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Transforming Nigeria’s Health Sector

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Where does one start analysing the recent claim by the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, that Nigeria is becoming a hub for quality health care and a destination choice for patients from the West African subregion and other parts of the world? Is it from the fact that as at the time he was making the statement on Tuesday, the number one citizen of the country, President Bola Tinubu was almost ready for a private visit, (believed by many to be health check related) to Paris, France the following day? Or, that the minister did not explain what he meant by “quality healthcare” nor did he tell the State House correspondents the number of patients that come to Nigeria from the USA and the UK for treatment and why.
Are they Nigerians in the diaspora visiting Nigeria and receiving treatment? Do the so-called people from all over the world come to Nigeria for medical treatment because Nigeria offers the best medical care better than anywhere in the world? No doubt, there may be some people who visit hospitals in Nigeria, maybe for fertility treatment due to certain restrictions in the countries they reside, who come to consult some particular health experts or those that find the treatment of certain ailments cheaper in Nigeria. There also exist some specialised hospitals in the country, particularly in Lagos and Abuja, who do attract patients from neighbouring West African countries for treatments in such areas as organ transplants, cardiology, fertility treatments, and advanced surgeries. But on a global scale, can Nigeria be regarded as a top destination for medical tourism? How did the minister arrive at that
And talking of quality healthcare, as earlier stated, it would have been nice if the Minister had given us the indices he used to arrive at his assertion and his own meaning of quality healthcare. Experts have defined quality healthcare as medical services that are effective, safe, timely, patient-centred, equitable, and efficient. It ensures that patients receive the right care at the right time, leading to better health outcomes. This means that, for healthcare to be considered quality, the treatments and interventions should be based on scientific evidence and best practices to improve patient health; it should minimise risks, errors, and harm to patients; patients should receive care without unnecessary delays; it should respect and respond to individual patient needs, values, and preferences; it should be accessible to all, regardless of socio-economic status, race, gender, or geographic location.
Above all, it should be efficient – resources should be used wisely to avoid waste and keep healthcare costs manageable. Are these the case in Nigeria? It is no hidden fact that many hospitals and clinics in the country, especially the public hospitals lack basic amenities like clean water, stable electricity, and modern medical equipment.  Rural areas suffer from a lack of healthcare facilities, forcing patients to travel long distances for medical attention. Many doctors, nurses, and other medical workers migrate abroad (japa syndrome) due to low wages and poor working conditions. The doctor-to-patient ratio is far below the WHO recommendation. Not once have we seen a doctor dozing off while consulting patients due to fatigue and heavy workload. All the doctors’ strike actions for these reasons have not brought about a significant change.
How easily do patients receive medical attention in our hospitals and clinics? In most government hospitals, patients spend almost a full day or more to see a doctor. When the doctor is a consultant, the waiting period will definitely be longer.  And how affordable are the treatments and the drugs? The National Health Insurance Scheme (NHIS) was established in 1999 in response to increased out-of-pocket payments and the call for a movement towards Universal Health Coverage (UHC). Since the scheme started its operations in 2005, how many people have enrolled in the programme? The current Minister for Education, Dr. Tunji Alausa, while serving as the Minister of State for Health in May 2024 said that the government had allocated dedicated funds and initiated collaborations to enhance primary healthcare services and expand health insurance coverage and that the president had mandated them to increase coverage from about seven million then to about 50 million people.
Today, records show that only a small percentage of the citizens are still covered by the scheme. According to a report by the Journal of Global Health Economic and Policy, less than 5 percent of Nigerians are enrolled in NHIS, while 70 percent still rely on out-of-pocket payments, making healthcare unaffordable for the poor The challenge of poor drug regulation, counterfeit medicine, inadequate funding, poor emergency response, inconsistent government policies and corruption, poor sanitation and hygiene are yet to be dealt with. How then do we have quality healthcare in Nigeria? What about the careless and nasty attitude of healthcare providers towards the patients. Many Nigerians are left with permanent scars and disabilities due to the negligence of so-called healthcare experts who treated them.
Sure, medical negligence is not peculiar to Nigeria but it has become a constant occurrence in our health facilities and must be looked into by the Medical and Dental  Council of Nigeria, the Nigeria Medical Association and other relevant authorities. To take the nation’s healthcare system to the desired eldorado, a combination of policy reforms, increased funding, infrastructure development, workforce enhancement, attitudinal change among the healthcare providers and reduction of corruption in the health sector is necessary. Pate on Tuesday revealed that federal government has approved the sum of N12 billion for Magnetic Resonance Imaging, an advanced diagnostic equipment, across six tertiary health institutions in addition to Nigeria’s ratification of the African Medicines Agency (AMA) Treaty, which aims to harmonise medical regulatory standards across the continent.
That is a commendable step by the government if only the government will ensure that the money when released will be used for the stated aim and the right equipment purchased and regularly maintained. It is also important that the government allocates at least 15 percent of the national budget to health, as recommended by the Abuja Declaration. They should explore public-private partnerships (PPPs) to attract investments in healthcare infrastructure. There is also the need to upgrade and equip existing hospitals with modern medical technology, establish more primary healthcare centers (PHCs), especially in rural areas and invest in digital health solutions such as telemedicine to improve access. The issue of shortage of healthcare workers must be addressed through improved salaries, benefits, and working conditions.
Incentives (such as scholarships, housing, and career growth opportunities) should be regularly offered to retain healthcare professionals. Other important measures to be taken include expansion of the NHIS to cover more citizens, including the informal sector; introduce community-based health insurance programmes to increase access to affordable healthcare; the government, both federal and states, should subsidise low-income families to reduce out-of-pocket expenses.The authorities should strengthen immunisation programmes to prevent disease outbreaks and promote health education campaigns on sanitation, hygiene and healthy lifestyles. The National Agency for Food and Drug Administration and Control (NAFDAC) should be empowered to monitor and regulate pharmaceutical products more effectively, while the law enforcement agencies should do more in the area of enforcing stricter penalties for drug counterfeiters.
Implement technology-driven tracking systems to detect and remove fake drugs from circulation.The government should also increase funding for medical research and encourage local drug production. Partnership with universities and research institutions to develop innovative health solutions will certainly be productive. Government should also consider supporting the development of traditional medicine through scientific validation. As Africans, many Nigerians in the diaspora believe in the potency of herbs. A story was recently told of how some Nigerians make money by sending herbal medicine to Nigerians abroad. So, developing and properly regulating this sector might be the major attracter of patients. To have people come from all over the world to Nigeria, with the assurance that they will get the best of medical care here is the wish of many Nigerians.
Maybe that will reduce the president’s trip to France and save the nation some money. But achieving that goes beyond rhetorics or making political statements. Let there be more actions than words

 

Calista Ezeaku

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Opinion

Balancing Religious Freedom and Community Rights

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Quote:”Communities have rights to peace, safety, and quality of life. Noise pollution, crowds, or other impacts from religious activities can affect these rights. Balancing these interests requires consideration and dialogue”.

Religious freedom, as a fundamental human right, encompasses the liberty to practise, express, and change one’s religion or belief without facing persecution, discrimination, or restriction. This right is recognized in various international human rights instruments. Article 18  of the Universal Declaration of Human Rights (UDHR) provides for the protection of the right to freedom of thought, conscience, and religion. Article 18 of the International Covenant on Civil and Political Rights (ICCPR) further elaborates on this right. From the afore-mentioned, individuals have the right to practise their religion or belief in worship, observance,  and teaching. This includes expressing one’s religion or belief through speech, writing, or other means of communication.They also have the right to change their religion or belief if they choose to do so.
While Religious freedom supports personal autonomy and the ability to make choices about one’s beliefs and practices, it also promotes diversity and coexistence among different religious and belief groups in a society. It  is a cornerstone of human rights, contributing to the protection of other rights and freedoms. Religious freedom became imperative to save  individuals who face persecution or discrimination for their religious beliefs or practices, check governments or communities who impose restrictions on religious expression or practice, citing various reasons like security, public order, or cultural preservation.
On the other hand, community rights refer to the rights of a community to protect their interests, culture, well-being, and other aspects that are significant to the community’s identity and functioning. These rights can encompass various dimensions including cultural preservation, economic interests, and social well-being. Communities often have rights to preserve their cultural heritage, traditions, languages, and practices. This can include protection of cultural sites, practices, and expressions. Communities may also have rights related to the management and benefit from natural resources within their territories or rights to economic development that aligns with their interests. Communities can as well ensure the social well-being of community members, including health, education, and safety. Beyond helping communities  preserve their identity and cohesion  by protecting aspects that are crucial to their way of life, support their determinations in making decisions about their own affairs, community rights can be particularly important for protecting against external pressures or exploitation.
In some climes, balancing religious freedom with community rights is a delicate task. Religious institutions play vital roles, but their activities can impact neighbors. Finding harmony between these interests is key to peaceful coexistence. Religious freedom is a fundamental right, allowing individuals and groups to practice their faith freely. However, this right isn’t absolute and must be balanced against other community rights and interests. Communities have rights to peace, safety, and quality of life. Noise pollution, crowds, or other impacts from religious activities can affect these rights. Balancing these interests requires consideration and dialogue. Noise from churches, mosques, temples, or other religious institutions can disturb neighbors. Managing noise levels is one way to balance religious expression with community peace. Many places have laws or guidelines governing noise, crowds, or other impacts from religious activities.
Understanding and complying with these frameworks can help balance interests.Dialogue between religious institutions and neighbors can prevent conflicts. By engaging with the community, religious groups can understand concerns and find mutually acceptable solutions. Religious institutions should consider impacts on neighboring properties. This includes noise, traffic, parking, and other factors affecting quality of life. In practice, balancing religious freedom and community rights requires flexibility and understanding from both sides. Religious groups can adopt practices to minimize impacts, while communities can understand the importance of religious expression. Some religious institutions successfully balance their activities with community needs through considerate scheduling, sound management, and community engagement. These examples show that balance is achievable.
Challenges arise when religious groups feel their freedom is restricted or when communities feel impacted by religious activities. Open communication can help address these challenges. Engaging with the community helps religious institutions understand local concerns. This engagement can lead to solutions that respect both religious freedom and community rights. Local authorities can facilitate balance by providing guidelines or mediating discussions between religious groups and neighbors. Their role is crucial in ensuring both sides are heard. Balancing religious freedom and community rights requires respect for diverse perspectives. Communities are made up of various groups with different needs and rights. Religious institutions can mitigate impacts through soundproofing, scheduling adjustments, or other measures. These steps can help minimize conflicts with neighbors.
Religious institutions often contribute positively to communities through charity, education, or social services. Recognizing these benefits can foster understanding.When conflicts arise, addressing them through dialogue is preferable to legal action. Mutual understanding can lead to solutions benefiting both sides.Educating both religious leaders and community members about the need for balance can prevent conflicts. Awareness of mutual rights and interests is key. Flexibility and compromise are essential in balancing religious freedom and community rights. Both sides may need to adjust to find harmony. By balancing religious freedom with community rights, communities can be more harmonious and inclusive. Respect for all interests leads to peaceful coexistence.
Above all, careful consideration of human rights principles, respect for diversity, and mechanisms for dialogue and mediation remain the hallmark of a harmonious community and religious institutions relationship
Revisiting Asuu’s Demand
Bright Amirize
Quote:” It should be remembered that ASUU warned Nigerians long ago about the antics and strategies of neocolonisation, especially what follows after a nation has experienced a civil war.
An understanding or agreement reached between the Federal Government of Nigeria and Academic Staff Union of Universities (ASUU) in 2009, which had not been fully implemented, accounts for current threats by the lecturers to go on strike . One of the vital issues of vexation is the proliferation of universities in Nigeria, both public and private ones, whose qualities are not quite of global standards.  It is obvious to those who care to know the details and implications, that there is a proliferation of universities in Nigeria, whose results can hardly produce salutary outcomes in the future. What we find is that Nigerians who had made enormous wealth usually invest in 5- star hotel business, private universities,    a airlines, or in oil and gas related plants outside Nigeria. Conditions for the establishment of a private university are quite capital intensive, yet applications are many for going into such a venture.
    The demand for university education is quite high among Nigerians, thus making the proliferation of such institutions inevitable. Even with such high growth rate of universities, Nigerians scramble to go to foreign universities to study, in spite of the high cost involved in such ventures. Foreign universities also embark on scrambles to get Nigerians to seek for admissions in their institutions, despite opposition to influx of foreigner in European countries. During the tenure of Margaret Thatcher as British Prime Minister, there were Policies and moves to merge or reduce the number of tertiary institutions, because of the high costs of running and maintaining them. It is natural that when an economy is robust and friendly, states and private entrepreneurs engage in the expansion of universities, as a means of expanding the economic boom is often followed by a recession which can arise from squandering of riches and resources. Moreover, nothing is stable in human affairs.
          Therefore, the process of rise and fall of nations, organization and individuals, is common as vital aspects persons are allowed to mess up the economy rather than restore it to a robust shape again. Sadof human experiences. What can be sad is a situation where quacks, impostors and incompetent ly what some nations do during economic downturn is to exploit other naïve and unsuspecting nations, using corrupt individuals to allow foreign interpreneurs to undermine national interests.   It should be remembered that ASUU warned Nigerians long ago about the antics and strategies of neocolonisation, especially what follows after a nation has experienced a civil war. Neither can it be denied that oil and gas resources in Nigeria were key factors in the turn of events in Nigeria since 1970. ASUU’s postures on national issues did not go down well with military regimes between 1970 and 1999. Yet ASUU spoke up!
 To describe Nigeria as a fantastically corrupt nation would not tell the whole story of what undermined Nigeria’s economy. Rather, foreign interests exploited loop-hopes and weaknesses in Nigeria’s institutions to undermine the nation’s economy. For example, countries that manufacture exotic cars, which their citizens rarely use, look for foreign buyers, especially countries that invest in flamboyant and profligate lifestyles. Who would not want to import 100 exotic cars and have 10 free, even with double the price of each car? Nigerians, especially private entrepreneurs and state officials, are known to be smart procurers and rent seekers. Even in the procurement of students for foreign universities, Nigerians are making fast business. Foreign universities student population is made up largely by students from developing countries, to the extent that fear of an influx of migrants is creating unrest in many European countries. Foreign students stay put rather than return to their countries after their studies. Rather they seek to bring in their spouses or relations.
 While we are busy establishing more universities, both public and private ones, developed countries are embarking on practical, direct-experience and on-the-job training strategies. Thus universities rarely have local students, but lure students from developing countries. With so much emphasis on book-oriented learning, and non-availability of jobs after graduation, university education becomes more of cosmetic adornment, where certificate talks.  Patriotic Nigerians, who would not shy away from the truth, recognize that our plight includes frivolous hankering for tinsel rather than real gold. Rather than embrace merit and standards of lasting values, we are satisfied with flamboyant braggarts who have money to throw about, even if it requires mortgaging our conscience. Even in the university environment where ideal man-power building should be a priority, what we find is a shameless and mad rush for things that glitter, so long as they give some temporary palliative..
   It is quite sad that the stock or tribe of patriotic lecturers in the university system is diminishing fast. If that sector of a nation’s institutions is allowed to mortgage the original “Ivory-Tower ethics” then a nation’s destiny would be in jeopardy. Noble minds are still everywhere in this country but we don’t look for, recognize or encourage them. Even when they are mobilized for service, some tend to join the band-wagon.   Proliferation of universities should stop and effort be made to foster practical skill acquisition and investment in research and development, so that what we buy abroad can be produced locally. Why must we spend billions of naira to import electric meters and transformers when professionals in that field can be given the task and challenge of developing such products? Nation building is more of character building, made possible by exemplary and inspiring leadership. The culture of 25% budget padding must stop!
 
By: Sylvia ThankGod-Amadi 
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Opinion

Kids Without Play Opportunities

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“All work and no play”, its said, “makes Jack a dull boy.” Despite this age-long maxim that recognises the role of play in early childhood development, play appears to be eluding many Nigerian kids. The deprivation of play opportunities comes in different forms for the Nigerian child depending on family’s social setting or status, but the effect is much the same. For children in Nigerian poor families, life is becoming as much a hassle as it is for their struggling parents. Due to harsh economic conditions, many families resort to engaging their kids prematurely in trading activities especially in hawking, to help boost family revenues, when these kids should be enjoying leisure after school. Some of these children barely attend schools while being forced to spend much of their childhood hustling in the streets. For children from well-off families, time could be as crunchy as it is for their busy parents when, obsessed with setting agenda for the future of their kids, parents arrange stringent educational regiment too early for their kids.
These group of children are made to get-off the bed by 5.30am every weekday, get ready for private school buses that call at 6.00am, otherwise report by however means to school at 7.20am.The situation is worse for kids in the city of Lagos where the need to beat urban traffic rush-hours is very high. Most children are further subjected to extra hours of lessons after school at 2.00pm, only to be released with loads of homework. On many occasions children who leave home for school at 6.30am get back by 3.30pm. With hardly enough time to eat, do school assignments and take afternoon naps, these children hardly had time for plays before dinners. In Nigeria, kids of ages between 3 and 12 spend averages of 9 hours a day and 45 hours a week to and from schools, and additional hours doing home assignments and domestic jobs, whereas their peers in developed countries spend about half that duration and have more time for leisure.
Any remaining spare time left after school work or street hustle is further stolen, when kids who usually are fascinated by gadgets, are exposed to household electronics like phones, tablets and gaming consoles. Electronic games may create a sense of leisure, but the difference with human interactions is that kids doing games interface mostly with machines or with programme structured in ways that entrap a child’s pysch directionally, according to the game’s programming, in ways that may not encourage independent thinking. Moreso, attraction to such gadgets displaces kids’ attention from important television and radio programmes. The prevalent tight, academic schedules for some Nigerian kids, though intended for academic excellence, encroaches on childhood leisure time needed to achieve an all-round childhood development, and could make children to resent formal education altogether. Besides, academic excellence or economic pursuit, is not all there is to living a well-nurtured life.
Children’s leisure time, defined as time left over after sleeping, eating, personal hygiene and attending school or day-care, is very crucial to childhood development. Sociologists recommend that children should have at least 40 per ceny of the day as leisure. According to Berry Brazelton, a former pediatrician at Harvard Medical School, “Play is the most powerful way a child explores the world and learns about him or herself.” Unstructured play encourages independent thinking and allows the young to negotiate their relationships with their peers, and in the process build self-confidence and self-control. Play is one of the important ways in which young children gain essential knowledge and skills. Leisure time enhances learning as fun enables children to learn at their own level and pace. Young children naturally explore and learn many skills by making cognitive connections from events that catch their attention.
Unstructured plays help children developed their cognitive, physical and communication skills that make them acquire social qualities necessary in navigating relationships in adult life. Plays enable children assess how others feel and learn perspectives as well as empathy through observing differences in facial expressions, body language and even tone of voice, which helps them copy how to express themselves to others, and therefore develop socially acceptable behavours that build relationships. In cooperative activities, children willingly take things in turn and may delegate roles. Children can also share the glory of winnings through competitive games, which is all great for working together in task sharing. Aside encouraging parents to ensure adequate leisure time for their kids at home, schools should make plays and exercises an integral part of the educational curriculum. The educational curriculum set by the Nigerian Educational Research and Development Council (NERDC) includes specific training durations and break periods, as well as sporting activities, as part of the school system.
Due to poor government funding, sports in public schools have declined, while most private schools lack sporting infrastructure or even play grounds. These make recreational activities and sports implementation almost impossible in schools. Also, the increasing rate of urbanisation in Nigerian communities is gradually eroding ancient playgrounds, while established urban centres have lost community playgrounds. With tightening apartment spaces now being the norm in most urban residential areas, many kids are forced to wriggle within burglary-proof enclosures. Nigerian governments and the relevant agencies should ensure that existing child labour protection laws, educational and urban development codes are implemented in the country, to enable proper nurturing of children as the future stakeholders of our society. Private schools, especially, should be supervised to ensure they follow the educational curriculum standards set by NERDC.
In a bid to impress parents and draw more patronage as better option than public schools, private schools, most of whom operate in cramped environments, have continued to set high regiments of training schedules beyond the capacity of most kids, and even encourage enrollment of pre-school age kids who can not sit still to listen for an extended periods of time. Schools, from creche to secondary levels, without playgrounds and recreational facilities should not be allowed to operate, and should be made to understand and implement appropriate curriculum and training durations. Many Nigerian kids, whether from rich or poor families, appear to have been set-up inadvertently, in the same leisure denial that affects their parents. All work and no play could lead to some messed-up kids who grow up not understanding social cues, and being unemotional and self-centered, manifest later as obsessive-compulsive adults.

By: Joseph Nwankwo

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Opinion

Congratulations Fubara, Joseph Of Rivers State

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We thank God who is above all human contrivance and arrogance. Congratulations, Your Excellency Amaopusenibo Sir Siminalayi Joseph Fubara. Your victory takes us back to the Bible as a living document of a God that rules in the affairs of all His creation. In a manner of speaking, welcome back from your first war with Phillistines, Your Excellency! Yes, first example is David and Goliath! And like David, Your Excellency  stands over Goliath in victory. But that is not enough. Our real enemy is that Your Excellency is Governor of a State with a wretched economy. Indigenes of Your State are today reduced to battalions of beggars waiting for who will hire their loyalty on the usual “pay-as-you-go” basis.
Your Excellency,  it brings us to another Bible- based parallel. Conscientious Rivers indigenes above 50, should identify with and commit our all to this second parallel. It is to liberate the economy and people of Rivers people from 23 years enslavement and poverty, for us to regain our dignity and pride. When the economy of Egypt was drifting into a disaster zone, even Pharaoh did not know it. He also did not know what to do. But God sent a Joseph to build the economy into a fortress of good fortune that overcame the economic and social disaster Egypt did not know was ahead. Your Excellency for 23 years, Rivers State has been ruled without any logical, credible and consistent PLAN of how to overcome mass poverty from our dehydrated local economies.
Your Excellency, Rivers State cannot survive one month without Federal allocation! So called IGR only about 10 per cent of Federal allocation.It is also not based on what we produce but on tax from other people’s productivity that pass through our State.  Pharaoh did not know what to do in the case of Egypt. May it please God to position another Joseph in Governor Siminalayi Joseph Fubara to heal Rivers State and build an economy that all Africa will come to access in order to chart a new course out of worsening economic hardship that is caused by  near zero investment in productivity and endemic reckless looting. They are the twin chambers nursing a  corporate cancer unfolding across Nigeria and Africa. The hard work begins today, Your Excellency.
We need an economic blueprint that will enrich  every Rivers senatorial district from investment to grow productivity and to enrich every Rivers person from career-based productive labour, just as Pharaoh was enriched by Joseph’s economic Blueprint. Let Rivers State stop the trend of waiting the lives of young Rivers people recruited by Phillistines into cultism, thuggery and easy money, as a career. These Phillistines believe they have only lost one phase of many legal battles and battles by other means. But from comments in the public media, their eyes are fixed on  4-years of war and more! Your Excellency, we the people will not let you forget what you owe us. We have to make unbelievers see that your leadership is different and that we are uprooting the old order of an unproductive Feudal System. That system makes a few persons and their cronies to monopolise our collective wealth, while the majority are left in misery. Let’s put an end to enslavement by cabals and mass poverty in Rivers State. That is when the Phillistines will surrender.

By: Amaopusenibo  Brown

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