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Halfway Scorecard :Still in the era of ‘mere consulting clinics’

The ministry has also survived three ministers during the period under review. The first was Professor Adenike Grange and her Minister of State for Health,…

The ministry has also survived three ministers during the period under review. The first was Professor Adenike Grange and her Minister of State for Health, Dr Gabriel Aduku. Both were implicated in a N300m scam. Then the ministry went under the leadership of Hassan Lawal who acted as the supervisory minister till the present ministers were sworn in.

During this turbulent period, the country has witnessed a rapid decline in our health facilities, a collapse in the surveillance system which has led to different disease outbreaks that have claimed thousands of lives. Under the present minister, Professor Babatunde Osotimehin and his Minister of State, Dr Aliyu Idi Hong, there have been several attempts to resuscitate the healthcare system by ensuring that all stakeholders are carried along in the mechanism of change. The ministry has identified that an increase in the budget allocation to the health sector will go a long way in toimprove the country’s low health indices.

In line with this, the Federal Government increased the ministry’s budget allocation from N17 billion to about N22.5 billion in 2009. Professor Osotimehin explained that there will be a drastic attempt to implement the policies meant to deliver good healthcare while domestic funding must be a significant contribution in achieving the MDG goals with an attempt to de-emphasise dependence on donor agencies.

He pointed out that the ministry lacked the necessary expertise to cost projects making it difficult to plan effectively.

His words: “We recognise that domestic funding should make a significant contribution in meeting the challenges for health – MDGs. Thus, the government has steadily improved its funding support for 2009.

“We are internally challenged by the issues of efficiency and spending wisely… and we are thus looking for technical assistance in these regards, especially in building capacity for proper costing for health — MDGs, and innovative mechanisms that offer tremendous potential to save lives through new and creative solutions”.

Meanwhile, through some of its parastatals, the Health Ministry had sought to bridge the gap that has made Nigerians so dissatisfied with the healthcare delivery system. The National Health Insurance Scheme (NHIS) was launched in 1997 to provide effective healthcare to Nigerians at low cost through pooling of funds. The organisation under the administration of Dr Muhammad Dogo Waziri, has so far registered 2.5m Nigerians and is quickly cascading into the informal sector. It has also initiated the community insurance to take care of states and other branches of the informal sector.

Though a laudable scheme which if fully implemented, can solve the health problems of Nigerians according to the executive secretary, it is still bedevilled by scepticism and public apathy towards insurance in general and creating mass public awareness on the principles of social health insurance.

Meanwhile, the Federal Government has, through its MDG office, provided funds to tackle the increasing infant and maternal mortality by providing free medical services in collaboration with the state governments. This would have been a success and a milestone achieved if the chosen state bought into the project, provided the counterpart fund to enable the project to cater for a larger number of women and children, but the state governors are still trying to make up their minds; and while they’re doing so, many more women and children will die.

Another agency under the ministry is the National Primary Health Care Development Agency which has in recent times been accused of doing nothing to improve our primary healthcare. This accusation led to the sack of the then executive director, Mrs Titilola Adelekan who was replaced by Dr Muhammad Pate. The Federal Government has identified the primary healthcare centres as a backbone to improve our healthcare facilities and treating and preventing a lot of these topical diseases that tend to claim lives in thousands.

Dr. Muhammed Pate said a lot of advocacy visits and campaigns have begun with the hope to rekindle the interest of state and local governments toward catering for the healthcare of the masses. Speaking on polio, measles and meningitis outbreaks in the recent past that led to the loss of lives, Pate admitted that it was as a result of the collapse of primary healthcare centres. He added that through the concrete action plan of the present ministers – Osotimehin and Hong – many governors are beginning to take active steps to equip their healthcare centres.

On the upsurge in diseases outbreak, Pate explained that it would have been a lot worse without the prompt report of the surveillance team and prompt  intervention by the Federal Government. Thousands have died from the outbreak of meningitis and measles, especially in the North. Then there was another shocker – the discovery of Lassa fever spread by rats. In the case of cerebrospinal meningitis, the Federal Government announced that it recorded about 5,323 cases with 333 deaths in 22 states and 217 local governments.

In the case of polio, there were 68 cases that cut across 20 states in Nigeria, a reduction from the 803 cases recorded in 2008. Pate added that the agency has already pooled the political will from all stakeholders and governments at all levels have started tackling the problems, adding that the government is planning to employ thousands of midwives who will be posted to rural areas and doctors from the NYSC, all in a bid to improve health centres. The National Agency for the Control of AIDS/HIV (NACA) is saddled with the responsibility of catering and creating awareness for the deadly virus.

Reports have revealed that about 3.5 million people are infected with AIDS and the prevalent rate of the disease has decreased as more awareness is being created for it. Osotimehin who was the then Director General of the agency, was able to ensure availability of the drugs at no cost for people living with the virus. Vice President Goodluck Jonathan launched the voluntary testing and counselling, saying there are plans to make it compulsory so as to help people know their status and get treatment early. The agency is presently headed by John Idoko.

In the meantime, another major health problem, that is, the resurgence of tuberculosis has made Nigeria to be regarded as the fifth among 22 burden countries. According to WHO, Nigeria contributes 80 per cent of the global burden of TB, with 460,000 cases occurring annually. But the greatest challenge is the emergence of a drug resistant TB, whose cause is yet to be completely ascertained.

The National Agency for Food, Drugs Administration and Control (NAFDAC) is headed by Paul Ohrii, who took over from Dora Akunyili. The agency had been quite steadfast in its fight against manufacturers of fake drugs who have killed many people in recent times. Unfortunately for the agency, in November 2008, it failed to capture the manufacturers of a teething drug called ‘My Pikin,’ which resulted in the death of about 84 children.

The agency has since retraced its steps and commenced legal proceedings against the manufacturers of that action. Paul Ohrii has promised to consolidate on Akunyili’s  work and ensure that manufacturers of fake drugs are brought to book. The ‘roll back malaria’ is a strategy by the Federal Government to flush malaria out of the country. The statistics given by the Health Ministry reveal that it is responsible for every one in four deaths among children under five and one in ten deaths among pregnant women, meaning that over 90% of Nigeria’s population is at risk, while at least 50 per cent will have one attack in a year.

In a bid to save people from this deadly scourge, the Federal Ministry of Health has purchased over N25.5 million worth dose of Artemisin-based combination therapies for the effective treatment of malaria for children. It has also brought 13 million doses of sulphodoxine pyrimethamine for pregnant women to prevent deaths. The government through the Health Ministry is to begin the distribution of treated mosquito nets to Nigerians. It has also promised to put in place effective environmental management, i.e. house-to-house inspections and environmental sanitations.

Still, Nigerians have to battle with other killer ailments like leukaemia and cancer, among others. Apart from trying to resolve the issues of a collapsing healthcare system, the ministry is presently being threatened with a strike action from doctors under the auspices of the Nigerian Medical Association (NMA), which is asking for the implementation of a medical salary structure.

The Nurses and Midwifery Association is also planning the same strike action, saying that they are not adequately provided for which according to them, is responsible for the brain drain in the country. The Medical and Dental Council of Nigeria is also calling for the inauguration of its Board to enable it function properly. The Council’s registrar is Dr Abdulmumini Ibrahim while  the Pharmacist Council of Nigeria headed by Ahmed Mora, has also begun a swift clampdown on all patent drug stores and an inspection of pharmacists in hospitals as a mechanism to ensure effective and best practices in the profession.