Collaboration, The Key to Healthcare Reform in Nigeria

Image Source- Nigeria Health Watch

The healthcare sector in Nigeria is in need of urgent development. Only when this change is led by the most influential players can the results be tangible. Titans of the industry and stakeholders from other sectors of the economy came together in Lagos recently to deliberate on solutions based on the public-private partnership model. The policy dialogue tagged ‘Disrupting Healthcare: PPPs As A Model For Health System Strengthening In Nigeria’ was organized by Nigeria Health Watch and PharmAccess group, two bodies improving access to healthcare in Nigeria using advocacy and technical assistance respectively.
Through partnerships, international organizations have rehabilitated health centres that had hitherto been operating below par. Most of this effort is targeted at the primary care level which is the first contact for eighty per cent of the population.

Nevertheless, health transformation is a struggle that must be undertaken across different levels. Much emphasis was placed on the new idea that for it to be sustainable, healthcare must be run as a business and not a social service.

Simple yet effective solutions like clean water and sanitation will yield the remarkable results in a country where forty-six million citizens stool in public. Currently, there is the binary option of care with the rich accessing the best available care and the rest of the country scrambling for what is left. The level of care in some primary healthcare centres is tragic. Quality is, therefore, a key element of viable healthcare PPPs.
There were two panel discussions with members from government and private institutions. The first emphasized the need for a stronger influence by doctors and other health stakeholders to push for reform at the federal level. The masses are more likely to protest against fuel price hikes but this energy is not reserved for another vital aspect of life- the dismal healthcare obtainable in many parts of the country.

It was also noted that the nation is in dire need of more health economists, health finance experts to formulate policy in the various health ministries. The current situation where every decision is made by only doctors whose training sadly often doesn’t include these fields will not help us achieve our goals.

Panel Session 1

Panel Session 1Session 1: Mr Voke Oshevire, Executive Director, Dr Ola Orekunrin-Brown, CEO, Flying Doctors Nigeria. Dr Jide Idris, Commissioner for Health, Lagos State. Mr Anthony Abou Nader, CEO, Tanit Medical Engineering. Dr Olaokun Soyinka, Director, Independent Verification Agent for Saving One Million Lives Nigeria. JNC International Ltd. Mr Abiodun Amokomowo CEO, Ibile Holdings Limited. Mr Felix Ezeh, Investment Executive, GroFin.
According to a recent TechCabal report on health tech sector, there are over eighty health tech companies in Nigeria providing solutions to a myriad of problems. Unfortunately, many entrepreneurs often lack access to financing and incentives to scale their companies. Creating an option for medical or premise licenses to be used as collateral was put forward.

Contrary to popular belief, finance is not limited to cash but includes personnel, material, endowments, real estate. It is imperative we are open to options and not be myopic. Patience is required of all involved for the process often isn’t an overnight one. Available resources must be maximized as wastage poses a huge threat to the proper utilization of allocated funds.

The true measure of a community’s health is the quality of its maternal care. –Dr Ifeanyi Nsofor

Government initiatives put in place through the Basic Health care Fund include those that simplify the payment process for people in need of care. The banking sector is contributing to healthcare by improving access to funds, educating providers on the cost benefits of establishing optimal services and facilitating partnerships. They also help health facilities bring their accounting systems to standard, provide flexible payment models and ensure controls are put in place to tackle the lack of trust.
In between the discussions were documentaries highlighting different missions to underserved areas showing the drastic impact personnel and cash financing bring to underserved communities, many of which are remote. Through initiatives like hospital camps, free emergency surgeries, education and health insurance; the quality of life in these communities was vastly improved with the joint efforts of PharmAccess and Toronto Hospital, local and state governments.

Panel Session 2

Panel Session 2

Session 2: Dr Tayo Lawal, Permanent Secretary, Lagos Primary Healthcare Board. Mrs Clare Omatseye, President, Healthcare Federation of Nigeria and Founder, JNCI. Dr Ben Nkechika, DG Delta State Contributory Health Commission. Dr Jide Idris, Commissioner for Health, Lagos. Prof Chris Bode, Chief Medical Director, Lagos University Teaching Hospital. Dr Oyebanji Filani, Senior Technical Assistant, Hon Minister for Health. Engr Chidi Izuwah DG/CEO, Infrastructure Concession Regulatory Commission.

Distrust of digital health records is rife in many centres necessitating gradual implementation and compromise. Pregnancy should not be an emergency as there is ample time to plan for childbirth. The absurdity of the current risk associated must be communicated with all members of the community. Mobile health clinics can be used in some areas to provide care and this circumvents the huge cost of facilities. These are a few examples of the unconventional options being applied in interventions across the country. In addition, adapting from a wide variety of working health systems worldwide to our local context will help us move closer to the desired level of development.
Nigerians spend millions of dollars on healthcare abroad. This amount is comparable to the health budget. This is a symptom of a deeper problem! Efforts need to be amped to ensure the working conditions here are brought to standard if we are serious about stemming the current tide of brain drain and haemorrhaging of funds to countries with better health systems. While some level of specialized care is available, most Nigerians do not know about it or trust it.

Documentary
Documentary

The onus is on us to build and maintain world class institutions to keep our health professionals, patients and money at home. To achieve this, the expertise and management of the private sector should be combined with the infrastructure and political will of the public sector. The distrust that currently exists between them can be mitigated by putting quality control in place. Within the private sector itself, collaboration rather than competition should be the watchword. This will help the health sector to be unified force and voice at the policy-making table for lasting progress.

The future is so bright, you are going to need sunglasses.

Mrs Clare Omatseye

On the bone of contetion that is health insurance in Nigeria, theappalling extent of coverage ofe constitues a barrier to providing universal health care. This has left the crowdfunding method of health financing as the only hope of many in need of expensive care. The estimates hover around one to five percent. Only twenty-eight states have a legal framework for health insurance with some like Lagos and Osun implementing state level schemes.

Through public-private partnership, government centres have been outsourced to the private sector with improved efficiency of service delivery, a marked reduction in mortality, increased profits and sustainability. Adequate communication at all levels with all stakeholders is however crucial to the success of these models as there exists cynicism towards it. Infrastructural gaps have been filled.

It is reassuring to see many stakeholders working and committing to improving the Nigerian health sector. Hopefully, these forged partnerships yield measurable results soon. To achieve the phenomenal change needed, we must be ready to disrupt!

Dr Mariam Toye

Of Prevention and Cures – Fighting Cervical Cancer



On either side of the Atlantic, two passionate individuals are taking the fight to cervical cancer. Both are women, have earned the Dr. title and are working tirelessly to save women from a preventable killer disease. What is particularly intriguing is the possibility that neither of them has met the other but are using different means to achieve a common goal; saving lives. These two are a source of inspiration for many. More crucially, they have become role models for millions of young women in developing countries and will motivate them to take up careers in STEM.Two days ago, the UN marked itsInternational Day for Women and Girls in Science.
For centuries, the immense contribution of women to science has been obscured. It is both illuminating and painful to discover advances in physics, chemistry, mathematics, health, programming, space science etc made or contributed to by women whose names have been buried in the footnotes. It is therefore imperative to celebrate those in our time doing such revolutionary work.


Meet our Women Crush Wednesday: Dr Onyedikachi Chioma Nwakanma and Dr Eva Ramon Gallegos.




Dr Nwakanma is a Nigerian doctor using storytelling for health advocacy. She is one of the foremost health advocates in a country where lack of health information increases the burden of disease and leads to thousands of death. She is a strong campaigner for cervical cancer awareness providing prevention, screening and treatment information to half a million people online.











Her impact is not restricted to the intricate highways of the internet. She is as tireless offline where she works on a variety of health programs. She organizes free health outreaches taking quality healthcare to underserved communities. Earlier today, Her Smile With Me NGO carried out a successful free cervical cancer screening program for hundreds of women in Lagos and Abia states. You can find her here on Twitter.




Dr Eva Ramon Gallegos is a Mexican scientist who has been working for two decades to find a cure for human papillomavirus, the pathogen implicated as the known cause of cervical cancer. She is a researcher at the National Polytechnic Institute. How does one keep up such determination and hope for that long? Many would have been discouraged but Dr Gallegos trudged on until a couple of days ago, she achieved her dream. Using photodynamic therapy, she and her team completely eliminated HPV in 29 infected patients. This article details the groundbreaking achievement that we must celebrate given its potential of saving millions of women.



We have a personal interest in this disease and thus all efforts and news like this make us jump for joy. It has always bothered us that something that can be easily treated and prevented still kills so many women. It feels like rainbows to know we now have a cure for the causative infection. There are valid concerns that historically, medical science has not given equal importance to women’s health. It is therefore of striking significance when women achieve feats that close that gap. This cure needs to be made accessible globally so it reaches those who need it the most.


To all the nerds and geeks out there you rock! Your work saves lives and its impact is felt around the world. To all who are working on an innovative solution to the problems facing us, hang in there and be patient. Learn from Dr Gallegos- stay strong, believe in your dream no matter what, keep working at it and don’t accept defeat.

The world awaits your work.

Oumissa,
Lagos Nigeria,
130219







Health and Books – My Social Media Week Lagos Experience

KhamisLifestyle Read a Book and Go Offline

The two books I just fell in love with at the KhamisLifestyle Social Media Week Lagos Event. I read a few pages from each and was enthralled!
(Mistress of Nothing by Kate Pullinger
And A Platter of Gold by Olasupo Shasore).

Two days ago, I hosted a session as CEO, KhamisLifestyle – Story Story: Read a Book And Go Offline with Spa Pampering At Home for its Offline Wellness Studio at the Social Media Week Lagos event. It was all shades of amazing. I had a great time with great participants.

Last Thursday was one of the most hectic and yet rewarding days I’ve had. All morning and afternoon was for the Hellocare Nigeria Telling Great Stories in Healthcare, a Social Media Week Off-Campus event which held at Doctoora Health hub at Surulere.

that smile is what everyone deserves to have.

Then came the rushed cab ride through Costain and Island traffic to Landmark Event Centre, Victoria Island to host the KhamisLifestyle event. I wish I had a helicopter! Of course I got there behind schedule but I had the best facilitators and participants who got things started. (Thank you!)

It was fun being on teams organizing two Social Media Week Lagos events in one day! I thought it was impossible at first but with a solid support system and positive affirmation I pulled through ( This throbbing headache is worth it!)

Harnessing the power of social media to change lives

I am immensely grateful to every single person who helped me do this. The donations, the kind words of encouragement, the listening ears, the backbreaking work, networks , flurry of calls and emails and so much more make me believe that humanity is alive and thriving.

Perhaps the greatest lesson I’ve learnt this past week is “Believe in yourself and your power to do great stuff. Don’t worry, Allah’s got it.”

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With Love,

Oumissa

090219

Together, We can End HIV- World AIDS Day 2018

For thirty years , thousands of warriors, among them patients , carers and healthcare workers have fought this ravaging disease. The early days of the battle were bleak but as research brings new treatments and knowledge, hope and recovery is here with the promise of victory on the horizon.

Today, we remember the struggle of all the heroes of HIV/AIDS – those who died before we figured how to treat or before treatment could get to them, the many health workers and researchers who sacrifice so we can have solutions, the many aid organizations who have donated so much to the cause in vulnerable groups (PEPFAR, UNAIDS, WHO etc) and the silent ones- the caregivers of people living with HIV. We commit to continuing the struggle to achieve an HIV-free world.

Growing up, I was sternly warned by the adults around me not to share cups , needles, haircare instruments and other sharp objects with strangers. This helped me stay safe outside the home. The stigma then was however rife and thus led to high rates of transmission. There were scary stories of people who knowingly infected others. Just imagine if they had received the care and support they so badly needed. Perhaps the most vivid memory of that time was a neighbour of ours named Dogo. (This is an Hausa word for one who is tall). He was a lanky giant of a man and was loved by us all. One day, he fell sick. After a while it was revealed he had HIV.

I didn’t have much details about his treatment. I watched him deteriorate and lose so much weight. Then the harrowing coughs began. By just listening to them, you could feel the depths of his pain. His eyes gradually lost their sparkle, his wide grin ebbed in radiance until all that remained was a hollow husk of the kind and lively man we once knew . Sadly, after months of fighting this disease, he was taken up North by a relative. A few weeks later, we got word that Dogo had died.

He couldn’t have been more than thirty-five.

That devastating experience made the disease very real for me. I knew first hand how it could cut promising lives short in their prime.

I remember having VCT (voluntary counselling and testing) as a medical student. That was the fourth time I was getting tested (two previous ones were for university entrance health registration and one at a blood donation exercise). The healthcare worker asked me what I would do if it came out positive. I replied, “I’d commence treatment immediately and continue living my life as normally as possible.”She smiled and continued teaching me and my colleagues how to carry out the test.

I sensed her mild surprise. She may have expected me to say the common Nigerian refrain of ‘God forbid!’ What she didn’t know was that I had seen the worst of it as a child and knew this happened only when treatment was not started on time and when the patient faced stigma. I knew that facing a positive diagnosis with courage could make a huge difference.

I was not afraid.

I remember having VCT (voluntary counselling and testing) as a medical student. That was the fourth time I was getting tested…….

Being a part of HIV/AIDS awareness walks, campaigns and community health outreaches as a volunteer for non-governmental organization has kept me aware of the need to continue education and not relent until we end this disease. I still have one of the campaign T-shirts. For years, it has kept this message alive for me and others.

As a physician, I have seen colleagues who got exposed but got prompt and timely access to PEP (post exposure prophylaxis) medication which contains the virus before it can spread in the blood . Sadly this is not always available in Nigeria and thus, many healthcare workers have become infected while trying to save lives. I myself have had quite a few scares in the line of work. This hazard is always present inspite of observing universal precautions. There is always that delirious or aggressive patient, the crying and kicking child, the honest mistakes that lead to these accidents.

Needle pricks are real and scary!

I have also worked on obstetric and gynaecology teams where our HIV positive pregnant mothers were able to deliver babies free of the virus. This was only possible with the full cooperation of these brave mothers who got tested or reported their status early and were fully involved in all stages of the PMTCT* programme. They made the work easier for us their doctors. The joy on everyone’s faces when the baby’s results come in negative is immeasurable.(*Prevention of Mother to Child Transmission)

Being HIV positive is not a death sentence. With prompt treatment and an absence of stigma, you can lead your best life; get a degree, have a great career, get married, have HIV-negative children and be happy!

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-View my Twitter thread on World AIDS Day here

-These organizations do great work in HIV/AIDS

AidsHealth Nigeria and Network of People Living With HIV/AIDS

-Watch this UK MP Lord Russell-Moyle give this powerful speech about coming out as HIV-positive in the House of Commons in this video.

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I know my status because I go for VCT regularly. You can too by visiting the nearest health centre or clinic near you.

Know your status.

Spread the knowledge not the virus.

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Thanks to contributors – Adefola Toye, Adetola Toye. ( No, this is not a mistake. They are two different people)

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With Love,

Oumissa,

011218.