CMDs, others call for strategic reforms in health sector

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By Reporters
Some administrators in the healthcare sector have called for strategic reforms that would improve healthcare service delivery in the country.
They spoke with the News Agency of Nigeria (NAN) in Lagos, while proposing areas of improvement during their appraisal of President Bola Tinubu’s One Year performance in the health sector.
Prof. Adetokunbo Fabamwo, the Chief Medical Director (CMD) of Lagos State University Teaching Hospital (LASUTH), lamented the low uptake of the National Health Insurance Scheme (NHIS), attributing its low uptake to the limited scope of the insurance cover.
“For example, if you take a basic insurance plan, you can get free consultation, free medication and few free tests.
“You won’t be able to access surgery and other treatments, unless you pay out-of-pocket.
“To make it attractive to citizens, the premium can be raised. As we speak, the premium is low, about N850 per month. If you raise the premium and increase the coverage, people would be more interested,” he said.
The CMD also appealed to the Federal Government to revitalise moribund medical research institutions across the country, noting that robust and functional medical research institutions would stimulate opportunities to solve health challenges locally.
He emphasised that medical researchers producing their research results would increase medical knowledge, improve patient care, develop new medicines or procedures, and help in formulating policies.
Prof. Wasiu Adeyemo, CMD of Lagos University Teaching Hospital (LUTH), Idi-Araba,noted that healthcare financing and National Health Insurance Scheme (NHIS) were part of the set agenda of the president for the health sector.

He said that if 50 to 60 per cent of Nigerians could be pulled into the NHIS, Nigerians would fare better and be closer to achieving Universal Health Coverage.

According to him, about three out of 10 Nigerians can pay out of pocket, while majority cannot, meaning that a lot of Nigerians have to be pulled into NHIS.

Adeyemo also noted that the issues of infrastructure and equipment were absolutely important.

He said that major reasons why people relocated abroad included remuneration, infrastructure and equipment.

However, he said the Federal Government was expending a lot of money in putting infrastructure in place.

He also identified that human resources, training and other welfare issues need to be improved upon.

On local manufacturing, he said: “Quite a large chunk of our equipment and drugs are imported and no country can survive or give its best in terms of healthcare dependent entirely on international things/imports’’.

On value chain in healthcare, he also said there was need to produce more in Nigeria, that way, we create employment and we also control our foreign exchange.

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According to Adeyemo, partnership is very key, particularly in the private sector, hence the need to keep encouraging public health institutions to go into partnership with private health institutions.

Commenting, Dr Olugbenga Owoeye, the CMD of Federal Neuro-psychiatric Hospital Yaba,   said there was need for more support to further enhance performance of the hospital, calling on the Federal Government for subsequent financial supports.

According to him, some buildings in the hospitals are old and need to either be renovated or rebuilt, saying that the Federal Government stepping forward to rebuild the structures will be a welcome development.

Owoeye said that the existing 90-bed drug rehabilitation centre of the hospital was grossly inadequate and needed to be expanded.

““To sustain development of the hospital and further enhance its operations, there is need for more support.

“Some of the buildings are old and there is need to either remove them and rebuild or renovate. This will also improve on the hospital’s mental health care services

“There is also need for expansion of our drug rehabilitation centre; we have 90 bed drug rehabilitation center for both male and female, and as at now, the facility is overstretched.

“So, a purpose built drug rehabilitation centre by the government, will be a welcome development,” Owoeye told NAN.

Also, Dr Livinus Abonyi, a Medical Imaging Scientist, decried the level of hardship and high cost of living in the country, calling on the government to intensify efforts to address the situation and stabilise the economy.
Abonyi said that leaders of governments at all levels need to win the trust of their citizens through their actions and not mere talks.
Abonyi, Head of Department, Medical Radiography at the University of Lagos, College of Medicine, said that most political leaders were disconnected from the led, such that government policies were antithetical to the welfare of citizens.
“The needs of the citizens appear to be at variance with that of the government. This has created a wide gap in the general acceptance of government policies and programmes.
“These adverse characteristics of leadership invokes disloyalty, lack of trust or patriotism to the Nigerian state.
“Leaders should be transparently exemplary in all their dealings, thereby, leading by example.
“Governments at all levels should address the issue of trust deficit. The current investment in infrastructure is not more important than in investing in the mindset of Nigerians.
“Corruption in government should be fought to a stand still,” he said.
Abonyi, therefore, called on the government to tackle all forms of poverty and hunger with greater vigour, in order to reduce the burden of ill health which adversely affects the country’s health indices.
“It is now approximately one year from the last inauguration and a very germane question to ask is ‘how far, so far’?
“The cost of living is so high with prices of goods and services, particularly drugs, skyrocketing out of the reach of an average Nigerian.
“Nigerians are suffering and the end is not in sight.
“The adverse effects of the current Nigerian government policies are excruciatingly painful to the citizens. Life is becoming more unbearable for the citizens,” he said.
Abonyi, emphasised the need for transparency of governance and involvement of experts to professionally proffer solutions to the nation’s challenges across sectors.
Similarly, Taiwo Obindo, President, Association of Psychiatrists in Nigeria (APN), urged the government to address the insecurity challenge of the country.
Obindo, ascribed terrorism and banditry as key threatening factors to achieving food security in the country.
According to him, there is no justification for government’s intervention in the form of loans, fertiliser provision or inputs to agriculture when security of life and properties of those that would work on the farms cannot be assured.
 He lamented that the high cost of transportation was responsible for the hike in the prices of food commodities across the country.
The psychiatrist emphasised that the solution to hunger and other challenges depended on restoring security of the country.
Obindo also highlighted that  more Nigerians were distressed now more than before, resulting to quite a number of mental health conditions.

He listed the social factors to include high cost of living, insecurity, kidnapping, financial problems, inflation, child abuse, rape, broken homes and broken marriages, traumatic experiences and degrees of violence among others.

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Obindo explained that people who were predisposed to the social factors were more likely to develop mental health issues particularly this period the country was faced with lots of economic challenges.

He decried the rate of multiple taxations on small scale businesses and individuals, stressing the need to streamline the taxes.

According to him, an average Nigerian is disposed to more pressure and distress now than before.

He called for intensified efforts by the Federal Government to release people of these pressures in order to safeguard mental health of its citizens.

“I cannot say I have seen any major shift when it comes to policies, when it comes to decisions and when it comes to the health and mental health of Nigerians.

“Looking at the pressure on an average Nigerian; with the increasing inflation, with the challenges that are happening around and pressure from overtaxing on them.

“One can say that an average Nigerian is put under pressure; more Nigerians are more distressed now than before. And this may predispose more Nigerians to develop mental health conditions,” Obindo said.

The APN President, therefore, called for swift implementation of the Nigeria’s National Mental Health Act, to pave the way for adequate protection of Nigerians mental health.

He explained that the National Mental Health Act 2021 was assented to by President Muhammadu Buhari on January 2023, saying that up till now, the Federal Government was yet to implement that Act.

“Before Buhari left, an Act was assented to by the President in 2023 and since the Tinubu led Administration came; the Federal Ministry of Health is yet to implement that Act.

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“Every push for its implementation is meeting with a major hindrance from the Federal Ministry. The beginning would have been the establishment of a department in the Federal Ministry of Health and up till now, nothing has been done.

“The department is meant to be in the forefront of seeing to the rights of people with mental health conditions; setting up a review committee, an assessment committee and mental health fund, but, up till now, we have not seen much.

“But, if we look at the effort of the mental health programme in the Federal Ministry; we can see a dilemma of hope; we have the Suicide Prevention Strategic Framework on ground, which is meant to decriminalised attempted suicide – giving those who attempt to take their lives a rebrief, sending them for treatment rather than prosecuting them.

“So, on that front, maybe we say we made a tentative step,” Obindo said.

Obindo said there was need for the integration of mental health services into the Primary Health Care system in Nigeria.

According to him, the integration has become imperative to create room for more and easy access to mental health services at grassroot as majority of the nation’s population dwell in the rural areas.

He said: “Over 60 per cent of the population dwell in the rural areas, but mental health services/facilities are hardly available in those areas.

“If the services for mental health can be integrated into primary healthcare; it means that even from primary health centres people can now access these services and it can bring protection to people working in that space.

“Similarly, it will create room for not only easy access to the services, but also for its readily availability, promote awareness and equally reduce mental health stigmatisation to a great extend.”(NAN) (www.nannews.ng)

Edited by Augusta Uchediunor/Vivian Ihechu

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