycles worth N589, 500, 000 till today despite full payment made and the long expiration of the last delivery date on August 21, 2008."
A National Assembly member who pleaded anonymity wants the government to immediately set up a panel to "review and advise it on the findings of the two available Reports by the Visitation Panel and the Senate Committee on National Planning and Poverty Eradication."
Friday, January 14, 2011
Effective financing critical to revamping Nigeria’s health sector
Across the globe, healthcare is a necessity and a basic human need. This is in view of the invaluable nature it confers. It is in recognition of this that the Alma Ata Declaration of 1979 in Kazakhstan called on all governments, all health and development workers, and the world community to protect and promote the health of all viz-a-viz ensuring the basic needs, including health and food are met.
Sadly however, for most developing nations, the prospects of achieving even a minimal level of adequacy in health services remain a mirage. While healthcare needs are increasing, government expenditure on health in developing countries is declining. This has resulted in a situation whereby as populations get older, as more people suffer chronic diseases, and as new and more expensive treatments appear, health costs seem to soar.
In Nigeria, healthcare sector hasn’t fared much better on the World Health Organisation’s measures for individual contribution to healthcare. This is because effective financing which is critical to revamping the health sector is lacking. ‘Out-of-pocket’ expenditure as percentage of private expenditure on health is put at 90 percent in Nigeria compared with 79 percent in Ghana and 24 percent in the United States of America.
This data show the nascent state of the health insurance scheme in Nigeria as patients bear the full and direct brunt of their medical expenses without any significant assistance from the company or institution they work for (if not enrolled in the National Health Insurance Scheme-NHIS)
Going further, WHO ’s report of 2005 revealed that per capital government expenditure on health in Nigeria was $14 compared to $32 (Ghana) and $2,861 (USA). In the same period, total expenditure on health as a percentage of Gross Domestic Product was put at 3.9 percent compared to 6.5 percent in Ghana and 15 percent in USA.
Furthermore, the total government expenditure on health as a percentage of total government expenditure in 2005 was 3.5 per cent compared to 6.9 percent (Ghana), and 18.7 per cent (USA).
Giving this reality, health experts have called for increased budgetary allocation for the health sector in Nigeria if the sector wants to operate at optimal capacity and deliver healthcare to millions of Nigerians
Speaking to BusinessDay, Saheed Babajide, Secretary General, Association of Resident Doctors, Lagos State University Teaching Hospital (LASUTH) disclosed that the health sector collects less than four per cent of the national’s budget which is inadequate in delivering the minimum health delivery.
Babajide stated that it the sector can get 25 per cent of budget allocations, it will go a long way in improving healthcare delivery in all tiers of government-Local, State and Federal in the sense that one won’t to travel outside the country for medical attention.
According to him “In this case, all levels of healthcare –from the primary, secondary and tertiary levels will be improved. Don’t forget that adequate equipment and the enabling environment for better health care delivery will be provided with these funds which will in turn reduce mortality rates in the country. Don’t forget that this will also improve health research which is currently been underfunded by the government and has left some of these research centres at the mercies of foreign agencies and grants.”
For Edamisan Temiye, Chairman, Nigerian Medical Association (NMA), Lagos state Branch, Nigeria has not able to meet the African heads of state commitment in Abuja in 2000 to spend 15 percent of their national budgets on health, since only N34 billion representing about seven percent has been proposed in the 2011 budget.
Temiye stated that it is believed that 70 percent of the nation’s health budget spent in urban areas where about 30 percent of the population resides. He noted that to actualize the goals of the Millennium Development Goals and solve most of health care problems, Nigeria is expected to spend 15 percent of its total budget on health.
In his words “Nigeria’s allocation to the health sector in the 2009 budget was N39.6 billion (out of N796 billion earmarked for capital expenditure the same year). If you cast your mind back, N114billion has been spent by Bill Gates in eradicating Polio in Nigeria. Gates have spent N1.2 Trillion on polio eradication globally. This amount is one-third of Nigeria’s 2010 budget of N4.079 Trillion.
No doubt, there is the need for increase in budgetary allocation which currently hovers between six and seven percent. Though there have been health reforms in the past as well as the exploration of e-health and m-health [electronic and mobile health] tools in the country, expectations of our people have not completely in providing care and ensuring that our people benefit from good health care. There is room for improvements in budgetary provisions to the health sector. The current health minister Onyebuchi Chukwu must be commended in with regards to reforms in the sector but there’s room for improvement.”
With the year set to meet the MDGs inch close and the nation’s worrisome indices, healthcare financing must not be left in the hands of government alone. At the moment, countries like Japan that manage to ensure health services are available to the entire population have done so by reducing dependence on direct, out of pocket payments and increasing prepayment - generally through insurance or taxes or a mix of the two.
The funds raised are then pooled, so that it is not just those who are unlucky enough to get sick that bear the financial burden. This is the model used in many European countries, with Chile, Colombia, Mexico, Rwanda, Thailand and Turkey all making significant progress in the last decade - along with Brazil, China, Costa Rica, Ghana and Kyrgyzstan.
For Femi Ajayi, Chairman, Olabisi Teaching University Teaching Hospital, Sagamu, given that most governments (even in more efficiently run countries) have shown that they cannot do better than the markets in terms of healthcare administration, it becomes imperative that Nigeria must redefine its policy to healthcare administration. The private sector must be allowed (indeed, encouraged) to lead development in this area.
“Government's role should not be in the provision of healthcare; instead, it should be to work with the private sector to ensure that policies are designed to meet the needs of consumers. Also, public private partnerships should be encouraged”, Ajayi concluded.
Alexander Chiejina
Sadly however, for most developing nations, the prospects of achieving even a minimal level of adequacy in health services remain a mirage. While healthcare needs are increasing, government expenditure on health in developing countries is declining. This has resulted in a situation whereby as populations get older, as more people suffer chronic diseases, and as new and more expensive treatments appear, health costs seem to soar.
In Nigeria, healthcare sector hasn’t fared much better on the World Health Organisation’s measures for individual contribution to healthcare. This is because effective financing which is critical to revamping the health sector is lacking. ‘Out-of-pocket’ expenditure as percentage of private expenditure on health is put at 90 percent in Nigeria compared with 79 percent in Ghana and 24 percent in the United States of America.
This data show the nascent state of the health insurance scheme in Nigeria as patients bear the full and direct brunt of their medical expenses without any significant assistance from the company or institution they work for (if not enrolled in the National Health Insurance Scheme-NHIS)
Going further, WHO ’s report of 2005 revealed that per capital government expenditure on health in Nigeria was $14 compared to $32 (Ghana) and $2,861 (USA). In the same period, total expenditure on health as a percentage of Gross Domestic Product was put at 3.9 percent compared to 6.5 percent in Ghana and 15 percent in USA.
Furthermore, the total government expenditure on health as a percentage of total government expenditure in 2005 was 3.5 per cent compared to 6.9 percent (Ghana), and 18.7 per cent (USA).
Giving this reality, health experts have called for increased budgetary allocation for the health sector in Nigeria if the sector wants to operate at optimal capacity and deliver healthcare to millions of Nigerians
Speaking to BusinessDay, Saheed Babajide, Secretary General, Association of Resident Doctors, Lagos State University Teaching Hospital (LASUTH) disclosed that the health sector collects less than four per cent of the national’s budget which is inadequate in delivering the minimum health delivery.
Babajide stated that it the sector can get 25 per cent of budget allocations, it will go a long way in improving healthcare delivery in all tiers of government-Local, State and Federal in the sense that one won’t to travel outside the country for medical attention.
According to him “In this case, all levels of healthcare –from the primary, secondary and tertiary levels will be improved. Don’t forget that adequate equipment and the enabling environment for better health care delivery will be provided with these funds which will in turn reduce mortality rates in the country. Don’t forget that this will also improve health research which is currently been underfunded by the government and has left some of these research centres at the mercies of foreign agencies and grants.”
For Edamisan Temiye, Chairman, Nigerian Medical Association (NMA), Lagos state Branch, Nigeria has not able to meet the African heads of state commitment in Abuja in 2000 to spend 15 percent of their national budgets on health, since only N34 billion representing about seven percent has been proposed in the 2011 budget.
Temiye stated that it is believed that 70 percent of the nation’s health budget spent in urban areas where about 30 percent of the population resides. He noted that to actualize the goals of the Millennium Development Goals and solve most of health care problems, Nigeria is expected to spend 15 percent of its total budget on health.
In his words “Nigeria’s allocation to the health sector in the 2009 budget was N39.6 billion (out of N796 billion earmarked for capital expenditure the same year). If you cast your mind back, N114billion has been spent by Bill Gates in eradicating Polio in Nigeria. Gates have spent N1.2 Trillion on polio eradication globally. This amount is one-third of Nigeria’s 2010 budget of N4.079 Trillion.
No doubt, there is the need for increase in budgetary allocation which currently hovers between six and seven percent. Though there have been health reforms in the past as well as the exploration of e-health and m-health [electronic and mobile health] tools in the country, expectations of our people have not completely in providing care and ensuring that our people benefit from good health care. There is room for improvements in budgetary provisions to the health sector. The current health minister Onyebuchi Chukwu must be commended in with regards to reforms in the sector but there’s room for improvement.”
With the year set to meet the MDGs inch close and the nation’s worrisome indices, healthcare financing must not be left in the hands of government alone. At the moment, countries like Japan that manage to ensure health services are available to the entire population have done so by reducing dependence on direct, out of pocket payments and increasing prepayment - generally through insurance or taxes or a mix of the two.
The funds raised are then pooled, so that it is not just those who are unlucky enough to get sick that bear the financial burden. This is the model used in many European countries, with Chile, Colombia, Mexico, Rwanda, Thailand and Turkey all making significant progress in the last decade - along with Brazil, China, Costa Rica, Ghana and Kyrgyzstan.
For Femi Ajayi, Chairman, Olabisi Teaching University Teaching Hospital, Sagamu, given that most governments (even in more efficiently run countries) have shown that they cannot do better than the markets in terms of healthcare administration, it becomes imperative that Nigeria must redefine its policy to healthcare administration. The private sector must be allowed (indeed, encouraged) to lead development in this area.
“Government's role should not be in the provision of healthcare; instead, it should be to work with the private sector to ensure that policies are designed to meet the needs of consumers. Also, public private partnerships should be encouraged”, Ajayi concluded.
Alexander Chiejina
Any end in sight for illicit drug trading in Nigeria?
Taking a holistic look at pharmaceutical drugs, its use is critical for the health and well-being of individuals. Their access and consumption can however be likened to a double-edged sword: they alleviate the manifestation of disease in an ailing person and on the other hand, if consumed wrongly without the prescription of a physician, can be injurious to one’s health system.
It is no longer news that pharmaceutical products, genuine and counterfeit are openly sold and marketed in the streets, markets, private and public places and un-licensed outlets across in Nigeria. What is rather worrisome is how those involved in the trade have been able to so successfully sustain it under the noses of relevant government agencies including the National Agency for Food and Drug Administration and Control (NAFDAC), Pharmaceutical Society of Nigeria (PSN) in major cities in the country.
In Lagos as indeed it is in some parts of the country, drugs are openly marketed and sold in streets, public places, commercial buses by unqualified personnel who see this as a lucrative business. Findings show that majority of those involved in the trade are people out of employment. A recent visit to Obalende, Ijora, CMS, bus stops in Lagos reveal that these medicine dealers in a bid to market these drugs claims they are potent enough to cure every ailment.
This business has been on-going for a while without the relevant agency saddled with prohibiting the public sale of drug from apprehending and prosecuting such individuals.
In a chat with Bose Adebiyi, a commuter plying Obalende-Oshodi route, she stated that had purchased drugs at different occasion from bus stops without thinking of the dangers associated with consuming the drugs. She noted that due to the cost of purchasing drugs from pharmaceutical shops, people are left with no option than to purchase such drugs at a cheaper rate without having to bother about the efficacy of the drug.
Benedict Okonkwo, a pharmacist who spoke with BusinessDay, noted that ignorance of some Nigerians has contributed in making people purchase drugs from unqualified personnel. Okonkwo noted that lack of adequate medical facilities in most areas has led people to look for alternatives.
According to the pharmacist, “the society is now overwhelmed by greediness and avarice. Nobody cares about the consequence unwholesome practice provided in a bid to make quick and cheap money out of the sale of drugs. People should be enlightened on the dangers of purchasing medications and drugs from drug hawkers.”
It is noteworthy to state that The Counterfeit and Fake drugs Act, Cap 73 of 1990 prohibits the production, importation, manufacture, sale and distribution of any counterfeit, adulterated, banned or fake drugs. Specifically, Act 25 of 1999 prohibits the sales of drugs in an unauthorized place including the open drug markets.
In the same vein, the Food and Drugs Act Cap 150 of 1990, among other provisions, prohibits practices such as misleading packaging, labeling and advertising, as well as manufacturing food and drugs in unsanitary conditions. These laws were made in recognition of the citizens’ right to good health and access to genuine medicines that are safe, effective and affordable. Unfortunately and for many years, some members of the public (Nigerians and non-Nigerians) in the name of business have treated these laws with reckless abandon and have continued to endanger the lives of many Nigerians.
No doubt, it is the duty of government, professional bodies and all members of the society to ensure that people are saved from untimely deaths and trauma inflicted on them by drug hawkers. More importantly, existing laws regarding the sale of drugs if enforced would check the activities of persons not authorised to be in the business of selling drugs.
Paul Orhii, Director General, NAFDAC, in an interview with BusinessDay noted that “the Agency is currently working with many stakeholders, including states like Kano and many Local Government councils across the country, Association of Patent Medicine Dealers and the general public with a few to proving the useful information which would lead to arrest of such dealers.”
For Okonkwo “Regulatory agencies like NAFDAC should redouble their efforts in supervision and ensure strict penalties for non-compliers. The Pharmaceutical Society of Nigeria and the states ministries of health should ensure that only qualified personnel are licensed to operate pharmacy shops. In addition, the government should provide more health centres especially in the rural areas and adequately manned by trained personnel so that people will have easy access to consultation and treatment. Also, health centres should have essential drugs so that patients can purchase their drugs from hospital pharmacy instead of chemist’s shops.”
Alexander Chiejina
It is no longer news that pharmaceutical products, genuine and counterfeit are openly sold and marketed in the streets, markets, private and public places and un-licensed outlets across in Nigeria. What is rather worrisome is how those involved in the trade have been able to so successfully sustain it under the noses of relevant government agencies including the National Agency for Food and Drug Administration and Control (NAFDAC), Pharmaceutical Society of Nigeria (PSN) in major cities in the country.
In Lagos as indeed it is in some parts of the country, drugs are openly marketed and sold in streets, public places, commercial buses by unqualified personnel who see this as a lucrative business. Findings show that majority of those involved in the trade are people out of employment. A recent visit to Obalende, Ijora, CMS, bus stops in Lagos reveal that these medicine dealers in a bid to market these drugs claims they are potent enough to cure every ailment.
This business has been on-going for a while without the relevant agency saddled with prohibiting the public sale of drug from apprehending and prosecuting such individuals.
In a chat with Bose Adebiyi, a commuter plying Obalende-Oshodi route, she stated that had purchased drugs at different occasion from bus stops without thinking of the dangers associated with consuming the drugs. She noted that due to the cost of purchasing drugs from pharmaceutical shops, people are left with no option than to purchase such drugs at a cheaper rate without having to bother about the efficacy of the drug.
Benedict Okonkwo, a pharmacist who spoke with BusinessDay, noted that ignorance of some Nigerians has contributed in making people purchase drugs from unqualified personnel. Okonkwo noted that lack of adequate medical facilities in most areas has led people to look for alternatives.
According to the pharmacist, “the society is now overwhelmed by greediness and avarice. Nobody cares about the consequence unwholesome practice provided in a bid to make quick and cheap money out of the sale of drugs. People should be enlightened on the dangers of purchasing medications and drugs from drug hawkers.”
It is noteworthy to state that The Counterfeit and Fake drugs Act, Cap 73 of 1990 prohibits the production, importation, manufacture, sale and distribution of any counterfeit, adulterated, banned or fake drugs. Specifically, Act 25 of 1999 prohibits the sales of drugs in an unauthorized place including the open drug markets.
In the same vein, the Food and Drugs Act Cap 150 of 1990, among other provisions, prohibits practices such as misleading packaging, labeling and advertising, as well as manufacturing food and drugs in unsanitary conditions. These laws were made in recognition of the citizens’ right to good health and access to genuine medicines that are safe, effective and affordable. Unfortunately and for many years, some members of the public (Nigerians and non-Nigerians) in the name of business have treated these laws with reckless abandon and have continued to endanger the lives of many Nigerians.
No doubt, it is the duty of government, professional bodies and all members of the society to ensure that people are saved from untimely deaths and trauma inflicted on them by drug hawkers. More importantly, existing laws regarding the sale of drugs if enforced would check the activities of persons not authorised to be in the business of selling drugs.
Paul Orhii, Director General, NAFDAC, in an interview with BusinessDay noted that “the Agency is currently working with many stakeholders, including states like Kano and many Local Government councils across the country, Association of Patent Medicine Dealers and the general public with a few to proving the useful information which would lead to arrest of such dealers.”
For Okonkwo “Regulatory agencies like NAFDAC should redouble their efforts in supervision and ensure strict penalties for non-compliers. The Pharmaceutical Society of Nigeria and the states ministries of health should ensure that only qualified personnel are licensed to operate pharmacy shops. In addition, the government should provide more health centres especially in the rural areas and adequately manned by trained personnel so that people will have easy access to consultation and treatment. Also, health centres should have essential drugs so that patients can purchase their drugs from hospital pharmacy instead of chemist’s shops.”
Alexander Chiejina
How law threatens reproductive health
There is no gain saying that unwanted pregnancy, unsafe abortion and terrible abortion laws are serious issues in women reproductive health/ rights in Nigeria. With an estimated 600, 000 abortions performed yearly, teenagers who constitute about 20 percent of the population are worse hit.
Demographic statistics reveal that teenagers between the ages of 15 and 21 years are responsible for about 60 percent of abortion cases in the country hence making unsafe abortions a major contributory factor to maternal deaths in Nigeria.
A major factor which is limiting safe abortion is the restrictive abortion law in Nigeria which only allows termination of pregnancy to save the life of the mother. The major drawback in the law is its inability to specify who should carry out an abortion, a practice still being regarded as unlawful despite being enshrined in the country’s laws and international documents to which Nigeria was a member.
There are laws and policies such as the Vienna Declaration on Human Rights 1993, the International Conference on Population and Development (ICPD) Programme of Action of 1994, the Beijing Platform for Action (BPFA) of 1995 and Beijing + 5 Outcomes Document 2000, the Nigerian Constitution of 1999, the Criminal Code and Penal Code Laws of Nigeria, the Matrimonial Causes Act (1990), the National Policy on Women (2001), the National Health Policy., the Social Development Policy (1989), the Millennium Development Goals and the Criminal Code Section 228 to 230 among others, all supporting safe abortions and maternal health at large.
For Okpete Kanu, President, African Foundation for Pro-Life Education, Counselling and Care (FLECC), the Assembly of the African Union in meeting in Maputo, Mozambique in July 2003 adopted a document titled “Protocol to the African Charter on Human and People’s Right of women in Africa.”
Otherwise known as the Maputo Agreement, a treaty which came in to effect November 2005 and as at June 2007, 43 nations signed and 21 have formally ratified including Nigeria, Kanu stated that the Maputo Protocol passed a referendum on female genital mutilation (FGM), certain parts of the charter x-rayed abortion and its legal implications
In her words” abortion is the intentional or unintentional expulsion of the pre-born child from the womb at anytime after conception (fertilization) and before the natural birth process is completed. However, it is intentional when it is purposefully induced. It is also unintentional when it is not willfully induced as in the case of miscarriage. What is medically referred to as an inevitable abortion is a condition in pregnancy marked by vaginal bleeding and dilation of the cervix that indicates an impending unpreventable miscarriage”
Taking a cursory look at the entire scenario, safe abortion in Nigeria is still regarded as a taboo. This is coming at the heels of the fact that several policy documents were adopted in the last five years on sexual and reproductive health and rights. Though commendable as this may be, it does not constitute legally enforceable standards.
However, they merely serve as administrative guidelines promising much, but need a lot of government’s commitment and political will to interpret the realities of maternal health in the country positively.
Going further, the call for genuine political will expressed in adequate interventions is lacking. No doubt, the absence of political will on the part of Government will only continue to send our women to their early graves in large numbers. But despite all these, medical service providers, journalists and lawmakers, should ensure that that the obnoxious law is reversed to save the women.
The legal indication for abortion is quite restrictive, therefore making unsafe abortion a silent and persistent pandemic. The need make access to abortion services important for women and girls who are victims of sexual violence, rape and incest is desired.
A review of the restrictive abortion laws due to the human rights implications of unsafe abortion is a must. The Criminal Code Section 228 to 230 regards abortion as a felony, crime against the country. The code reads in part: “Any person who, with intent to procure miscarriage of a woman whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind or uses any other means whatever, is guilty of a felony, and is liable to imprisonment for seven years. Any person who unlawfully supplies to or procures for any person anything whatever, knowing that it is intended to be unlawfully used to procure the miscarriage of a woman, whether she is or is not with child, is guilty of a felony, and is liable to imprisonment for three years.”
No doubt, social stigma and political pressure render many health care providers unwilling to offer abortion services even within the limits of the law. Calls have been made in recent times by change agents under the reproductive-health networks and partnerships that have been functional to ensure that abortion law is reformed to include additional legal indications such as rape, incest and protection of the health of the woman.
Exerts said improved access to safe, legal services would greatly reduce the number of woman’s deaths and injuries caused by unsafe abortion. Efforts were made by IPAS, a woman reproductive health/ rights in 1987, when it introduced Manual Vacuum Aspiration (MVA) into public teaching hospital and the private sector.
The body had previously in 1996 worked with the Federal Government officials and colleagues to develop a national strategy for expanding Post-Abortion Care (PAC) services and to set up a team to establish and manage the PAC net. This coalition of representatives from government, Non-Governmental Organizations (NGOs) and civil society groups meets regularly to share knowledge and discuss tactics to improve the reproductive health and rights of women.
It is noteworthy to state that the criminal codes of the southern states and the penal codes of the Northern States are the major statutes about abortion in the country. The codification of Sharia Law in 1999, most Penal Codes has been amended to reflect Sharia-based values and standards.
Alexander Chiejina
Demographic statistics reveal that teenagers between the ages of 15 and 21 years are responsible for about 60 percent of abortion cases in the country hence making unsafe abortions a major contributory factor to maternal deaths in Nigeria.
A major factor which is limiting safe abortion is the restrictive abortion law in Nigeria which only allows termination of pregnancy to save the life of the mother. The major drawback in the law is its inability to specify who should carry out an abortion, a practice still being regarded as unlawful despite being enshrined in the country’s laws and international documents to which Nigeria was a member.
There are laws and policies such as the Vienna Declaration on Human Rights 1993, the International Conference on Population and Development (ICPD) Programme of Action of 1994, the Beijing Platform for Action (BPFA) of 1995 and Beijing + 5 Outcomes Document 2000, the Nigerian Constitution of 1999, the Criminal Code and Penal Code Laws of Nigeria, the Matrimonial Causes Act (1990), the National Policy on Women (2001), the National Health Policy., the Social Development Policy (1989), the Millennium Development Goals and the Criminal Code Section 228 to 230 among others, all supporting safe abortions and maternal health at large.
For Okpete Kanu, President, African Foundation for Pro-Life Education, Counselling and Care (FLECC), the Assembly of the African Union in meeting in Maputo, Mozambique in July 2003 adopted a document titled “Protocol to the African Charter on Human and People’s Right of women in Africa.”
Otherwise known as the Maputo Agreement, a treaty which came in to effect November 2005 and as at June 2007, 43 nations signed and 21 have formally ratified including Nigeria, Kanu stated that the Maputo Protocol passed a referendum on female genital mutilation (FGM), certain parts of the charter x-rayed abortion and its legal implications
In her words” abortion is the intentional or unintentional expulsion of the pre-born child from the womb at anytime after conception (fertilization) and before the natural birth process is completed. However, it is intentional when it is purposefully induced. It is also unintentional when it is not willfully induced as in the case of miscarriage. What is medically referred to as an inevitable abortion is a condition in pregnancy marked by vaginal bleeding and dilation of the cervix that indicates an impending unpreventable miscarriage”
Taking a cursory look at the entire scenario, safe abortion in Nigeria is still regarded as a taboo. This is coming at the heels of the fact that several policy documents were adopted in the last five years on sexual and reproductive health and rights. Though commendable as this may be, it does not constitute legally enforceable standards.
However, they merely serve as administrative guidelines promising much, but need a lot of government’s commitment and political will to interpret the realities of maternal health in the country positively.
Going further, the call for genuine political will expressed in adequate interventions is lacking. No doubt, the absence of political will on the part of Government will only continue to send our women to their early graves in large numbers. But despite all these, medical service providers, journalists and lawmakers, should ensure that that the obnoxious law is reversed to save the women.
The legal indication for abortion is quite restrictive, therefore making unsafe abortion a silent and persistent pandemic. The need make access to abortion services important for women and girls who are victims of sexual violence, rape and incest is desired.
A review of the restrictive abortion laws due to the human rights implications of unsafe abortion is a must. The Criminal Code Section 228 to 230 regards abortion as a felony, crime against the country. The code reads in part: “Any person who, with intent to procure miscarriage of a woman whether she is or is not with child, unlawfully administers to her or causes her to take any poison or other noxious thing, or uses any force of any kind or uses any other means whatever, is guilty of a felony, and is liable to imprisonment for seven years. Any person who unlawfully supplies to or procures for any person anything whatever, knowing that it is intended to be unlawfully used to procure the miscarriage of a woman, whether she is or is not with child, is guilty of a felony, and is liable to imprisonment for three years.”
No doubt, social stigma and political pressure render many health care providers unwilling to offer abortion services even within the limits of the law. Calls have been made in recent times by change agents under the reproductive-health networks and partnerships that have been functional to ensure that abortion law is reformed to include additional legal indications such as rape, incest and protection of the health of the woman.
Exerts said improved access to safe, legal services would greatly reduce the number of woman’s deaths and injuries caused by unsafe abortion. Efforts were made by IPAS, a woman reproductive health/ rights in 1987, when it introduced Manual Vacuum Aspiration (MVA) into public teaching hospital and the private sector.
The body had previously in 1996 worked with the Federal Government officials and colleagues to develop a national strategy for expanding Post-Abortion Care (PAC) services and to set up a team to establish and manage the PAC net. This coalition of representatives from government, Non-Governmental Organizations (NGOs) and civil society groups meets regularly to share knowledge and discuss tactics to improve the reproductive health and rights of women.
It is noteworthy to state that the criminal codes of the southern states and the penal codes of the Northern States are the major statutes about abortion in the country. The codification of Sharia Law in 1999, most Penal Codes has been amended to reflect Sharia-based values and standards.
Alexander Chiejina
Global strategy to detect Tuberculosis underway
Over the years, health experts have been faced with the challenge of reducing the incidence of Tuberculosis (TB), a contagious disease caused by a bacterium known as Mycobacterium tuberculosis, which mostly affects the lungs. According to recent statistics, it is estimated that one-third of the world's population is currently infected with the TB bacillus.
It is believed that about 5 to 10 percent of people infected with TB bacilli (but who are not infected with Human Immuno Virus (HIV) ) become sick or infectious at some time during their life even as people with HIV and TB infection are much more likely to develop TB.
Like the common cold, the infection spreads from infectious individuals who cough, sneeze, talk or spit hereby propelling TB germs, known as bacilli, into the air. However, an individual needs only to inhale a small number of these to be infected.
As various countries across the globe continues its quest to reach Millennium Development Goal for TB incidence and the Stop TB Partnership 2015 target for mortality especially in Africa and Eastern Europe, the World Health Organization (WHO) recently endorsed a new and novel rapid test for tuberculosis especially relevant in countries most affected by the disease.
The test is expected to revolutionize TB care and control by providing an accurate diagnosis for many patients in about 100 minutes, compared to current tests that can take up to three months to obtain the results.
WHO's endorsement of the rapid test, which is a fully automated NAAT (nucleic acid amplification test), follows 18 months of rigorous assessment of its field effectiveness in the early diagnosis of TB, as well as multidrug-resistant TB (MDR-TB) and TB complicated by HIV infection, which are more difficult to diagnose.
The health body also released recommendations and guidance for countries to incorporate this test in their programs which includes testing protocols (or algorithms) to optimize the use and benefits of the new technology in those persons where it is needed most.
Evidence to date indicates that implementation of this test could result in a three-fold increase in the diagnosis of patients with drug-resistant TB and a doubling in the number of HIV-associated TB cases diagnosed in areas with high rates of TB and HIV.
In an interview with Folasade Ogunsola, Head, Department of Medical Microbiology, college of medicine, Lagos State University Teaching Hospital (LUTH), Ogunsola disclosed that TB drug resistance is a major public health problem which may threaten the success of directly observed treatment (DOTS), which is the WHO-recommended treatment approach for detection and cure of TB. The medical expert noted that currently, strains of TB resistant to major anti-TB drugs have emerged which is traceable to improper use of antibiotics in chemotherapy of drug-susceptible TB patients.
According to her, “a dangerous form of drug-resistant TB, multidrug-resistant TB (MDR-TB), resists the treatment of at least isoniazid and rifampicin, the two most powerful anti-TB drugs. The emergence of extensively drug-resistant (XDR) TB occurs particularly in settings where many TB patients are also infected with HIV, and this poses serious threat to TB control.
The challenge of detecting the etiological agent M. tuberculosis is that many countries still rely principally on sputum smear microscopy, a diagnostic method that was developed over a century ago. But this new 'while you wait' test incorporates modern DNA technology that can be used outside of conventional laboratories. It also benefits from being fully automated and therefore easy and safe to use.”
For Giwa Temidayo, a health expert, some teaching hospitals as well as medical laboratories though might be aware of the rapid test for TB, medical facilities to conduct such diagnosis is not operational in most laboratories where such TB tests are carried out.
According to Temidayo “few hospitals in the country may possess the equipment to conduct this rapid TB tests. If teaching hospitals where lots of medical personnel are produced don’t have equipment to conduct this kind of test then, latent TB cases may be difficult to ascertain. Though there have been major improvements in TB care and control, there is the need for in improving access to diagnosis and treatment, and also in the scale up of TB/HIV intervention as well as laboratory strengthening.”
Even as the world health body (WHO) is calling for the fully automated NAAT to be rolled out under clearly defined conditions and as part of national plans for TB and MDR-TB care and control, affordability of facilities for NAAT has been a major concern.
Just before the end of 2010, co-developer FIND (the Foundation for Innovative and New Diagnostics) announced that it has negotiated with the manufacturer, Cepheid, a 75 percent reduction in the price for countries most affected by TB, compared to the current market price. Health experts are of the believe that preferential pricing will be granted to 116 low- and middle- income countries where TB is endemic, with additional reduction in price once there is significant volume of demand.
For Giorgio Roscigno, FIND's Chief Executive Officer, “There has been a strong commitment to remove any obstacles, including financial barriers that could prevent the successful roll-out of this new technology. For the first time in TB control, we are enabling access to state-of-the-art technology simultaneously in low, middle and high income countries. The technology also allows testing of other diseases, which should further increase efficiency.”
Alexander Chiejina
It is believed that about 5 to 10 percent of people infected with TB bacilli (but who are not infected with Human Immuno Virus (HIV) ) become sick or infectious at some time during their life even as people with HIV and TB infection are much more likely to develop TB.
Like the common cold, the infection spreads from infectious individuals who cough, sneeze, talk or spit hereby propelling TB germs, known as bacilli, into the air. However, an individual needs only to inhale a small number of these to be infected.
As various countries across the globe continues its quest to reach Millennium Development Goal for TB incidence and the Stop TB Partnership 2015 target for mortality especially in Africa and Eastern Europe, the World Health Organization (WHO) recently endorsed a new and novel rapid test for tuberculosis especially relevant in countries most affected by the disease.
The test is expected to revolutionize TB care and control by providing an accurate diagnosis for many patients in about 100 minutes, compared to current tests that can take up to three months to obtain the results.
WHO's endorsement of the rapid test, which is a fully automated NAAT (nucleic acid amplification test), follows 18 months of rigorous assessment of its field effectiveness in the early diagnosis of TB, as well as multidrug-resistant TB (MDR-TB) and TB complicated by HIV infection, which are more difficult to diagnose.
The health body also released recommendations and guidance for countries to incorporate this test in their programs which includes testing protocols (or algorithms) to optimize the use and benefits of the new technology in those persons where it is needed most.
Evidence to date indicates that implementation of this test could result in a three-fold increase in the diagnosis of patients with drug-resistant TB and a doubling in the number of HIV-associated TB cases diagnosed in areas with high rates of TB and HIV.
In an interview with Folasade Ogunsola, Head, Department of Medical Microbiology, college of medicine, Lagos State University Teaching Hospital (LUTH), Ogunsola disclosed that TB drug resistance is a major public health problem which may threaten the success of directly observed treatment (DOTS), which is the WHO-recommended treatment approach for detection and cure of TB. The medical expert noted that currently, strains of TB resistant to major anti-TB drugs have emerged which is traceable to improper use of antibiotics in chemotherapy of drug-susceptible TB patients.
According to her, “a dangerous form of drug-resistant TB, multidrug-resistant TB (MDR-TB), resists the treatment of at least isoniazid and rifampicin, the two most powerful anti-TB drugs. The emergence of extensively drug-resistant (XDR) TB occurs particularly in settings where many TB patients are also infected with HIV, and this poses serious threat to TB control.
The challenge of detecting the etiological agent M. tuberculosis is that many countries still rely principally on sputum smear microscopy, a diagnostic method that was developed over a century ago. But this new 'while you wait' test incorporates modern DNA technology that can be used outside of conventional laboratories. It also benefits from being fully automated and therefore easy and safe to use.”
For Giwa Temidayo, a health expert, some teaching hospitals as well as medical laboratories though might be aware of the rapid test for TB, medical facilities to conduct such diagnosis is not operational in most laboratories where such TB tests are carried out.
According to Temidayo “few hospitals in the country may possess the equipment to conduct this rapid TB tests. If teaching hospitals where lots of medical personnel are produced don’t have equipment to conduct this kind of test then, latent TB cases may be difficult to ascertain. Though there have been major improvements in TB care and control, there is the need for in improving access to diagnosis and treatment, and also in the scale up of TB/HIV intervention as well as laboratory strengthening.”
Even as the world health body (WHO) is calling for the fully automated NAAT to be rolled out under clearly defined conditions and as part of national plans for TB and MDR-TB care and control, affordability of facilities for NAAT has been a major concern.
Just before the end of 2010, co-developer FIND (the Foundation for Innovative and New Diagnostics) announced that it has negotiated with the manufacturer, Cepheid, a 75 percent reduction in the price for countries most affected by TB, compared to the current market price. Health experts are of the believe that preferential pricing will be granted to 116 low- and middle- income countries where TB is endemic, with additional reduction in price once there is significant volume of demand.
For Giorgio Roscigno, FIND's Chief Executive Officer, “There has been a strong commitment to remove any obstacles, including financial barriers that could prevent the successful roll-out of this new technology. For the first time in TB control, we are enabling access to state-of-the-art technology simultaneously in low, middle and high income countries. The technology also allows testing of other diseases, which should further increase efficiency.”
Alexander Chiejina
How Poor implementation of Health insurance scheme impedes economic development
Health is Wealth. So goes a popular saying and therefore in every country, the health sector is critical to social and economic development with ample evidence linking productivity to quality of health care. In Nigeria, the vision of becoming one of the leading 20 economies of the world by the year 2020 is closely tied to the development of its human capital through the health sector.
Given this lofty dream, the nation’s quest for rapid economic development could be a mirage unless federal government intervenes in the current operations of the National Health Insurance Scheme (NHIS), charged with the responsibility of providing easy access to health care to all Nigerians.
This is so because the 11 year old scheme which is to provide health care at affordable prices to Nigerians, who, will in turn contribute to the nation’s Gross Domestic Product (GDP) are being denied under the pretext that the current 15 percent deductions from workers salaries is not enough to avail them of the necessary health care services.
The Scheme, which was established under Act 35 of 1999 by the Federal Government of Nigeria, is aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems.
Under the scheme, employers contribute 10 percent while employees make it up with the 5 percent monthly. Health insurance is a social security system that guarantees the provision of needed health services to persons on the payment of token contributions at regular intervals.
GDP is the total market value of all final goods and services produced by labour in a country within a given year. It can be estimated, in theory, on expenditure basis, which is how much money was spent, output, how many goods and services were sold and Income basis, how much income (profit) was earned within that period.
Being as it may, economists use GDP indices to measure the overall growth or decline of a nation's economy among others.
Although most of the stakeholders who spoke with Business Day agreed that capitation, which is the monthly payment of between N500 and N550 per head by Health Management Organizations (HMOs) to primary health care providers (Hospitals) is too meager, they deplored activities of the two parties which embark on delay tactics, thereby frustrating the patients. The essence is to maximize gains from the contributions as 62 percent of the capitation is expected to be expended on the patients.
The hospitals make recourse to HMOs on complicated ailments or those that require attention of specialists for authorization before proceeding to treat the patients. In most cases, the HMOs would foot drag in sending the needed code that will enable the hospital access to funds on treating the patients. Hospitals, on the other hand, resort to dispensing low quality drugs to patients. At the end of the day, patients are forced to seek for alternative services, while the capitation, which is usually paid in advance, will not be used for the purpose for which it was released.
Adeyeye Arigbabuwo, General Secretary, Healthcare Providers Association of Nigeria (HCPAN), who spoke exclusively to BusinessDay disclosed that the 62 percent of the capitation meant per head for enrollees to receive healthcare services under the scheme has led to the low quality of services and drugs administered to Nigerians
who may not be commensurate to improve the health of the patient.
According to Arigbabuwo, capitation is used for providing primary healthcare services only hence it is also used to control use of health resources by putting the physician at financial risk for services provided to the patient. He hinted that providers are paid according to the number of enrollees attached to the family.
In his words “Don’t forget that the actual amount of money paid (capitation) is determined by the range of services provided, the number of patients involved, the period of time during which the services are provided. All these are developed using local cost and average utilisation of services. Aside this, the HMO makes the fee for service payment to non-capitation receiving healthcare providers who offer services on referral from other approved providers.
Arigbabuwo maintained that why hospitals make recourse to HMOs for authorization before embarking on higher/expensive treatment is that the level of care has gone beyond the primary care level and as such codes or pre-authorization are needed to be given by the HMO to the secondary care provider to treat the patient.
He added “though the authorization is to prevent abuses as well as ensure that appropriate healthcare provider provides the relevant healthcare services which is commensurate to the patient’s need, more often than not, providers take undue advantage of the low tariff to foot drag on issues of carrying out treatment which sometimes lead to the death of such patients.
You will recall that in the United States of America, about 90 percent of the health budget of 2010 was passed to the general practitioners to decide what the primary, secondary or tertiary healthcare provider receives for services rendered enrollees of the health insurance scheme, adding “such a feat can be replicated in Nigeria.”
For Victor Amadi, Lagos State Coordinator, NHIS, drugs that are administered to enrollees at the hospitals are the prescribed drugs, pharmaceutical care and diagnostic tests contained in the National Essential Drugs List and Diagnostic Test Lists. He noted that if the drugs are not covered with the scheme, the enrollees through its healthcare provider are given the drug list which he should purchase elsewhere.
Amadi disclosed that at the moment, a 48 hour range is given for response by HMO to carry on with the treatment as if such doesn’t happen, the other provider can carry on with the treatment pending when the HMO respond.
There is no gain saying that with life expectancy in Nigeria at approximately 47 percent as against World Health Organization’s (WHO) life expectancy average at 67.2 percent, providing quality healthcare services to Nigeria will not in any way portend danger for the economy.
Critical interventions recommended to revamp the healthcare system in the country include increasing government allocation to health at all levels, expanding the NHIS coverage and regulatory functions, implementation of the community-based health insurance schemes, as well as pooling funds using common basket approaches by all actors involved in financing health in Nigeria.
Alexander Chiejina
Given this lofty dream, the nation’s quest for rapid economic development could be a mirage unless federal government intervenes in the current operations of the National Health Insurance Scheme (NHIS), charged with the responsibility of providing easy access to health care to all Nigerians.
This is so because the 11 year old scheme which is to provide health care at affordable prices to Nigerians, who, will in turn contribute to the nation’s Gross Domestic Product (GDP) are being denied under the pretext that the current 15 percent deductions from workers salaries is not enough to avail them of the necessary health care services.
The Scheme, which was established under Act 35 of 1999 by the Federal Government of Nigeria, is aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems.
Under the scheme, employers contribute 10 percent while employees make it up with the 5 percent monthly. Health insurance is a social security system that guarantees the provision of needed health services to persons on the payment of token contributions at regular intervals.
GDP is the total market value of all final goods and services produced by labour in a country within a given year. It can be estimated, in theory, on expenditure basis, which is how much money was spent, output, how many goods and services were sold and Income basis, how much income (profit) was earned within that period.
Being as it may, economists use GDP indices to measure the overall growth or decline of a nation's economy among others.
Although most of the stakeholders who spoke with Business Day agreed that capitation, which is the monthly payment of between N500 and N550 per head by Health Management Organizations (HMOs) to primary health care providers (Hospitals) is too meager, they deplored activities of the two parties which embark on delay tactics, thereby frustrating the patients. The essence is to maximize gains from the contributions as 62 percent of the capitation is expected to be expended on the patients.
The hospitals make recourse to HMOs on complicated ailments or those that require attention of specialists for authorization before proceeding to treat the patients. In most cases, the HMOs would foot drag in sending the needed code that will enable the hospital access to funds on treating the patients. Hospitals, on the other hand, resort to dispensing low quality drugs to patients. At the end of the day, patients are forced to seek for alternative services, while the capitation, which is usually paid in advance, will not be used for the purpose for which it was released.
Adeyeye Arigbabuwo, General Secretary, Healthcare Providers Association of Nigeria (HCPAN), who spoke exclusively to BusinessDay disclosed that the 62 percent of the capitation meant per head for enrollees to receive healthcare services under the scheme has led to the low quality of services and drugs administered to Nigerians
who may not be commensurate to improve the health of the patient.
According to Arigbabuwo, capitation is used for providing primary healthcare services only hence it is also used to control use of health resources by putting the physician at financial risk for services provided to the patient. He hinted that providers are paid according to the number of enrollees attached to the family.
In his words “Don’t forget that the actual amount of money paid (capitation) is determined by the range of services provided, the number of patients involved, the period of time during which the services are provided. All these are developed using local cost and average utilisation of services. Aside this, the HMO makes the fee for service payment to non-capitation receiving healthcare providers who offer services on referral from other approved providers.
Arigbabuwo maintained that why hospitals make recourse to HMOs for authorization before embarking on higher/expensive treatment is that the level of care has gone beyond the primary care level and as such codes or pre-authorization are needed to be given by the HMO to the secondary care provider to treat the patient.
He added “though the authorization is to prevent abuses as well as ensure that appropriate healthcare provider provides the relevant healthcare services which is commensurate to the patient’s need, more often than not, providers take undue advantage of the low tariff to foot drag on issues of carrying out treatment which sometimes lead to the death of such patients.
You will recall that in the United States of America, about 90 percent of the health budget of 2010 was passed to the general practitioners to decide what the primary, secondary or tertiary healthcare provider receives for services rendered enrollees of the health insurance scheme, adding “such a feat can be replicated in Nigeria.”
For Victor Amadi, Lagos State Coordinator, NHIS, drugs that are administered to enrollees at the hospitals are the prescribed drugs, pharmaceutical care and diagnostic tests contained in the National Essential Drugs List and Diagnostic Test Lists. He noted that if the drugs are not covered with the scheme, the enrollees through its healthcare provider are given the drug list which he should purchase elsewhere.
Amadi disclosed that at the moment, a 48 hour range is given for response by HMO to carry on with the treatment as if such doesn’t happen, the other provider can carry on with the treatment pending when the HMO respond.
There is no gain saying that with life expectancy in Nigeria at approximately 47 percent as against World Health Organization’s (WHO) life expectancy average at 67.2 percent, providing quality healthcare services to Nigeria will not in any way portend danger for the economy.
Critical interventions recommended to revamp the healthcare system in the country include increasing government allocation to health at all levels, expanding the NHIS coverage and regulatory functions, implementation of the community-based health insurance schemes, as well as pooling funds using common basket approaches by all actors involved in financing health in Nigeria.
Alexander Chiejina
Placing health research in the Nation’s healthcare agenda
There is no gain saying that the improvement in healthcare delivery is closely associated with advances in medical research. However, strengthening medical research capacities at country levels have constituted the most powerful cost effective and sustainable means of advancing a nation’s health and development.
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.
With Nigeria yet to assume the driving seat of health research within sub Saharan Africa let alone the African continent, medical experts in the country have called for on Government at all levels to provide the necessary leadership in the area of developing and sustaining health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in the country.
Speaking recently in Lagos on the theme “Nigeria: Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja disclosed that till date, medical research has provided the strongest support for preventive and curative medicine.
While recounting 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, he regretted that till date, certain policy directives to champion health research in the country are yet to be implemented thus stalling the advancement of medical research in the country.
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 further 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, inadequate research priority setting, dearth of research infrastructures, sub-optimal capacity building strategies, and ineffectual documentation.
For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (for research institutes in the country like Nigerian Institute of Medical Research (NIMR)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 compounded the relegation of medical research in the country.
Nwanyanwu stated that currently, health research is not a priority of governments as it 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, partners 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 and increasingly successful treatments for cancer and other emerging diseases.
Aside this, 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 quest 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 - a heath component of Vision 20; 2020), which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP.
At the national level, it is imperative 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
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.
With Nigeria yet to assume the driving seat of health research within sub Saharan Africa let alone the African continent, medical experts in the country have called for on Government at all levels to provide the necessary leadership in the area of developing and sustaining health research, create enabling policies, guidelines, ethics and legal framework in lieu of current health challenges in the country.
Speaking recently in Lagos on the theme “Nigeria: Health Research for National Development” Lecky Mohammed, Director, Health, Planning, Research and Statistics in the Federal Ministry of Health, Abuja disclosed that till date, medical research has provided the strongest support for preventive and curative medicine.
While recounting 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, he regretted that till date, certain policy directives to champion health research in the country are yet to be implemented thus stalling the advancement of medical research in the country.
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 further 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, inadequate research priority setting, dearth of research infrastructures, sub-optimal capacity building strategies, and ineffectual documentation.
For Okey Nwanyanwu, Country Director, Centre for Diseases and Country, (CDC) Nigeria, irregular and insufficient funding of health institutes (for research institutes in the country like Nigerian Institute of Medical Research (NIMR)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 compounded the relegation of medical research in the country.
Nwanyanwu stated that currently, health research is not a priority of governments as it 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, partners 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 and increasingly successful treatments for cancer and other emerging diseases.
Aside this, 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 quest 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 - a heath component of Vision 20; 2020), which is to serve as a tool for resource mobilization, develop plans that are aligned to NSHDP.
At the national level, it is imperative 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
Subscribe to:
Posts (Atom)