Health
Nigeria At 52: Assessing Health Sector
Health, they say, is
wealth and
being in good health is the centre of all human endeavours. Being in good
health is not just the absence of illness, but it entails holistic
harmony-spiritual, social, economic etc., which is primarily the responsibility
of the individual.
However, government owes it as a duty to its citizens to
ensure that affordable, accessible, adequate and sustainable healthcare
services are provided to promote good health.
In doing this,
government must carefully and strategically plan the healthcare delivery system
in the nation.
The bedrock of strategic healthcare delivery and planning is
anchored on Primary Health Care (PHC), no wonder on September 12, 1978, 134
countries met at a conference in Alma Ata, Russia, under the auspices of World
Health Organisation (WHO), the United Nations Children’s Fund (UNICEF) and formulated
the PHC concept.
According to WHO, PHC
is an essential component of healthcare, which is based on practical
scientifically sound and socially acceptable methods and technology, made
universally accessible to individuals and families in the communities through
their full participation and at a cost which the country can afford to maintain
at every stage of their development in the spirit of self-reliance and self
determination.
Nigeria launched the National Primary Health care during the
Babangida led administration in 1988, 28 years after Nigeria became a nation
and 10 years after it was first launched.
Primary Health Care is the first level contact of the
individual and community in the national healthcare, which brings healthcare as
close as possible to the people.
The Rivers State government
in its determination to make this a reality, did not only adopt it, but
pushed it farther by undertaking to
build 160 primary Health Centres in 160 communities of the state of this number
110 have been completed and handed over to the Rivers State Primary Healthcare
Management Board (PHCMB), according to the chairman of the Board, Professor,
Urial Etawo.
Professor Etawo stated that in addition to the 110 health
centres delivered to the Board, 200 existing health facilities being managed by
the local government councils were taken over by the state government, some of
which he said, would be upgraded to model health centres while others would be
model led into health posts for use during immunisation campaigns.
The Rivers State government went beyond the PHC scheme and
introduced free medical care scheme for children between zero to six years and
adults of 60-years and above in the first instance which presently has been
modified to Universal Free Medical Care
Scheme, open to all bona fide residents of the state. Under the scheme,
only those who can show evidence of voters
registration card and payment of social responsibility tax are eligible
to register and benefit.
Additionally, the RSPHCMB has introduced Home Based Care
(HBC) still under the Primary Health Care scheme, in which every family in the
community would be visited by a healthcare provider.
According to the chairman of the PHCMB, the advantage of HBC
is that diseases in the family can easily be identified and immunisation would
be 100 percent.
He noted that the over 300 primary health centres spread
across the state would be the focal points for the exchange of visits, adding
that, “each health centre will be in charge of 10 villages while everyone in
those 10 villages would be registered” and a record of new birth and deaths,
kept though this would require heavy funding, he observed.
If what the chairman, Rivers State Primary Health Care
Management Board, Prof. Etawo has said is anything to go by, one can say that
the health sector, since Nigeria’s Independence, 52 years ago has remarkably
improved.
In the past, the local communities never had health centres
or General Hospitals. At best what they had were sick bays and dispensaries and
the difficult cases would have to make long distances to get to a general
hospital to receive medical attention.
According to the Director, Public Health, Rivers State
Ministry of Health, Akuro Okujagu, “I don’t know what we had 52 years back, but
today, you can see the remarkable improvement. For instance, in the primary
health sector, you can see the number of facilities have increased, quality of
healthcare delivery and personnel has also improved.”
Dr Okujagu admitted that no one ever thought 30 years ago
that Rivers State would have a teaching hospital, which is now presently
located at Alakahia.
He observed that the progress might be slow but the
healthcare services are certainly better than what they were, 52 years ago.
He said: “statistically, the number though may not be too
encouraging, we are on the way forward, the health indices are getting better,
though they may not be too good but they’re certainly on the better side.”
If the health sector has improved so tremendously, why then
the exodus to India for medical attention?
Dr Okujagu said “it is just a Nigerian factor, not that most
of those cases they take to India cannot be handled here.”
He commended Nigerian medical personnel practicing outside
the shores of the country, saying “if you go to other countries where Nigerian
doctors or nurses are working, they make their mark, they’re highly respected
and most of them graduated from Nigerian medical schools.”
He expressed the hope that someday, “we will get to the
situation where no one would border to go to India.”
To further improve Nigeria’s health sector, Dr. Okujagu
said, training and retaining of healthcare providers is pivotal, adding that
since the infrastructures are now in place, modern equipment and yearly upgrade
would do the sector a lot of good.
The chairman, Rivers State Chapter of the National
Association of Perioperative Nurse of Nigeria (NAPON), Mrs Bridget Ogbannaya
also agreed that training is important if the health sector must further
improve.
On his part, Director, Environmental Health and Safety,
Rivers State Ministry of Environment, Dr Napoleon Isha Ewule feels that proper
policy implementation would place the country’s health sector at par with their
international counterpart.
For Consultant Surgeon, University of Port Harcourt Teaching
Hospital and Senior lecturer, University of Port Harcourt, Rollins Jamabo,
there has been tremendous changes over the years, particularly in the surgical
treatment of patients.
“In the past, we had only a surgeon, a nurse with or without
anesthetist with very few instruments and sutures to operate on a patient and
also we had reuseable gloves, needles and syringes and these were boiled and
reboild and re sterilised for reuse.
“Nowadays, we have disposable gloves, syringes, needles and
in fact the needles are now directly attached to the sutures such that at the
end of the usage of the sutures, they are disposed.
Furthermore, he said surgeries have been changed too, in the
past open surgery was the only way to operate on a patient but now, endoscope,
which applies minimal access is being used and “surgery was used in the
treatment of peptic ulcer but now drugs can do the job.”
Dr Jamabo regretted that the mass movement of Nigerians to
India was not orchestrated by the lack of expertise in Nigeria but that doctors
in India were offering as much as 10 per cent cost if they would refer patients
to them.
In his words, “the annoying thing about this India
expedition is that they are now paying other surrogates, if you send me one
patient, we’ll send you 10 per cent of the cost or they tell you clear cut
N150,000 is yours.
“So now, whether you want to go India or not, they’ll tell
you it’s better you go to India or better the India doctor will ring you,” he
said.
Unfortunately, he said the prognosis in India is not
encouraging at all and prays that the ‘expedition’ as he calls it, will end
soon.
He suggests increased funding, provision of equipment, drugs
and manpower as the way forward to further improve the sector.
Tonye Nria-Dappa
To address the increasing number of rape and defilement cases in Lagos communities, the State Ministry of Health has trained healthcare workers on the prevention and management of sexual assault cases.
The Director, Public Affairs in the ministry, Tunbosun Ogunbanwo, in a statement on Monday said the training equipped health workers with the knowledge and skills to provide professional, compassionate, and timely care to survivors.
Dr Folasade Oludara, Director, Family Health and Nutrition, State Ministry of Health, said the growing number of rape and defilement cases in Lagos communities necessitated the upskilling of healthcare workers who are often the first responders to survivors.
Oludara, represented by Dr Oluwatosin Onasanya, Deputy Director, Child Health, said the government recognised the critical role of health professionals in both clinical management and legal documentation of sexual assault cases.
She explained that the training was designed to ensure healthcare workers are adequately equipped to identify, document, and manage sexual assault cases effectively.
According to her, the training will strengthen Lagos’ coordinated health system response to gender-based violence.
She disclosed that the state government had already provided equipment and specimen collection tools to health facilities, noting that the training complemented this investment by building the competence of personnel handling such sensitive cases.
Oludara explained that doctors and nurses at the primary, secondary, and tertiary levels who serve as first contact points for survivors were carefully selected from all 57 LGAs and LCDAs, particularly from areas with higher incident rates.
The SGBV Programme Manager, Lagos State Ministry of Health, Dr Juradat Aofiyebi, emphasised that the capacity-building initiative was a strategic step toward improving survivor-centred healthcare delivery and prosecution outcomes.
Aofiyebi added that the training underscored the government’s commitment to reducing the prevalence of sexual assault through a robust, multi-sectoral approach.
“The training provides healthcare workers with the knowledge to properly identify survivors, document findings accurately, and provide comprehensive care, all of which contribute to justice delivery and prevention of repeat offences.
She said the ministry would sustain such training to ensure that every survivor who presented at a Lagos health facility received quality, non-judgmental care.
Mrs Adebanke Ogunde, Deputy Director, Directorate of Public Prosecutions (DPP), Lagos State Ministry of Justice, highlighted the importance of medical documentation in sexual assault trials.
She explained that most convictions hinge on the quality of medical reports and forensic evidence provided by healthcare professionals, noting that medical reports served as vital corroborative evidence in court, particularly in cases involving children.
“Your medical reports are crucial; they can determine whether justice is served or denied,” she said.
Ogunde reminded health workers of their legal duty to report suspected sexual assault cases to the police or the Lagos State Domestic and Sexual Violence Agency (DSVA).
Similarly, Dr Oluwajimi Sodipo, Consultant Family Physician, Lagos State University Teaching Hospital (LASUTH), underscored the importance of timely medical attention, psychosocial support, and non-stigmatising care for survivors.
Sodipo explained that immediate presentation within 72 hours of assault improved chances of preventing infections and collecting viable forensic evidence.
He commended Lagos State for sustaining its inter-agency collaboration and continuous professional training on SGBV.
Sodipo, however, called for the strengthening of DNA and forensic capacities, improved insurance coverage, and better remuneration for healthcare workers.
“We must sustain motivation and continuous retraining if we want to retain skilled professionals and enhance justice outcomes,” he added.
Also, Mrs Margret Anyebe, Claims Officer, Lagos State Health Management Agency (LASHMA), said domestic and sexual violence response had been integrated into the ILERA EKO Health Insurance Scheme.
Anyebe explained that survivors of sexual and domestic violence are covered for medical treatment, investigations, and follow-up care under the state’s Equity Fund for vulnerable groups.
“Hospitals are to provide first-line care, document, and refer survivors appropriately, while LASHMA ensures prompt reimbursement and oversight,” she said.
The technical session of the ongoing National Council on Health (NCH) meeting on Monday reviewed 35 out of the 82 policy memos submitted ahead of full Council deliberations scheduled for later in the week.
Dr Kamil Shoretire, Director of Health Planning, Research and Statistics, disclosed this on Tuesday during the Technical Session of the 66th Regular meeting of the NCH ongoing in Calabar, Cross River.
He said that 10 of the memos considered were recommended for Council’s approval, eight were noted, and 18 stepped down for further work.
According him, two additional memos were deferred and will be re-presented after revisions are made.
At the reconvening of the session, Ms Kachallom Daju, Permanent Secretary, Ministry of Health and Social Welfare, said that there were five memos from the Coordinating Minister of Health, adding that they were all related to the Department of Food and Drugs.
Daju said that the memos were stepped down on Monday and scheduled for re-presentation.
She also provided clarification on the previously contentious healthcare waste-management memo, explaining that the N3.5 million requests tied to the proposal had already been repurposed by the Global Fund.
“I have followed up, and I am informed that the funds have been reprogrammed. Just so we put it to rest, we will not be discussing that memo anymore,” she said.
She also said that the final memo considered on Monday was the proposal for the inclusion of telemedicine services under the National Health Insurance Authority (NHIA).
“The next memo scheduled for presentation is the proposal for the establishment of Medipool as a Group Purchasing Organisation (GPO) for medicines and health commodities in Nigeria.
Meanwhile, Dr Oritseweyimi Ogbe, Secretary of the Ministerial Oversight Committee (MOC), formally notified the Council of the establishment of Medipool, a new public-private GPO created to strengthen the procurement of medicines and health commodities nationwide.
Presenting an information memorandum at the technical session, Ogbe explained that Medipool was the first nationally approved GPO designed to leverage economies of scale, negotiate better prices, and ensure quality-assured medicines.
He said this was beginning with primary healthcare facilities funded through the Basic Health Care Provision Fund (BHCPF).
According to him, Medipool was established after a proposal to the Ministry of Health, followed by appraisals and endorsements by the Project Implementation and Verification Committee (PIVAC) and the Ministry of Finance Incorporated (MOFI).
“It subsequently received Federal Executive Council approval, with MOFI now owning 10 per cent of the company’s shares. The Infrastructure Concession Regulatory Commission has also approved its operations.
“Under the model, Medipool will work with Drug Management Agencies (DMAs) in all states to aggregate national demand and negotiate directly with reputable manufacturers to obtain competitive prices and guaranteed-quality supplies.
“The platform will function as a one-stop shop for DMAs, who will then distribute medicines to health facilities through existing state structures.”
Ogbe added that while Medipool will initially focus on BHCPF-supported primary healthcare centres, it was expected to expand to other levels of care nationwide.
“The organisation will provide regular reports to the ministry of health and participate in national logistics working groups to ensure transparency, oversight, and technical guidance,” he said.
The News Agency of Nigeria (NAN) reports that Day One of the 66th NCH technical session opened with a call reaffirming the Ministry’s commitment to advancing Universal Health Coverage under the theme “My Health, My Right”.
“The delegates also adopted the amended report of the 65th NCH, setting the stage for informed deliberations.
The implementation status of the 19 resolutions from the previous Council was also reviewed, highlighting progress and gaps.
The authorities of Police Clinic in Port Harcourt have reported high cases of Malaria in its facility.
The revelation was made by Mrs Udoh Mba Robert, a Chief Superintendent of Police and senior medical personnel in the Clinic.
She told The Tide that,”the Hospital admits sixty (60) to seventy (70) patients in a month”.
On how the facility runs, she stated that the hospital is under the National Health Insurance Scheme as most patients are treated almost free.
She maintained that staff of the hospital have been trained professionally to manage health issues that come under the purview of the National Health Insurance Scheme.
Mrs. Robert explained that malaria treatment also falls under NHIA, as patients are expected to pay only 10 per cent for their treatment while the government takes care of the outstanding bills.
NHIA, she further stated covers treatment and care for uniform personnel like the police force, military men, civil servants and all others working for the government.
Urging the public to seek professional medical attention, Mrs. Robert said the facility is open to workers in the federal services, especially police staff.
Favour Umunnakwe, Victory Awaji, Excel Nnodim
