Mr. Oseloka Henry Obaze, MD/CEO Selonnes Consult Ltd., and Anambra State 2017 PDP Governorship Aspirant tackles Health Care in Anambra state
Quality And Affordable Healthcare Is a
Right
Keynote Address By Mr. Oseloka Henry
Obaze, MD/CEO Selonnes Consult Ltd. and Anambra State 2017 PDP Governorship
Aspirant! at the Public Brainstorming Forum on “Ideas That Can Propel
Individual/Private Sector Interest To Erect World-class Health Firms For
Quality Medicare To Man” At the St. Cletus Auditorium, Otolo Nnewi, On Saturday
8th July, 2017
[Protocols]
I am glad to be here and to have been
invite to this forum. I thank the convener and the organizers. Healthcare
delivery is a very important public sector and private sector issue. An
unhealthy nation or society is a in crisis and a profound on at that.
As a person, though I pray every day, my
one singular wish is not to fall sick or have any reason to end up in a
Nigerian hospital. Sad as it is to publicly admit that reality, it is a feeling
that is broadly shared, even by most of the people in this auditorium.
As a public policy expert and someone who
is seeking public office in our state, I know that our healthcare delivery is
in serious crisis. People still die of preventable causes in Nigeria. This is
sad, worrisome and scary, but it is the reality.
My
disposition to problem solving is first to determine or diagnose the problem
then find the appropriate solution. When that is done then we can start filling
the critical yawning gaps. Prevailing healthcare challenges in Nigeria and
Anambra State, could be attributed to limited funding, diminished
professionalism, dearth of infrastructure, poor policy focus and regulation and
absence of critical partnership between the state and the churches and private
investors.
Healthcare delivery anywhere in the world
is not cheap. But a slant towards social healthcare delivery is possible. What
is more important is to start on the premise that quality and affordable health
care should be a right, not a privilege. But to attract investors, both
domestic and foreign, we must focus on the right policies, the correct
regulation, insist on full compliance and have a commitment to service
delivery.
We must train and retrain our personnel,
ensure continuing medical education and respect for environment where investors
will deliver very costly equipments. We
must incentivize those who work in the rural settings.
I believe that to address the existing
void in healthcare delivery, healthcare firms that could be erected for quality
Medicare by individual/private interests should address the following gaps.
Human Resources for health: This is
deficient both in quantity and quality. The quality refers to the specialists
available. We claim to have Primary Health Care as our health policy in this
country, but indeed we cannot honestly say that we are practicing primary
health care.
In primary health care, every sick person
must first see a primary healthcare physician, who can treat the case or refer
to an appropriate specialist after thorough investigation. The numbers could be
addressed on the long run by good policies that will train more primary health/
specialist health personnel. The current situation could be addressed
collaboratively by outsourcing the deployment of our human resources mix to
health managers, who after a baseline accessement of our current situation can
deploy available staff for maximum benefit. This aspect has a public policy
angle to it.
Lack of Diagnostic Centers: In advanced
societies there is division of roles in every sense of it. In house or external
laboratories and other ancillary aids in hospitals are very necessary and are
pivotal in the accurate diagnosis of a patient.
I am not a physician, but I am married to
one. But as a member of the attentive public and a public policy expert, I know
that any wrong diagnosis could be deleterious to a patient. Some persons have
lost their lives because of wrong diagnosis or no diagnosis at all. We have
moved from the stage of treating every fever as a case of malaria or typhoid to
really getting a laboratory confirmation of malaria before using the anti
malaria. By treating every case of fever as malaria especially in children
under 5 years old, we might be over using the drugs and the issue of resistance
could arise. Indeed we may lose the child to other causes of fever like urinary
tract infection and its sequel. Individual/private sector interest could be in
the area of collaboration with government. Individuals could establish a
well-equipped centre under a Public-private partnership (PPP) arrangement.
Methods of assessing this should be in place and rigidly/strictly carried out.
First Responders and Emergency Medical
Units: Disasters and medical emergencies occur frequently and always
unannounced. They come unannounced and of different magnitude. Such crisis
results from variants of causes-- building collapse, fuel tanker fire, motor
vehicle accident, stampedes, motorboats collision, etc. Natural causes include
cardiac arrests, and aneurism. Such crisis could be overwhelming atimes.
Unfortunately our level preparedness for
emergencies is lacking and indeed alarming. The aftermaths of accidents are
injuries to human beings. Private individuals could establish Emergency
Response Units, Emergency Transport Units and Emergency and Trauma Units that
could be easily put to use in case of disasters/ emergencies.
These so-called First Responders must
consist of well-equipped Ambulance Units with well-trained personnel who are
trained in Bascis Live Support (BLS); Pediatric Life Support (PALS) and Advance
Live Support (ALS). Beyond reaching those in crisis quickly, these personnel
must be up to date with their certification and continuing medical
education.
First Responders must also be familiar
with resuscitation including management of periarrest condition, management of
acute coronary syndromes (ACS). They must be accustomed to the use of automated
external defibrillators (AED). By Law, AEDs and various appliances to free
trapped victims should be available in strategic locations in public and
privately owned businesses and hospitals. An operational public access number
that ties the public, security agencies and first responders by telephone or
other smart telecommunications to hospitals remain imperative.
Funding Health Care: We must adapt our
healthcare delivery services to global best practices. The recent clamour to
retain Obamacare by the Americans was spearheaded by the democrats who cried
wolf when it was first instituted under President Barrack Obama. The cost of
health care is a huge challenge to the citizens of Nigeria. Healthcare is said
to be available when it is accessible, affordable and of good quality. The
advantages/benefits of health insurance could be harnessed by the private
sector to make healthcare available, affordable and indeed accessible.
Outside the Federal Government funded
National Health Insurance Scheme (HIS), additional and alternative insurances
funding could be pooled by a private sector consortium for the purpose of
providing healthcare. The managers of such fund would ensure the proper use of
the fund to provide quality healthcare. Of course when the contributors don’t
get value for their money questions would be asked and refund
issues/litigations could come up.
Sectoral schemes are also possible. It is all
about demand, supply and accountability. Indeed there are some existing
functional schemes, such as those at Annunciation Hospital in Emene and Mother
of Christ Hospital in Enugu. The public make annual contributions to the scheme
and get quality healthcare.
At present, Anambra State has not joined
the NHIS and is still tinkering with the idea of establishing a
community-health insurance scheme. The risk and I can say this with some degree
of authority having been in government, is that such schemes, like the
community bank scheme, the social-welfare for the aged scheme soon enough
become transaction-driven instead of public-interest driven. So far in Anambra,
it has been all talks and no work. A US-based private group has just started a
scheme to take care of their kit and kin in Nigeria when they fall sick. They
have credible laboratories, pharmacies and hospitals register under the scheme.
Their relations get Medicare from these registered facilities. Then
reimbursement is done electronically to the facility for the service(s)
rendered.
Provision and Management of efficacious,
affordable, and potent Drugs: Nigeria can be proud that it inherited and has
expanded its pharmaceutical and drugs production base over the years. Foreign
drug companies are also investing in Nigeria. Individuals could undertake drug
manufacturing in this country and state. So far what is going on in this area
is a far cry from the demands. Generic drugs could be manufactured to lower
cost and thus making healthcare affordable.
Since its establishment, NAFDAC has done
well to combat illegal and fake drugs. But there is more to be done. The
collaboration between doctors and pharmacists is sadly very poor. So the
prescription and dispensing of drugs has fallen to non-professional and quacks.
There must be a law restricting the prescription and dispensing of drugs,
especially controlled substances to licensed professional only.
WATERSHED: If I were to offer a synoptic
overview of our state of healthcare delivery using Anambra as a yardstick, I
will identify these areas of unmet needs.
• No general hospital in Anambra state can
or runs a 24-hours service.
• No functional toilets for staff,
patients and patient-relations in any of our general hospitals; waiting areas
are dismally poor.
• No constant water supply in our
hospitals; despite numerous boreholes.
• No alternative power supply in our
hospitals. Most not connected to National grid.
• Construction of Helipad at General
Hospital Onitsha was most senseless. Where is the helicopter coming from or
going to?
• Recently Anambra lost its hard-earned
UNICEF award for state performance on immunization though all vaccines
including the cold-chain are donor-funded.
• Despite the fact that HIV/AIDS services,
which include counseling and testing, treatment and care are sponsored by
foreign donors, including, PEPFAR (Presidents Emergency Plan for Aids Relief);
The Global Fund; The World Bank etc. Tuberculosis drugs are provided by GLRA
(German Leprosy Relief Association), our people are not being tested robustly,
and availed these service.
• Our World Bank funded save-a-million
lives programme is being used for political patronage.
Summation: Let’s talk frankly. When nit
come to healthcare delivery, Nigeria has really not gotten it right both at
national, state and local government levels. Our healthcare delivery remedial
measures must begin with a re-energized collaboration, state funding support
for mission and faith-based hospitals. We must look anew, how we fund our
university hospitals.
Private endowments, donations in cash or
buildings and equipment by corporations and individuals remain imperative. In
return, the names of the donors can adorn the specific wings and facilities
funded. Above all, government healthcare policies must be proactive and
focused.
All said there is a vast scope for
collaboration and involvement of private and individual investors in promoting
healthcare delivery in Nigeria and in our state. We just need to make it our
priority or pet and niche project.
I thank you for your kind attention.
Mr. Oseloka Henry Obaze, MD/CEO Selonnes Consult Ltd., and Anambra State 2017 PDP Governorship Aspirant tackles Health Care in Anambra state
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Saturday, July 08, 2017
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