Health Policy

The best private hospitals and private clinics in Nigeria deliver excellent health care services if you can afford to pay their exorbitant charges. The doctors and nurses are highly skilled. The operating theaters are well-equipped with the best technologies available in the health industry; and there is usually a good back--up of diagnostic laboratories and consultants. Judged by the standards of high-brow services which can be found in Abuja, Lagos, Kaduna and Port Harcourt, Nigerian health care delivery services leave nothing to be desired.

But at the other end of the spectrum the situation is very different. Our general hospitals nation-wide are in ruins. Defective equipment are not repaired or replaced. Drugs are in short supply or non-existent. Patients are often made to buy their own medicines, surgical dressings, drips, blood for transfusion, hypodermic syringes, and razor blades. Hospital fees, which have to be paid up-front now, are so excessive that the great majority of the common people have to seek for medical help, not from hospitals, but from babalawos and prayer houses.

These developments are taking place in a depressed economy in which general adversity malnutrition and urban squalor are cooperating to undermine the health of the people. Cholera, celebre-spinal meningitis and tuberculosis are once again on the rampage. The Global scurge of HIV threatens not only the lives but the livelihood of families. Yet with these conditions, the best of our doctors, pharmacists and nurses are checking out. There is no record of the number of our medical people who have emigrated to Saudi Arabia, the United States of America and Great Britain; but the exodus has been such as to empty the teaching hospitals, general hospitals and the rural areas.

To make a totally intolerable health emergency even more desperate, a good many of the drugs sold off the counter in Nigeria today are fake concoctions more liable to harm than to heal the sick.

The crisis of health care delivery in the nation requires dramatic high-priority attention. And already the present government appears to be taking some action to stop the decay in teaching hospitals and government hospitals. The All Progressive Grand Alliance proposes that as these facilities are re-equipped, re-staffed and re-financed, they will begin to specialize as national centres of excellence in their chosen field, in open heart surgery for example, or renal medicine, or the treatment of the complications of hypertension. Until we are able to concentrate specialists, technology and other resources in specific hospitals to enable them give the best care possible anywhere in the world, rich Nigerians will not stop traveling abroad even for the treatment of minor conditions. Quite apart from the question of national pride and of saving hard currency costs, there is the question of making specialist medical services more generally available to the people.

But the great health care challenge for us is the challenge of providing a primary health care programme for the nation as a whole. A National Commission for this purpose has apparently already been set up. According to reports, the Commission has equipped 200 federally sponsored clinics for its programme. But the truth of the matter is that the Federal Government has no business in running a clinic anywhere. What is going on is a Federal Government usurpation for political purposes of state or local council duties.

Properly understood, primary health care is a wide range of actions which communities take to promote good health for the benefit of the people with the participation of the people. It includes actions taken to promote food supply and nutrition, safe water supply, sanitation in households and the environment, health education, maternal and child care, prevention and control of endemic diseases, routine care in hospitals and clinics, and rehabilitation. These are not matters which can be taken care of in 200 federal clinics.

The All Progressives Grand Alliance proposes that duties for the actualization of primary health care should be allocated to the three tiers of government as follows:

1. Duties of the Federal Government
i. To set up a National Health Council which will develop comprehensive national policies, strategies and plans of action to ensure good medical services, healthy living and socio-economic well being for the people.

ii. To mobilize health resources, train manpower, establish standards, recommend technologies, monitor and evaluate programmes of action, and maintain reliable statistics on the health of the nation.

iii. To vote money and other resources for the actualization of the agreed programme of action.

iv. Through NAFDAC and other inspectorate and standard organizations, to ensure that drugs manufactured in the country or imported into the country conform with medical specification and the highest international standards.

v. To mobilize FEPA and other agencies and non-governmental organizations concerned with the environment to fight pollution and minimize environmental damage to public health.

2. The Duties of State Governments
State governments, acting through their Ministries of Health inter-ministerial Health Management Boards will form national policies into operational activities. They will take responsibility.

i. To create Health Management Boards to co-ordinate all service producers including the Ministry of Health, Education and Finance; the Water Board environmental agencies, donor organizations and non-governmental organizations. Boards will also be responsible for the co-ordination of work in the local council areas.

ii. To provide funding, technical services, the monitoring of standards, the choice of technologies, lists of essential drugs which must be held stock evaluation and upgrading of services.

iii. To maintain high quality specialist hospitals, laboratories and technical services, to which referrals from communities should he made.

3. Community Health
Since primary health care is what the people do to promote and preserve their health and wellbeing, local movement council areas are the places where the real action must be.

The All Progressives Grand Alliance will encourage local councils to create Health Management Committees to set local priorities and targets to plan, implement, monitor, evaluate and upgrade health-related actions. These actions should include progmmes for the health of women, reproductive health, nutrition education, diets, hygiene and sanitation, medical care, the care of the elderly, dental health, psychiatric health, accident prevention and rehabilitation.

The entire programme of action aims at mobilizing entire communities to act purposefully for the protection of socio economic well being, health practices and medical care. Until the government of the day recognizes the need to do this and take measures to stimulate the creative response of our communities to take appropriate action, we cannot begin to think of ourselves a modern people-centred democracy.