health and politics today
DESCRIPTION
As the MDGs 2015 deadlines approach, we ask 'Is it time to remind Africa of its failure?' It’s almost 15 years since the UN Millennium Declaration to eradicate poverty in the world and improve global health. We are nearing the end of 2015 which was set as the deadline for all the goals to be achieved. So we ask; how has Africa fared? Our cover story is broken into smaller segments for the convenience of our readers. We focus on poverty eradication (MDG 1) and maternal mortality (MDG 4) in Africa.TRANSCRIPT
health & politics today, 1st quarter, 2015
Health & Politics Today is published by Litera Media Network Ltd.
Undoing Africa:
Huge Foreign Aid, Little Development Cover Story
MDGs: Taking the African Stock
13
Health & Safety Tips
Diabetic & Confused?
7
Commentary
15, 21
28
OnyebuchiChukwu
A Failed Health Minister?
A Review of the “no advert” ethics
Why Africa turnto China
for Development.
Obstructed Labour, Surgery& Maternal Mortality
5
NigerianMedical Association
Media Team
Contents
Opeyemi Akindele
Temitope Ojedokun
Oyewole Oladapo
Raina Agrima
Olusola Orimoloye
Editor-in-Chief
Managing Editor
Editor, Development Communication
Editor, South Asia
Medical Fact-checking
16
All correspondence to [email protected]
Felix I D Konotey-Ahulu, Paul M FentonCommentary
2
You’rewelcome to this edition...
log in
health & politics today, 1st quarter, 2015
I?
I am
Rene Descartes (1596-1650)French philosopher and mathematician
3
Litera Media
Network
health & politics today, 1st quarter, 2015
Health & Politics Today is published by Litera Media Network Ltd.
Undoing Africa:
Huge Foreign Aid, Little Development Cover Story
MDGs: Taking the African Stock
13
Health & Safety Tips
Diabetic & Confused?
7
Commentary
15, 21
28
OnyebuchiChukwu
A Failed Health Minister?
A Review of the “no advert” ethics
Why Africa turnto China
for Development.
Obstructed Labour, Surgery& Maternal Mortality
5
NigerianMedical Association
Media Team
Contents
Opeyemi Akindele
Temitope Ojedokun
Oyewole Oladapo
Raina Agrima
Olusola Orimoloye
Editor-in-Chief
Managing Editor
Editor, Development Communication
Editor, South Asia
Medical Fact-checking
16
All correspondence to [email protected]
Felix I D Konotey-Ahulu, Paul M FentonCommentary
2
You’rewelcome to this edition...
log in
health & politics today, 1st quarter, 2015
I?
I am
Rene Descartes (1596-1650)French philosopher and mathematician
3
Litera Media
Network
igeria's 2013 MDGs Report signal to us a better way of using the
indicates that for the three media than for counting victims and
directly health-based goals for mending wounds. This raises the N(reduce child morality, reduce maternal question whether there is more the
mortality and combat HIV/AIDS, malaria media can do to revive the confidence
& other diseases), there is a strong of Nigerians in the local healthcare
supportive policy environment for sector at this time when health tourism
meeting them and that there is a high has become a major source of revenue
likelihood of meeting them. However, it is for some developed countries with
already a quarter into 2015 and there are Nigeria on the receiving end.
still so much to do as a country to attain
these goals. If asked, an average Nigerian would
say the Nigerian healthcare sector is in style journalism to deliver to Nigeria that
Besides the policies that are designed shambles. The citizens know much coveted development seen in the
specifically to drive the attainment of the everything that is wrong with the West. Without such a media model that
health-based MDG goals, there are Nigerian healthcare system but hardly speaks to the realities of our complicated
certain professional policies that are anything that is right, due to no fault of political-economic structures, we may
equally strategic. One of them is the either the people or the media to which not be making much progress in making
regulatory frameworks of different they turn for information. While there media an ally in the development
professions in the health sector. In fact, is no restriction on reporting what is aspiration of Sub-Saharan African
such regulatory documents go a long way wrong with the health sector, there is, countries. The appreciable level of
in determining the success of any policy to a great extent, on reporting its attention Nigerian media give to health
introduced into the sector. As a result, strength. It is not that media issues at the present within the confines
there is need to ensure that professional practitioners avoid reporting of legal restraints witnesses their willing
regulatory environments are conducive landmarks made in the Nigerian readiness to partner with stakeholders in
for policy implementation. This article healthcare sector. In fact, most the health sector to revive people's
explores the implications of the MDCN television and radio stations, and confidence in the sector, given a
Code's no-advert clause for the health- newspapers and magazines feature regulatory atmosphere that is more
seeking habits of Nigerians and for public h e a l t h p r o g r a mm e s a n d conducive for such.
awareness of the strength of the Nigerian columns/segments respectively and
health sector. those are no little service to the health While popular distrust has often been
development of the citizens. By law, cited as a reason for growing health
Not many Nigerians would discount the however, the media could not go tourism among Nigerians, the regulatory
power of information media to influence beyond educating people on the do's constraint that shrouds a great deal of
action after the Ebola disease “hot and don'ts of common and severe medical practice in secrecy has mostly
salted-water bath” cure joke that diffused diseases. Beyond such, however, been overlooked. Decrying popular
across Nigeria from BlackBerry availability of healthcare information distrust in the Nigerian healthcare sector
Messenger to other social media that meets the specific needs of without addressing the root cause of the
plat forms wi th in few hours . people in serious situations remains problem cannot produce any desired
Unsuspecting people adopted the critical to reviving confidence in the result.
prescribed concoction en-masse and, for Nigerian healthcare sector.
some, with fatal consequences. Days At this critical stage, there is need to
after the misadventure left the media, For Sub-Saharan African countries, uncover the factors that sustain the
both print and electronic, rummaging the current realities suggest that it is mistrust and address them decisively, if
debris of the avoidable disaster. Popular needless dwelling on the age-long we really consider development of the
social media sites also became cluttered argument that media should or should healthcare sector an imperative. One of
with messages of apology, regrets and not promote national development those factors is lack of information on the
emotional repudiations. As usual, that agenda. No signal could be stronger in human resource strength of the Nigerian
seems to be the end of the story. The suggesting the need for an alternative healthcare system. It could also be a
mammoth media events and texts that media model than the failure of over major factor that drives health tourism
grew in response to that disaster should 150 years of romance with western among Nigerians.
ealth information and literacy are grossly
inadequate among the people of Africa. Also, Tonnes of foreign aids cannot make up for unfair Hhealth issues are hardly made election or international trade policies to the disadvantage of Africa. It
political issue. Therefore, it is important for a medium is like giving crutches to a man with broken limbs and hoping
to exist whereby both lay persons, professionals and he'll keep up with Ousian Bolt.
policymakers can read and be engaged with health
policy analysis, needful health information, as well as Foreign aid appears to be an interventional measure to
political issues and take action. I thought that such augment the clear disadvantage of the African region in
media effort should create a confluence of health and attaining the MDGs targets. Since virtually all African
politics while focussing on Africa specifically and countries have either been former colonies of European
other developing economies generally. countries who severely exploited them, it appears that the
mentality of Africa is the idea that it is owed by the West.
So, about the middle of 2014, I conceived the idea of This must change.
this journal. And here is the maiden edition. Time
flies. Our editorial team has adopted a writing style We believe that justice and fairness to Africa in
which stands between strictly academic writings and international trade and foreign direct investment are the
informative writings for public consumption. In order way to go if developed countries are really out to help
to engage both technical and lay people, our articles Africa. African governments must also make use of their
are not overly technical nor simplistic. We hope to own experts in driving their developmental agenda.
add more interesting sections in our future editions.
We also critically examine Nigeria’s failure to significantly
In this issue, our dedicated editorial team focuses on reduce poverty among its citizenry, despite the immense
the Millennium Development Goals. It’s almost 15 opportunities and prosperity. While China has taken three
years since the UN Millennium Declaration to times the population of Nigeria out of poverty between
eradicate poverty in the world and improve global 1990-2015, Nigeria has only plunged more people into
health. Time flies. We are nearing the end of 2015 extreme poverty over the same period. Billion dollars oil
which was set as the deadline for all the goals to be revenue has made little or no difference in the lives of most
achieved. So we ask: How has Africa fared? Nigerians.
Our cover story is broken into smaller segments for Furthermore, our policy analysis focus on the regulatory
the convenience of our readers. We focus on poverty bottlenecks of the Nigerian Medical Association (NMA) with
eradication (MDG 1) and maternal mortality (MDG 4) respect to its “no advert” clause; and its effect on the dearth
in Africa. of healthcare Information in Nigeria.
We take a critical look at the idea of foreign aid. How In the segment on health information, we focus on diabetes
much has Africa achieved with it? Is it the best management,. We discuss how African women who often
approach to development? face family and financial challenges can manage diabetes
and minimise the risk of having complications such as
Dissenting voices in the field of international diabetic foot.
development have accused Western countries of
using their aids mainly to further their own agenda in We hope you will enjoy this edition and anticipate our next
Africa and other developing economies, and so edition.
cannot give them real development.
Thank you!
But then, it is difficult if not impossible to eliminate a
donor's vested interest when such is putting down Opeyemi Akindele
huge sums which the recipients are not able to obtain
themselves.
Editor’s Note
Submit an article or a suggestion:
health & politics today, 1st quarter, 2015
Individual authors own the copyright of their essays or pictures.
Where we provide health information, it is no substitute for expert medical advice or
consultation.
The contents and opinions expressed in this publication belong to the contributors or
various news sources we use, and not the official position of Health and Politics Today
or Litera Media Network Ltd.
4
Navigating the system in search of capable hands, for ailing citizens and their caregivers,is like walking in a maze. This article explores the implications of the no-advert clause in theMedical and Dental Council of Nigeria’s (MDCN) Code for the health-seeking habits ofNigerians and for public awareness of the strength of the Nigeria's health sector.
Regulatory Constraints, Popular Distrust andthe Dearth of Healthcare Information in Nigeria
health & politics today, 1st quarter, 20155
Policy
Oyewole Oladapo
igeria's 2013 MDGs Report signal to us a better way of using the
indicates that for the three media than for counting victims and
directly health-based goals for mending wounds. This raises the N(reduce child morality, reduce maternal question whether there is more the
mortality and combat HIV/AIDS, malaria media can do to revive the confidence
& other diseases), there is a strong of Nigerians in the local healthcare
supportive policy environment for sector at this time when health tourism
meeting them and that there is a high has become a major source of revenue
likelihood of meeting them. However, it is for some developed countries with
already a quarter into 2015 and there are Nigeria on the receiving end.
still so much to do as a country to attain
these goals. If asked, an average Nigerian would
say the Nigerian healthcare sector is in style journalism to deliver to Nigeria that
Besides the policies that are designed shambles. The citizens know much coveted development seen in the
specifically to drive the attainment of the everything that is wrong with the West. Without such a media model that
health-based MDG goals, there are Nigerian healthcare system but hardly speaks to the realities of our complicated
certain professional policies that are anything that is right, due to no fault of political-economic structures, we may
equally strategic. One of them is the either the people or the media to which not be making much progress in making
regulatory frameworks of different they turn for information. While there media an ally in the development
professions in the health sector. In fact, is no restriction on reporting what is aspiration of Sub-Saharan African
such regulatory documents go a long way wrong with the health sector, there is, countries. The appreciable level of
in determining the success of any policy to a great extent, on reporting its attention Nigerian media give to health
introduced into the sector. As a result, strength. It is not that media issues at the present within the confines
there is need to ensure that professional practitioners avoid reporting of legal restraints witnesses their willing
regulatory environments are conducive landmarks made in the Nigerian readiness to partner with stakeholders in
for policy implementation. This article healthcare sector. In fact, most the health sector to revive people's
explores the implications of the MDCN television and radio stations, and confidence in the sector, given a
Code's no-advert clause for the health- newspapers and magazines feature regulatory atmosphere that is more
seeking habits of Nigerians and for public h e a l t h p r o g r a mm e s a n d conducive for such.
awareness of the strength of the Nigerian columns/segments respectively and
health sector. those are no little service to the health While popular distrust has often been
development of the citizens. By law, cited as a reason for growing health
Not many Nigerians would discount the however, the media could not go tourism among Nigerians, the regulatory
power of information media to influence beyond educating people on the do's constraint that shrouds a great deal of
action after the Ebola disease “hot and don'ts of common and severe medical practice in secrecy has mostly
salted-water bath” cure joke that diffused diseases. Beyond such, however, been overlooked. Decrying popular
across Nigeria from BlackBerry availability of healthcare information distrust in the Nigerian healthcare sector
Messenger to other social media that meets the specific needs of without addressing the root cause of the
plat forms wi th in few hours . people in serious situations remains problem cannot produce any desired
Unsuspecting people adopted the critical to reviving confidence in the result.
prescribed concoction en-masse and, for Nigerian healthcare sector.
some, with fatal consequences. Days At this critical stage, there is need to
after the misadventure left the media, For Sub-Saharan African countries, uncover the factors that sustain the
both print and electronic, rummaging the current realities suggest that it is mistrust and address them decisively, if
debris of the avoidable disaster. Popular needless dwelling on the age-long we really consider development of the
social media sites also became cluttered argument that media should or should healthcare sector an imperative. One of
with messages of apology, regrets and not promote national development those factors is lack of information on the
emotional repudiations. As usual, that agenda. No signal could be stronger in human resource strength of the Nigerian
seems to be the end of the story. The suggesting the need for an alternative healthcare system. It could also be a
mammoth media events and texts that media model than the failure of over major factor that drives health tourism
grew in response to that disaster should 150 years of romance with western among Nigerians.
ealth information and literacy are grossly
inadequate among the people of Africa. Also, Tonnes of foreign aids cannot make up for unfair Hhealth issues are hardly made election or international trade policies to the disadvantage of Africa. It
political issue. Therefore, it is important for a medium is like giving crutches to a man with broken limbs and hoping
to exist whereby both lay persons, professionals and he'll keep up with Ousian Bolt.
policymakers can read and be engaged with health
policy analysis, needful health information, as well as Foreign aid appears to be an interventional measure to
political issues and take action. I thought that such augment the clear disadvantage of the African region in
media effort should create a confluence of health and attaining the MDGs targets. Since virtually all African
politics while focussing on Africa specifically and countries have either been former colonies of European
other developing economies generally. countries who severely exploited them, it appears that the
mentality of Africa is the idea that it is owed by the West.
So, about the middle of 2014, I conceived the idea of This must change.
this journal. And here is the maiden edition. Time
flies. Our editorial team has adopted a writing style We believe that justice and fairness to Africa in
which stands between strictly academic writings and international trade and foreign direct investment are the
informative writings for public consumption. In order way to go if developed countries are really out to help
to engage both technical and lay people, our articles Africa. African governments must also make use of their
are not overly technical nor simplistic. We hope to own experts in driving their developmental agenda.
add more interesting sections in our future editions.
We also critically examine Nigeria’s failure to significantly
In this issue, our dedicated editorial team focuses on reduce poverty among its citizenry, despite the immense
the Millennium Development Goals. It’s almost 15 opportunities and prosperity. While China has taken three
years since the UN Millennium Declaration to times the population of Nigeria out of poverty between
eradicate poverty in the world and improve global 1990-2015, Nigeria has only plunged more people into
health. Time flies. We are nearing the end of 2015 extreme poverty over the same period. Billion dollars oil
which was set as the deadline for all the goals to be revenue has made little or no difference in the lives of most
achieved. So we ask: How has Africa fared? Nigerians.
Our cover story is broken into smaller segments for Furthermore, our policy analysis focus on the regulatory
the convenience of our readers. We focus on poverty bottlenecks of the Nigerian Medical Association (NMA) with
eradication (MDG 1) and maternal mortality (MDG 4) respect to its “no advert” clause; and its effect on the dearth
in Africa. of healthcare Information in Nigeria.
We take a critical look at the idea of foreign aid. How In the segment on health information, we focus on diabetes
much has Africa achieved with it? Is it the best management,. We discuss how African women who often
approach to development? face family and financial challenges can manage diabetes
and minimise the risk of having complications such as
Dissenting voices in the field of international diabetic foot.
development have accused Western countries of
using their aids mainly to further their own agenda in We hope you will enjoy this edition and anticipate our next
Africa and other developing economies, and so edition.
cannot give them real development.
Thank you!
But then, it is difficult if not impossible to eliminate a
donor's vested interest when such is putting down Opeyemi Akindele
huge sums which the recipients are not able to obtain
themselves.
Editor’s Note
Submit an article or a suggestion:
health & politics today, 1st quarter, 2015
Individual authors own the copyright of their essays or pictures.
Where we provide health information, it is no substitute for expert medical advice or
consultation.
The contents and opinions expressed in this publication belong to the contributors or
various news sources we use, and not the official position of Health and Politics Today
or Litera Media Network Ltd.
4
Navigating the system in search of capable hands, for ailing citizens and their caregivers,is like walking in a maze. This article explores the implications of the no-advert clause in theMedical and Dental Council of Nigeria’s (MDCN) Code for the health-seeking habits ofNigerians and for public awareness of the strength of the Nigeria's health sector.
Regulatory Constraints, Popular Distrust andthe Dearth of Healthcare Information in Nigeria
health & politics today, 1st quarter, 20155
Policy
Oyewole Oladapo
health & politics today, 1st quarter, 2015
Diabetic &Confused?
To eat or not to eat...
7 health & politics today, 1st quarter, 2015
Apart from teaching hospitals and some sector. Instead, everything suggests a ignorant of what the healthcare sector of
general hospitals, extremely few need for a realistic review of that their country can do. Until this is done,
hospitals in Nigeria could boast of clause to permit profiling of healthcare healthcare reporters in Nigeria may have
capable hands in a number of cases they centres and their special strengths so no choice but maintain the status quo,
handle on a daily basis. Given that that Nigerians would know when and counting victims and mourning the state
situation, navigating the system in search where what they travel abroad to get is of the system without being able to
of capable hands, for ailing citizens and available at home also at best quality. provide the citizens with much needed
their caregivers, is like walking in a maze. information on how the healthcare sector
To avoid this kind of situation and the Gbenga Akinfenwa in The Guardian of can serve them better.
frustration it produces, many Nigerians Sunday 28 December 2014 chronicles
who can afford it resort to seeking the harrowing experiences of some Admitted, the no-advertising clause in
medical care abroad where they can get Nigerians and Africans seeking the MDCN Code is inspired by the
ready information on what they need and medical care abroad. He emphasises foresight and wisdom of those who
where to find it. that not all medical tourists do have it drafted the document, many decades of
pleasant on such trips. Knowing this, significant social and professional
If Nigerians travel abroad seeking however, cannot dissuade people changes have gone over it. Leveraging on
medical care because they are convinced from such medical trips as they are the existing framework, contemporary
the healthcare system at home cannot hardly aware of better alternatives at medical practitioners need to make a
give what they need, carefully designed home. The only local alternative timely response to this critical situation.
campaigns cannot dissuade people from promoted in the media and through This is a digital age that is driven by
such tours, only awareness of a better various exhibitions is traditional information which in turn drives the
alternative at home can. How then do medical practice. market forces. There is need to review the
people become aware of what the regulatory restrictions on disseminating
healthcare system at home has to offer? Without prejudice to its many certain medical information that is
Obviously, it is not through such acclaimed potentials, traditional critical to people's awareness of the
harrowing experiences of trial and errors medicine in Nigeria has not developed strength of the Nigerian health sector.
at different hospitals. The media to a stage where Nigerians can
occupies a critical position in comfortably resort to it to compensate Contemporary medical professionals
disseminating such crucial information to their lack of confidence in the need to strategise on how to achieve this
the citizens. country's orthodox healthcare without compromising the great value
system. Without useful information on that the medical profession places on the
After so much has been said around the the potentials of local healthcare sanctity of human life. They must see far
main issue at hand, here is the dilemma of system, people are left with no choice into the future to prevent all the possible
health sector information in Nigeria: If the than to go where such is available. If loopholes so that mindless capitalists do
media profile prominent healthcare care seekers and caregivers are aware not take advantage of the situation to
centres, their specialties and of cases similar to theirs which have exploit patients and caregivers. If Nigeria
professional capability, they contravene been successfully handled by Nigerian will record much greater success in the
an injunction in the MDCN code which medical experts at home, there is a health sector, stakeholders must ensure
forbids the promotion medical possibility that they consider seeking that crucial information is provided about
practitioners or their services. If the treatment at home, more so when they what the sector has to offer the public.
media don't, Nigerians will remain are aware that medical experts abroad This need can't be more urgent when no
unaware that such services, facilities and also are not magicians. law in Nigeria forbids foreign hospitals
human capacities are available in the from advertising their services in the
country's health sector. In an April 21, 2014 Editorial titled: N i g e r i a n media.
“Medical Tourism: Healing Nigeria's
From the foregoing, it becomes obvious Health Sector”, The Punch bemoans
that bemoaning the medical tourism the precarious situation of the
expenses of Nigerians as different Nigerian healthcare sector and
Ministers of Health occasionally do proposes quality training of medical
would not solve the problem. I do not practitioners, adequate funding and
advocate an abolition of the no-advert equipping of teaching hospitals
injunction in the NMA Code, for trado- among others as viable way out. In
medical practitioners have shown us how addition to all these, there is need to
bad the scuttle could be in the health address the system that keeps citizens
tweet
Nigerians spend over 80 billion($400m) on medical tourism (MT).About 50% of outbound MTin Nigeria goes to India.
6
Policy Regulatory Constraints, Popular Distrust andthe Dearth of Healthcare Information in Nigeria
health & politics today, 1st quarter, 2015
Diabetic &Confused?
To eat or not to eat...
7 health & politics today, 1st quarter, 2015
Apart from teaching hospitals and some sector. Instead, everything suggests a ignorant of what the healthcare sector of
general hospitals, extremely few need for a realistic review of that their country can do. Until this is done,
hospitals in Nigeria could boast of clause to permit profiling of healthcare healthcare reporters in Nigeria may have
capable hands in a number of cases they centres and their special strengths so no choice but maintain the status quo,
handle on a daily basis. Given that that Nigerians would know when and counting victims and mourning the state
situation, navigating the system in search where what they travel abroad to get is of the system without being able to
of capable hands, for ailing citizens and available at home also at best quality. provide the citizens with much needed
their caregivers, is like walking in a maze. information on how the healthcare sector
To avoid this kind of situation and the Gbenga Akinfenwa in The Guardian of can serve them better.
frustration it produces, many Nigerians Sunday 28 December 2014 chronicles
who can afford it resort to seeking the harrowing experiences of some Admitted, the no-advertising clause in
medical care abroad where they can get Nigerians and Africans seeking the MDCN Code is inspired by the
ready information on what they need and medical care abroad. He emphasises foresight and wisdom of those who
where to find it. that not all medical tourists do have it drafted the document, many decades of
pleasant on such trips. Knowing this, significant social and professional
If Nigerians travel abroad seeking however, cannot dissuade people changes have gone over it. Leveraging on
medical care because they are convinced from such medical trips as they are the existing framework, contemporary
the healthcare system at home cannot hardly aware of better alternatives at medical practitioners need to make a
give what they need, carefully designed home. The only local alternative timely response to this critical situation.
campaigns cannot dissuade people from promoted in the media and through This is a digital age that is driven by
such tours, only awareness of a better various exhibitions is traditional information which in turn drives the
alternative at home can. How then do medical practice. market forces. There is need to review the
people become aware of what the regulatory restrictions on disseminating
healthcare system at home has to offer? Without prejudice to its many certain medical information that is
Obviously, it is not through such acclaimed potentials, traditional critical to people's awareness of the
harrowing experiences of trial and errors medicine in Nigeria has not developed strength of the Nigerian health sector.
at different hospitals. The media to a stage where Nigerians can
occupies a critical position in comfortably resort to it to compensate Contemporary medical professionals
disseminating such crucial information to their lack of confidence in the need to strategise on how to achieve this
the citizens. country's orthodox healthcare without compromising the great value
system. Without useful information on that the medical profession places on the
After so much has been said around the the potentials of local healthcare sanctity of human life. They must see far
main issue at hand, here is the dilemma of system, people are left with no choice into the future to prevent all the possible
health sector information in Nigeria: If the than to go where such is available. If loopholes so that mindless capitalists do
media profile prominent healthcare care seekers and caregivers are aware not take advantage of the situation to
centres, their specialties and of cases similar to theirs which have exploit patients and caregivers. If Nigeria
professional capability, they contravene been successfully handled by Nigerian will record much greater success in the
an injunction in the MDCN code which medical experts at home, there is a health sector, stakeholders must ensure
forbids the promotion medical possibility that they consider seeking that crucial information is provided about
practitioners or their services. If the treatment at home, more so when they what the sector has to offer the public.
media don't, Nigerians will remain are aware that medical experts abroad This need can't be more urgent when no
unaware that such services, facilities and also are not magicians. law in Nigeria forbids foreign hospitals
human capacities are available in the from advertising their services in the
country's health sector. In an April 21, 2014 Editorial titled: N i g e r i a n media.
“Medical Tourism: Healing Nigeria's
From the foregoing, it becomes obvious Health Sector”, The Punch bemoans
that bemoaning the medical tourism the precarious situation of the
expenses of Nigerians as different Nigerian healthcare sector and
Ministers of Health occasionally do proposes quality training of medical
would not solve the problem. I do not practitioners, adequate funding and
advocate an abolition of the no-advert equipping of teaching hospitals
injunction in the NMA Code, for trado- among others as viable way out. In
medical practitioners have shown us how addition to all these, there is need to
bad the scuttle could be in the health address the system that keeps citizens
tweet
Nigerians spend over 80 billion($400m) on medical tourism (MT).About 50% of outbound MTin Nigeria goes to India.
6
Policy Regulatory Constraints, Popular Distrust andthe Dearth of Healthcare Information in Nigeria
5
1 2
34
Work toward yourtreatment goals
What should Ibuy at the grocery?
What should Ieat or not eat?
1. Maintain optimum blood glucose level
between (20-40mmol/L or <200mg/dL)
2. Prevent hypoglycaemia (too low level of
blood glucose) by eating regularly
3. Maintain blood pressure of 130/80mmHg or
below
Adequate control of your blood sugar &
pressure will help you prevent
the complications of diabetes:
1. Blindeness (retinopathy)
2. Kidney failure (nephropathy)
3. Diabetic foot (neuropathy)
4. Arthropathy (joint disorder)
You can stock all
kinds of fruits
and vegetables.
So, feel free.
You can eat varieties of food and enjoy your
favourite meals. What matters now is how you
cook (e.g. avoid fried foods) & how you eat.
1. Eat regular meals: breakfast, lunch,
dinner. Skipping meals usually lead
to symptoms of hypoglycaemia such
as sudden bout of hunger, dizziness,
loss of consciousness etc. and may
lead to death.
2. Ensure the proportion of fibre or vegetables
is higher than that of digestible glucose.
3. After you’ve eaten, check your blood glucose
level 2 hours later to know its effect. With that,
you can compare different foods and determine
the quantity that is good for you.
1. Avoid too much of sweet fruits with
high sugar contents,
because they can
make you gain weight.
2. Weight gain will
increase insulin
resistance and impair
your body’s
mechanism for making
use of glucose.
3. Being overweight will also increase your
risk of cardiovascular diseases e.g.
stroke.
1. Making a habit of eating garlic
as part of your meals is good, as
they help lower blood sugar level
2. Get regular moderate exercise,
but avoid doing strenous workout.
Your physiotherapist or
doctor can prescribe appropriate
schedules for you.
3. Buy a glucometer for monitoring your
blood sugar yourself. It is worth having so
you won’t have to go through the stress of
queuing at the hospital and losing productive
hours just to check your sugar level at the
hospital.
Fruits are good for you, but Other important tips
MIND YOU
Grape fruit contains natural
chemicals that can
interfere with the
metabolism of a lot of
drugs including the ones
used in diabetes
health & politics today, 1st quarter, 2015
HealthTips
8
HealthTips
Challenges of African Women Managing Diabetes Mellitus
linical management of diabetes mellitus (DM) cognitive ability, their perceptions and contextual
requires that practitioners work hand in hand with experiences.
patients in order to maximise therapeutic care and As I mentioned earlier, effective diabetes management Cencourage self-management. Studies have shown schedules are those revolving around the patient
that patients who take more responsibility for their care themselves, involving full patient participation and thus
have better health outcomes such as lowered blood empowering them for self-management.
glucose levels, ideal body weight, quality nutrition and
improved physical activity. The effect of education on women's health cannot be
overemphasised and as an advocate for women's health
The context of the day to day lives of women however and empowerment, I implore the government, non-
affects their ability to improve their health and effectively governmental organisations as well as different ethnic
manage diabetes mellitus. As shown by various studies groups to embrace women education by giving equal rights
involving African-American women, women are and opportunities to women and men.
particularly affected by social and family barriers which
hinder their capability to manage their disease states. Coupled with the deficient educational status of women
especially those living in rural communities, unequal
First of such barriers is the social perception of women as access to employment opportunities is another factor that
sole caregivers. Typically in the African context, women are influences women's treatment outcomes in diabetes care.
charged with the responsibilities of child-care, Standard diabetes management includes training patients
housekeeping and preparing meals with no help from their to use glucometers at home to monitor blood glucose
husbands. Hence, where the woman is diabetic, she levels. Pervasive prevalence of poverty among African
receives little or no support from her husband or other women and those from low-income economies means that
members of the family in terms of monitoring her diet these women are either unable to afford healthy meals
regimen, salt intake medication adherence, as she would and/or the blood glucose apparatus for self-monitoring.
herself render if her husband were diabetic. The situation In this way, meagre family income or economic deprivation
even becomes worse and stressful when the woman is the encourage poor control of blood sugar leading to
bread-winner of the family. Thus, everyday physical and avoidable complications of diabetes such as blindness,
emotional stress makes women less able to take care of kidney failure, and diabetic foot.
their own health effectively.
Therefore, governments should intensify efforts to improve
Studies on clinical follow-up for women with gestational the social status of women through education, deliberate
diabetes (a type of diabetes detected during pregnancy) creation of more employment opportunities, platforms for
puts lack of time and family stress as critical determinants women development and poverty alleviation programs.
of screening uptake and as major reasons for missed Funds should also be committed to researches which focus
clinical appointments. The family environment can provide on diabetes outcomes among women.
negative or positive reinforcement for dietary change and
general diabetes management. By providing emotional Summary. It is evident that women in Africa are faced with
support for diabetic women and ensuring they have healthy peculiar socioeconomic constraints which in turn affect
foods that can help them achieve their treatment goals their locus of control, ability to initiate and sustain dietary
available in the house, women can initiate and sustain and lifestyle changes which can help them effectively
dietary changes easily. Family members of women with manage their diabetes. Except these factors are
diabetes can provide support for them by adopting healthy addressed, majority of women from deprived communities
eating styles themselves, by offering to help with meal will continue to
preparation and providing some motivation and experience poor
opportunity for physical activity around the home. quality of life and
mortality due to
The educational status of women also affects DM complications of
prognosis. First, is the ability to comprehend health uncontrolled type 2
messages especially when they are transmitted through diabetes mellitus.
print media, radio or television broadcast. Health
professionals such as nutritionists, nurses, pharmacists or
physicians do their best in enlightening patients about their
disease states. The problem, however, is that many of
these experts are usually not participatory in their
approaches. Thus, diabetes education is at best a system
of diffused information without regard for the woman's
9 health & politics today, 1st quarter, 2015
Temitope Ojedokun
5
1 2
34
Work toward yourtreatment goals
What should Ibuy at the grocery?
What should Ieat or not eat?
1. Maintain optimum blood glucose level
between (20-40mmol/L or <200mg/dL)
2. Prevent hypoglycaemia (too low level of
blood glucose) by eating regularly
3. Maintain blood pressure of 130/80mmHg or
below
Adequate control of your blood sugar &
pressure will help you prevent
the complications of diabetes:
1. Blindeness (retinopathy)
2. Kidney failure (nephropathy)
3. Diabetic foot (neuropathy)
4. Arthropathy (joint disorder)
You can stock all
kinds of fruits
and vegetables.
So, feel free.
You can eat varieties of food and enjoy your
favourite meals. What matters now is how you
cook (e.g. avoid fried foods) & how you eat.
1. Eat regular meals: breakfast, lunch,
dinner. Skipping meals usually lead
to symptoms of hypoglycaemia such
as sudden bout of hunger, dizziness,
loss of consciousness etc. and may
lead to death.
2. Ensure the proportion of fibre or vegetables
is higher than that of digestible glucose.
3. After you’ve eaten, check your blood glucose
level 2 hours later to know its effect. With that,
you can compare different foods and determine
the quantity that is good for you.
1. Avoid too much of sweet fruits with
high sugar contents,
because they can
make you gain weight.
2. Weight gain will
increase insulin
resistance and impair
your body’s
mechanism for making
use of glucose.
3. Being overweight will also increase your
risk of cardiovascular diseases e.g.
stroke.
1. Making a habit of eating garlic
as part of your meals is good, as
they help lower blood sugar level
2. Get regular moderate exercise,
but avoid doing strenous workout.
Your physiotherapist or
doctor can prescribe appropriate
schedules for you.
3. Buy a glucometer for monitoring your
blood sugar yourself. It is worth having so
you won’t have to go through the stress of
queuing at the hospital and losing productive
hours just to check your sugar level at the
hospital.
Fruits are good for you, but Other important tips
MIND YOU
Grape fruit contains natural
chemicals that can
interfere with the
metabolism of a lot of
drugs including the ones
used in diabetes
health & politics today, 1st quarter, 2015
HealthTips
8
HealthTips
Challenges of African Women Managing Diabetes Mellitus
linical management of diabetes mellitus (DM) cognitive ability, their perceptions and contextual
requires that practitioners work hand in hand with experiences.
patients in order to maximise therapeutic care and As I mentioned earlier, effective diabetes management Cencourage self-management. Studies have shown schedules are those revolving around the patient
that patients who take more responsibility for their care themselves, involving full patient participation and thus
have better health outcomes such as lowered blood empowering them for self-management.
glucose levels, ideal body weight, quality nutrition and
improved physical activity. The effect of education on women's health cannot be
overemphasised and as an advocate for women's health
The context of the day to day lives of women however and empowerment, I implore the government, non-
affects their ability to improve their health and effectively governmental organisations as well as different ethnic
manage diabetes mellitus. As shown by various studies groups to embrace women education by giving equal rights
involving African-American women, women are and opportunities to women and men.
particularly affected by social and family barriers which
hinder their capability to manage their disease states. Coupled with the deficient educational status of women
especially those living in rural communities, unequal
First of such barriers is the social perception of women as access to employment opportunities is another factor that
sole caregivers. Typically in the African context, women are influences women's treatment outcomes in diabetes care.
charged with the responsibilities of child-care, Standard diabetes management includes training patients
housekeeping and preparing meals with no help from their to use glucometers at home to monitor blood glucose
husbands. Hence, where the woman is diabetic, she levels. Pervasive prevalence of poverty among African
receives little or no support from her husband or other women and those from low-income economies means that
members of the family in terms of monitoring her diet these women are either unable to afford healthy meals
regimen, salt intake medication adherence, as she would and/or the blood glucose apparatus for self-monitoring.
herself render if her husband were diabetic. The situation In this way, meagre family income or economic deprivation
even becomes worse and stressful when the woman is the encourage poor control of blood sugar leading to
bread-winner of the family. Thus, everyday physical and avoidable complications of diabetes such as blindness,
emotional stress makes women less able to take care of kidney failure, and diabetic foot.
their own health effectively.
Therefore, governments should intensify efforts to improve
Studies on clinical follow-up for women with gestational the social status of women through education, deliberate
diabetes (a type of diabetes detected during pregnancy) creation of more employment opportunities, platforms for
puts lack of time and family stress as critical determinants women development and poverty alleviation programs.
of screening uptake and as major reasons for missed Funds should also be committed to researches which focus
clinical appointments. The family environment can provide on diabetes outcomes among women.
negative or positive reinforcement for dietary change and
general diabetes management. By providing emotional Summary. It is evident that women in Africa are faced with
support for diabetic women and ensuring they have healthy peculiar socioeconomic constraints which in turn affect
foods that can help them achieve their treatment goals their locus of control, ability to initiate and sustain dietary
available in the house, women can initiate and sustain and lifestyle changes which can help them effectively
dietary changes easily. Family members of women with manage their diabetes. Except these factors are
diabetes can provide support for them by adopting healthy addressed, majority of women from deprived communities
eating styles themselves, by offering to help with meal will continue to
preparation and providing some motivation and experience poor
opportunity for physical activity around the home. quality of life and
mortality due to
The educational status of women also affects DM complications of
prognosis. First, is the ability to comprehend health uncontrolled type 2
messages especially when they are transmitted through diabetes mellitus.
print media, radio or television broadcast. Health
professionals such as nutritionists, nurses, pharmacists or
physicians do their best in enlightening patients about their
disease states. The problem, however, is that many of
these experts are usually not participatory in their
approaches. Thus, diabetes education is at best a system
of diffused information without regard for the woman's
9 health & politics today, 1st quarter, 2015
Temitope Ojedokun
Cholesterol:
Your Heart
and Your
HealthIf not all cholesterols are bad, then which is the good guy?
What is cholesterol? Is cholesterol really bad?
What are the symptoms of high
How can I reduce bad cholesterol?
cholesterol?
.Cholesterol is naturally found in all cells No. But you must avoid consuming much
of the body. It is a type of fat that cholesterol because your body makes
circulates in the blood. We get more than it needs for metabolic
Cholesterol in two forms. A activities.
bout
he liver and other
body tissues daily, while d
Cholesterol performs various functions
in the body such as repair of body cells
and formation of new cells, production of
bile, vitamin D synthesis, production of
sex hormones such as testosterone and
progesterone and other important
hormones which help in the metabolism
of glucose, minerals and fats.
For cholesterol to travel in the blood, It
would need to be coupled to a carrier
protein, to form a lipoprotein. There are
two types of lipoproteins:
1. Low-density lipoproteins (LDLs) also
termed "bad cholesterol”
2. High-density lipoproteins (HDLs), also
referred to as "good" cholesterol”
ccording to While HDL is associated with
the American Heart Association, a prevention of fat deposits in the arteries
75 percent of the cholesterol in the (hence called good cholesterol), LDL
blood is produced by t leads to a deposit of fats which
ietary eventually narrow the arteries. This
cholesterol make up the remaining 25%. narrowing of the arteries is called
artherosclerosis, a condition which
results in high blood pressure, angina
pectoris and myocardial infarction.What normal function do they
perform?
How many forms of cholesterol
do we have in the body?
brand with a high proportion of
unsaturated fats. sunflower oil, soya oil
and sesame oil are examples of good oil.
5. Avoid frying your food as much as
possible.
6. Do not exceed the daily allowed limit
for alcohol (3 units for men and 2 units for
women).
7. Eat the recommended five portions of
fruits and vegetables regularly.
There are no symptoms of high
cholesterol, which is why regular Here are some tips for you:screening is important from the age of 40
years. Below is a guide on how to 1. Stop smoking or do not smoke: interpret your cholesterol levelsmoking is associated with high
cholesterol levels and increased risk for
stroke, heart diseases and lung cancer.
2. Control your weight. High cholesterol
level is associated with being obese or
overweight.
3. Eat more fish and less meat. Fish oil is
rich in omega-3 fatty acid and other
healthy unsaturated fatty acids.
4. Check oil labels to ensure you buy the
health & politics today, 1st quarter, 2015
Normal
High
Very high
InterpretationTotalcholesterol
Totalcholesterol(mg/dL) (mmol/L)
Below 200
200-239
240 andabove
Below 5.0
5.0-6.2
Above 6.2
10
HealthTips
health & politics today, 1st quarter, 2015
HealthHealth &Safety
Carbohydrate - 30g
Dietary Fiber - 3g
Protein - 1 g
Potassium - 450 mg
Magnesium - 34 mg
Vitamin C - 9 mg
Niacin - .8 mg
Vitamin B6 - .5 mg
Manganese - .3 mg
Iron - .3 mg
Riboflavin - .1 mg
Folate - 25.0 mcg
Vitamin A - 81 IU
anana Facts: Why Monkeys are Always Happy!
Just what amount of nutrients do we have in a banana?
We have arranged them for you by their quantity.
You may want to compare that to some of the supplements
you buy from your pharmacy.
CAUTION
If you are on
antihypertensive
medications such as
labetalol, losartan,
lisinopril or
spironolactone, you need
to be mindful of your
potassium level as these
drugs normally increase
the potassium level of
the body. Excessive
potassium levels can
lead to heart failure and
muscle dysfunction.
Tomatoes are also very
rich in potassium. You
may discuss this with you
clinician if you are
worried.
One medium banana weighs about 125g, 110 calories,
30g carbohydrate and 1g protein. It is rich in
serotonin which works in the brain as a natural anti-
depressant. Serotonin helps boost memory and a
lively mood.
Bananas are free of fats, cholesterol and sodium. As a
result, bananas help lower blood pressure, reduce
asthma and cancer risks and help the heart function
healthily.
The high potassium content in bananas helps lower
blood pressure as much as reducing sodium intake
does. Hence it is good for the elderly who are at
increased risk of developing high blood pressure,
stroke and other cardiovascular diseases.
The vitamin C content of banana mops up free
radicals which are known to cause cancer in the body.
Its high fibre contents (much like oranges and leafy
vegetables help reduce risk of colorectal cancer.
11
HealthTips
Cholesterol:
Your Heart
and Your
HealthIf not all cholesterols are bad, then which is the good guy?
What is cholesterol? Is cholesterol really bad?
What are the symptoms of high
How can I reduce bad cholesterol?
cholesterol?
.Cholesterol is naturally found in all cells No. But you must avoid consuming much
of the body. It is a type of fat that cholesterol because your body makes
circulates in the blood. We get more than it needs for metabolic
Cholesterol in two forms. A activities.
bout
he liver and other
body tissues daily, while d
Cholesterol performs various functions
in the body such as repair of body cells
and formation of new cells, production of
bile, vitamin D synthesis, production of
sex hormones such as testosterone and
progesterone and other important
hormones which help in the metabolism
of glucose, minerals and fats.
For cholesterol to travel in the blood, It
would need to be coupled to a carrier
protein, to form a lipoprotein. There are
two types of lipoproteins:
1. Low-density lipoproteins (LDLs) also
termed "bad cholesterol”
2. High-density lipoproteins (HDLs), also
referred to as "good" cholesterol”
ccording to While HDL is associated with
the American Heart Association, a prevention of fat deposits in the arteries
75 percent of the cholesterol in the (hence called good cholesterol), LDL
blood is produced by t leads to a deposit of fats which
ietary eventually narrow the arteries. This
cholesterol make up the remaining 25%. narrowing of the arteries is called
artherosclerosis, a condition which
results in high blood pressure, angina
pectoris and myocardial infarction.What normal function do they
perform?
How many forms of cholesterol
do we have in the body?
brand with a high proportion of
unsaturated fats. sunflower oil, soya oil
and sesame oil are examples of good oil.
5. Avoid frying your food as much as
possible.
6. Do not exceed the daily allowed limit
for alcohol (3 units for men and 2 units for
women).
7. Eat the recommended five portions of
fruits and vegetables regularly.
There are no symptoms of high
cholesterol, which is why regular Here are some tips for you:screening is important from the age of 40
years. Below is a guide on how to 1. Stop smoking or do not smoke: interpret your cholesterol levelsmoking is associated with high
cholesterol levels and increased risk for
stroke, heart diseases and lung cancer.
2. Control your weight. High cholesterol
level is associated with being obese or
overweight.
3. Eat more fish and less meat. Fish oil is
rich in omega-3 fatty acid and other
healthy unsaturated fatty acids.
4. Check oil labels to ensure you buy the
health & politics today, 1st quarter, 2015
Normal
High
Very high
InterpretationTotalcholesterol
Totalcholesterol(mg/dL) (mmol/L)
Below 200
200-239
240 andabove
Below 5.0
5.0-6.2
Above 6.2
10
HealthTips
health & politics today, 1st quarter, 2015
HealthHealth &Safety
Carbohydrate - 30g
Dietary Fiber - 3g
Protein - 1 g
Potassium - 450 mg
Magnesium - 34 mg
Vitamin C - 9 mg
Niacin - .8 mg
Vitamin B6 - .5 mg
Manganese - .3 mg
Iron - .3 mg
Riboflavin - .1 mg
Folate - 25.0 mcg
Vitamin A - 81 IU
anana Facts: Why Monkeys are Always Happy!
Just what amount of nutrients do we have in a banana?
We have arranged them for you by their quantity.
You may want to compare that to some of the supplements
you buy from your pharmacy.
CAUTION
If you are on
antihypertensive
medications such as
labetalol, losartan,
lisinopril or
spironolactone, you need
to be mindful of your
potassium level as these
drugs normally increase
the potassium level of
the body. Excessive
potassium levels can
lead to heart failure and
muscle dysfunction.
Tomatoes are also very
rich in potassium. You
may discuss this with you
clinician if you are
worried.
One medium banana weighs about 125g, 110 calories,
30g carbohydrate and 1g protein. It is rich in
serotonin which works in the brain as a natural anti-
depressant. Serotonin helps boost memory and a
lively mood.
Bananas are free of fats, cholesterol and sodium. As a
result, bananas help lower blood pressure, reduce
asthma and cancer risks and help the heart function
healthily.
The high potassium content in bananas helps lower
blood pressure as much as reducing sodium intake
does. Hence it is good for the elderly who are at
increased risk of developing high blood pressure,
stroke and other cardiovascular diseases.
The vitamin C content of banana mops up free
radicals which are known to cause cancer in the body.
Its high fibre contents (much like oranges and leafy
vegetables help reduce risk of colorectal cancer.
11
HealthTips
health & politics today, 1st quarter, 2015 12
March, 2015
is this the year to remind Africa of its
failure?
Health
TODAYPolitics&
MDGs 2015 Deadlineshealth & politics today, 1st quarter, 201514
health & politics today, 1st quarter, 2015 12
March, 2015
is this the year to remind Africa of its
failure?
Health
TODAYPolitics&
MDGs 2015 Deadlineshealth & politics today, 1st quarter, 201514
health & politics today, 1st quarter, 2015 14
MDGs, Countdown to2015, and “concern” for Africa
n his excellent Comment summarising the (thinks the African) why not try the East this time?
2015 Countdown process (April 12, p 1237), IRichard Horton expresses “concern for a Everywhere you go in Ghana today you’ll fi nd
stronger and more just society, one that Chinese workers building roads, clinics, hotels,
values every life…”. How will this be seen from farms, and dams. Since J F Kennedy helped to build
an African point of view? our Volta River hydroelectricity dam, dam-building
activity has not been as frenetic as current Chinese
Horton has previously demonstrated that his efforts with our Bui River Dam. China is also
concern is genuine, but some Africans are still equipping the Ghana Air Force.
wary of other types of “concern” from
developed countries— eg, the paradoxical Ghanaians in the diaspora have sent home US$6
interest in malaria control at the same time as billion in the past 12 months (Kufour J, President of
cur tail ing population growth. Ghana, personal communication)— more than the
totality of aid from developed countries. We need
Get into Africans ’ innermost thoughts, and to channel much of this into public health, and we
you will realise that they are slightly less must use our own experts at home and abroad,
concerned about the rate at which people are rather than foreign ones.
dying (for death has always been with them)
than about infrastructure building. We are grateful to developed countries for helping
curtail morbidity and mortality, but for real
While developed countries interpret development, Africa is now looking to China and
Millennium Development Goals in terms of India. I declare that I have no conflict of interest.
how much less morbidity and mortality there
should be in 2015, we natives seize on the word Reference
“development” and think about agriculture, Horton R. Countdown to 2015: a report card on
covering of open drains, and pipe-borne maternal, newborn, and child survival. Lancet
water. 2008; 371: 1217–19.
The West will only give you tablets and Source: The Lancet Vol 372 August 2, 2008
vaccines, and will even prevent your goods
from being sold on the European market. So
Felix I D Konotey-Ahulu
We are grateful to developed countries for helping curtail morbidity and mortality, but for real development, Africa is now looking to China and India.The West will only give you tablets and vaccines, and will even prevent your goods from being sold on the European market.
HealthHealth &Safety
Commentary
tweet
Tonnes of foreign aids cannot make up for unfair
international trade policies to the disadvantage of
Africa.
health & politics today, 1st quarter, 201515
health & politics today, 1st quarter, 2015 14
MDGs, Countdown to2015, and “concern” for Africa
n his excellent Comment summarising the (thinks the African) why not try the East this time?
2015 Countdown process (April 12, p 1237), IRichard Horton expresses “concern for a Everywhere you go in Ghana today you’ll fi nd
stronger and more just society, one that Chinese workers building roads, clinics, hotels,
values every life…”. How will this be seen from farms, and dams. Since J F Kennedy helped to build
an African point of view? our Volta River hydroelectricity dam, dam-building
activity has not been as frenetic as current Chinese
Horton has previously demonstrated that his efforts with our Bui River Dam. China is also
concern is genuine, but some Africans are still equipping the Ghana Air Force.
wary of other types of “concern” from
developed countries— eg, the paradoxical Ghanaians in the diaspora have sent home US$6
interest in malaria control at the same time as billion in the past 12 months (Kufour J, President of
cur tail ing population growth. Ghana, personal communication)— more than the
totality of aid from developed countries. We need
Get into Africans ’ innermost thoughts, and to channel much of this into public health, and we
you will realise that they are slightly less must use our own experts at home and abroad,
concerned about the rate at which people are rather than foreign ones.
dying (for death has always been with them)
than about infrastructure building. We are grateful to developed countries for helping
curtail morbidity and mortality, but for real
While developed countries interpret development, Africa is now looking to China and
Millennium Development Goals in terms of India. I declare that I have no conflict of interest.
how much less morbidity and mortality there
should be in 2015, we natives seize on the word Reference
“development” and think about agriculture, Horton R. Countdown to 2015: a report card on
covering of open drains, and pipe-borne maternal, newborn, and child survival. Lancet
water. 2008; 371: 1217–19.
The West will only give you tablets and Source: The Lancet Vol 372 August 2, 2008
vaccines, and will even prevent your goods
from being sold on the European market. So
Felix I D Konotey-Ahulu
We are grateful to developed countries for helping curtail morbidity and mortality, but for real development, Africa is now looking to China and India.The West will only give you tablets and vaccines, and will even prevent your goods from being sold on the European market.
HealthHealth &Safety
Commentary
tweet
Tonnes of foreign aids cannot make up for unfair
international trade policies to the disadvantage of
Africa.
health & politics today, 1st quarter, 201515
HE STATE CANNOT BE ESTABLISHED A MEMO FROM A PROMINENT GLOBAL dropping further…” Clearly, the foreign
and cannot prosper if there is no investment bank reads: “Historically, Sub- assistant funds are being mismanaged in Tprogress, development, political and Saharan Africa has been considered more of Africa.
economic growth. Foreign aid is a a target for aid rather than investment. With
supplement of dependency that prevents most Sub-Saharan Africans still living in FOREIGN AID SHOULD NOT BE
the state from growing collectively. p overty on less than $2 per day, many people DISCONTINUED IN AFRICA because a
Countries develop and grow due to trade, have questioned the effectiveness of difference, however small, has been made
innovation and business. There isn’t a trillions of aid dollars doled out over the last because of foreign aid. It appears the
country in the world that has prospered 50 years in achieving economic growth, developmental system in Africa is severely
being solely dependent on aid as a source of arguing for more investment and less aid. compromised. A cycle has been created
development. Because aid has been so Years of widespread corruption, political with foreign aid in Africa, which prevents and
prevalent in associating itself with Africa, it unrest, and news footage filled with images hinders significant growth for the states
has hindered and convoluted alternative of famine, war, and civil insurrections paint a collectively. Foreign aid, foreign direct
solutions such as global trade and foreign challenging picture for investors. But Sub- investment and trade are all convoluted. All
direct investment. Saharan Africa is multi-faceted, and these of these things, like democracy, foreign aid,
portrayals by the press mask an emerging FDI and trade have to work cohesively
WHAT HAS ALSO BEEN COMPROMISED IS investment opportunity getting more together in order to achieve significant
the perspective of the African continent. It attention from institutional investors who results. How can Africa wean itself off aid
is pity that most people have when looking see it as the biggest frontier market when all of the alternatives such as FDI and
from the outside in, inspiring our desire to opportunity, even when compared with Asia, trade are just as complex as aid is?
donate so much. Some people do not Latin America and the Middle East.” Everything needs to be taken into
perceive Africans as adequate business consideration and audited in some way.
partners because of this aid culture that has FINALLY, AFRICA IS BEING INCLUDED MORE Many of the risks in foreign aid have been
been created. The perception of Africa has and more in the international conversation identified therefore it should not be
been tainted by continuous open-ended about globalization. Aid is not a bad thing, considered as the number one go-to
deals to supply Africa with foreign aid and it is very helpful in many situations, solution to all of Africa’s problem. In the
assistance. Development should be the however, it appears the structure of foreign globalized economy, there new financial
main objective in these countries and aid for Africa is mismanaged and has a lot of tools are emerging, new relationships
attention should be taken off aid as the critically high risk involved the entire process forming between countries. The
solution to all problems. China is investing from determining how much aid is going to be opportunities in Africa are there and
in Africa and all around the world and seizing given, who receives the funds, how the funds desperately waiting to be taken advantage
opportunity that the western world and are delegated, and finally spent. Because of.
Europe has been ignoring. there are so many different variables Adapted from: Foreign Aid in Africa: A Short Term Solution involved in each of those processes, the risks to Long-Term Issues Trade Inequality, Corruption, Aid
AID IS NECESSARY IN CERTAIN SITUATIONS, that are involved are so high and dire, that Dependency & Factors that Hinder Socio-Economic
especially humanitarian/emergency aid in foreign aid reform is necessary. Development in Africa. mizzrebelution.wordpress.com
response to a disaster. However, Africa is
bombarded and overwhelmed with foreign POVERTY IS SOMETHING THAT IS CLOSELY
aid. However, systematic aid is not related to all things previously mentioned
compulsory for most countries and has had such as corruption, trade inequality and
little to no effect on directly influencing foreign direct investment (FDI). Poverty’s
socio-economic development. This type of close relation to these variables is the fact
aid should be curved and closely analyzed in that poverty is directly affected by the
regards to the direct and indirect effects variables ’ status. Poverty is the true
there are on the surrounding communities. measurement of a states ’ success. If
Corruption, agriculture, exports and imports poverty is prominent and every other person
are all related to aid and development. counted is associated and/or affected by
Alternative solutions to aid dependency for poverty, clearly the state needs to improve.
socio-economic growth and development A lot argue whether or not foreign aid
can all be found in agriculture, trade and reduces poverty in Africa. “Africa lags
corruption prevention. As we get further into behind all other regions in progress to date.
the millennium with so many things rapidly About half of Sub-Saharan Africa’s 750
changing in the emerging global market, million-plus people still live on less than one
foreign aid and investment is slowly dollar a day, a figure that has been static
transforming and undergoing reform. since 1990, whereas in South Asia it dropped
from 39% in 1990 it 30% in 2001 and is
UNDOING AFRICA: HUGE FOREIGN AID, LITTLE DEVELOPMENT
It appears the developmental system in Africa is severely compromised. A cycle has been created
with foreign aid in Africa, which prevents and hinders significant growth for the states collectively.“
“
tweet
Because aid has been so prevalent in associating itself with Africa, it has hindered and convoluted alternative solutions such as global trade and foreign direct investment.
health & politics today, 1st quarter, 2015
Feature
16
Taking the African Stock
health & politics today, 1st quarter, 2015
Cover story
off-track
on-track
fast-paced
5/8
3/8
Source: Africa Development Bank MDG Report, 2013
A Quick Look at Africa’s MDG Performance
HealthHealth &Safety
Cover story
17
HE STATE CANNOT BE ESTABLISHED A MEMO FROM A PROMINENT GLOBAL dropping further…” Clearly, the foreign
and cannot prosper if there is no investment bank reads: “Historically, Sub- assistant funds are being mismanaged in Tprogress, development, political and Saharan Africa has been considered more of Africa.
economic growth. Foreign aid is a a target for aid rather than investment. With
supplement of dependency that prevents most Sub-Saharan Africans still living in FOREIGN AID SHOULD NOT BE
the state from growing collectively. p overty on less than $2 per day, many people DISCONTINUED IN AFRICA because a
Countries develop and grow due to trade, have questioned the effectiveness of difference, however small, has been made
innovation and business. There isn’t a trillions of aid dollars doled out over the last because of foreign aid. It appears the
country in the world that has prospered 50 years in achieving economic growth, developmental system in Africa is severely
being solely dependent on aid as a source of arguing for more investment and less aid. compromised. A cycle has been created
development. Because aid has been so Years of widespread corruption, political with foreign aid in Africa, which prevents and
prevalent in associating itself with Africa, it unrest, and news footage filled with images hinders significant growth for the states
has hindered and convoluted alternative of famine, war, and civil insurrections paint a collectively. Foreign aid, foreign direct
solutions such as global trade and foreign challenging picture for investors. But Sub- investment and trade are all convoluted. All
direct investment. Saharan Africa is multi-faceted, and these of these things, like democracy, foreign aid,
portrayals by the press mask an emerging FDI and trade have to work cohesively
WHAT HAS ALSO BEEN COMPROMISED IS investment opportunity getting more together in order to achieve significant
the perspective of the African continent. It attention from institutional investors who results. How can Africa wean itself off aid
is pity that most people have when looking see it as the biggest frontier market when all of the alternatives such as FDI and
from the outside in, inspiring our desire to opportunity, even when compared with Asia, trade are just as complex as aid is?
donate so much. Some people do not Latin America and the Middle East.” Everything needs to be taken into
perceive Africans as adequate business consideration and audited in some way.
partners because of this aid culture that has FINALLY, AFRICA IS BEING INCLUDED MORE Many of the risks in foreign aid have been
been created. The perception of Africa has and more in the international conversation identified therefore it should not be
been tainted by continuous open-ended about globalization. Aid is not a bad thing, considered as the number one go-to
deals to supply Africa with foreign aid and it is very helpful in many situations, solution to all of Africa’s problem. In the
assistance. Development should be the however, it appears the structure of foreign globalized economy, there new financial
main objective in these countries and aid for Africa is mismanaged and has a lot of tools are emerging, new relationships
attention should be taken off aid as the critically high risk involved the entire process forming between countries. The
solution to all problems. China is investing from determining how much aid is going to be opportunities in Africa are there and
in Africa and all around the world and seizing given, who receives the funds, how the funds desperately waiting to be taken advantage
opportunity that the western world and are delegated, and finally spent. Because of.
Europe has been ignoring. there are so many different variables Adapted from: Foreign Aid in Africa: A Short Term Solution involved in each of those processes, the risks to Long-Term Issues Trade Inequality, Corruption, Aid
AID IS NECESSARY IN CERTAIN SITUATIONS, that are involved are so high and dire, that Dependency & Factors that Hinder Socio-Economic
especially humanitarian/emergency aid in foreign aid reform is necessary. Development in Africa. mizzrebelution.wordpress.com
response to a disaster. However, Africa is
bombarded and overwhelmed with foreign POVERTY IS SOMETHING THAT IS CLOSELY
aid. However, systematic aid is not related to all things previously mentioned
compulsory for most countries and has had such as corruption, trade inequality and
little to no effect on directly influencing foreign direct investment (FDI). Poverty’s
socio-economic development. This type of close relation to these variables is the fact
aid should be curved and closely analyzed in that poverty is directly affected by the
regards to the direct and indirect effects variables ’ status. Poverty is the true
there are on the surrounding communities. measurement of a states ’ success. If
Corruption, agriculture, exports and imports poverty is prominent and every other person
are all related to aid and development. counted is associated and/or affected by
Alternative solutions to aid dependency for poverty, clearly the state needs to improve.
socio-economic growth and development A lot argue whether or not foreign aid
can all be found in agriculture, trade and reduces poverty in Africa. “Africa lags
corruption prevention. As we get further into behind all other regions in progress to date.
the millennium with so many things rapidly About half of Sub-Saharan Africa’s 750
changing in the emerging global market, million-plus people still live on less than one
foreign aid and investment is slowly dollar a day, a figure that has been static
transforming and undergoing reform. since 1990, whereas in South Asia it dropped
from 39% in 1990 it 30% in 2001 and is
UNDOING AFRICA: HUGE FOREIGN AID, LITTLE DEVELOPMENT
It appears the developmental system in Africa is severely compromised. A cycle has been created
with foreign aid in Africa, which prevents and hinders significant growth for the states collectively.“
“
tweet
Because aid has been so prevalent in associating itself with Africa, it has hindered and convoluted alternative solutions such as global trade and foreign direct investment.
health & politics today, 1st quarter, 2015
Feature
16
Taking the African Stock
health & politics today, 1st quarter, 2015
Cover story
off-track
on-track
fast-paced
5/8
3/8
Source: Africa Development Bank MDG Report, 2013
A Quick Look at Africa’s MDG Performance
HealthHealth &Safety
Cover story
17
Although the MDGs were formulated in 2000, the year 2000 was not the first time
that countries of the world would set ambitious goals. From 6-12th September
1978, the International Conference on Primary Health Care was held in the
defunct USSR's Alma-Ata where 10 declarations were made.
At the historic conference, the issue of health was made a political one; and
health was given a comprehensive definition as contained in the first
Declaration of Alma-Ata. Departing from the traditional biomedical model,
health was defined as not just the absence of disease but also psychosocial
wellness.
Having given a broad definition of health, the conference then set an ambitious
but vague goal in its fifth declaration: “...the attainment by all peoples of the
world by the year 2000 of a level of health that will permit them to lead a socially
and economically productive life.”
Expecting every one of the billions of people in the world living in widely varying
economic, political and socio-cultural contexts to attain an optimal level of all-
round, comprehensive health in just a little over two decades (1978-2000) was
quite an ambition. Moreover, the set goal was vague in the sense that the Alma-
Ata Declaration did not precisely pin down what things constitute 'to lead a
socially and economically productive life'. Even if all the human and financial
resources required by every country of the world to achieve the lofty goal were
available at the time, the global events following 1978 would still have caused
enormous humanitarian crisis as to impede the realisation of it nonetheless.
The Shah revolution of 1979 which toppled the Iranian monarchy was soon
followed by Iraq's invasion of oil-rich Kuwait. That also was followed by the
military involvement of the United States and her allies in the Iraqi war and the
attendant arms proliferation in the region. Combined with the activities of
Somali pirates, the war in the Middle East affected the oil market and the price
went up. Sudan was still fighting a bitter civil war inflicting deaths and
deformities on civilian population. In Europe, political and ethnic tensions
continued to rise within the socialist USSR leading to its eventual dissolution
under the leadership of Mikhail Gobachev on 25 December, 1991. Brutal wars
and ethnic cleansing soon broke out among countries that emerged from the
erstwhile USSR, notably Yugoslavia. All these events and a host of other factors
clearly setback the realisation of the Alma-Ata agenda.
That “all peoples of the world by the year 2000" did not attain the desired level of
health is now a fact of history. Therefore, at the dawn of this millennium the UN
deemed it fit to adopt pragmatic resolutions by which governments can be held
accountable and responsible for the development of their country and people.
So, the Millennial Declaration gave birth to the MDGs. While the MDGs (with a 15-
year time frame for their actualisation) were equally ambitious like the Alma-Ata
Declaration, their targets are more specific with a long list of carefully selected
specific and measurable indicators.
Before the Beginning:Revisiting the Russian Alma-Ata
Declaration V
“Governments have a responsibility for the health of their people… A main social target of governments, should be the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially a n d e c o n o m i c a l l y productive life. Primary health care is the key to attaining this target as part of development in the spir it of social justice.”
health & politics today, 1st quarter, 2015
Declaration I
The Conference strongly reaffirms that health, [which is a state of c o m p l e t e p h y s i c a l , m e n t a l a n d s o c i a l wellbeing, and not merely the absence of disease or i n f i r m i t y ] , i s a fundamental human r i g h t a n d t h a t t h e attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.
18
HealthCover story
On 8th September 2000, at the United goals. For example, the indicator for
Nations (UN) 8th plenary session, 189 measuring progress towards achieving
world leaders gathered at the UN Goal 4 (Reduce child mortality) was 'under-
headquarters, New York, to affirm the five mortality rate' of which the target was
Millennium Declaration. The 'Reduce by two-thirds, between 1990 and
Millennium Declaration was a 2015, the under-five mortality rate'. Thus,
document which highlighted the regional and national development can be
resolutions of the heads of states on appraised within the framework of the
their commitment to solving key MDGs since they provide specific,
problems confronting humanity: measurable targets against which global or
poverty, preventable deaths, regional progress can be gauged.
insecurity and illiteracy. Population health was recognised as
crucial to human development. Thus, three
That the concern for Africa [as a of the MDGs (4, 5, and 6) were directly
region] was central to the adoption of related to health: Reduce child mortality;
the MDGs was reflected in the special Improve maternal health; and Combat
attention given to Africa in the historic HIV/AIDS, malaria and tuberculosis
resolution. The 30-point Declaration respectively. Some MDGs also have a lot to
was divided into VIII sections, of which do with health: MDG1 was set to eradicate
section VII (resolutions 27 & 28) was extreme poverty and hunger; MDG7
dedicated to 'Meeting the special targeted environmental health and
needs of Africa'. sustainability; and one of the key indicators
of MDG8 was 'Proportion of population with
“We will support the consolidation of access to affordable essential drugs on a
democracy in Africa and assist sustainable basis'.
Africans in their struggle for lasting
peace, poverty eradication and An important criticism of the MDGs is that
sustainable development, thereby African countries had minimal input when
bringing Africa into the mainstream of the MDGs that are now used as yardsticks to
the world economy.” measure their success or failure were being
formulated. Ordinarily, African countries
Therefore from the outset, it appeared (and other developing countries) should
that meeting the MDGs was more an have made substantial contribution to
issue for Africa (and the rest of the devising the yardsticks for measuring
developing countries than it is for developmental issues affecting them,
developed economies. based on an objective appraisal of their
human and financial capacity and what
In 2001, eight Mil lennium they could possibly achieve with
Development Goals (MDGs) to be supplementary foreign aids and
achieved by the year 2015 were assistance. However, the main actors
worked out based on the broad involved in designing the MDGs were
principles of the Millennial members of the UN secretariat and
Declaration and as specifically representatives of the International
delineated in section III (Development Monetary Fund (IMF), the World Bank and
and poverty eradication). The 8 MDGs the Organisation for Economic Co-
were subdivided into 18 targets and operation and Development (OECD).
48 indicators which can be used to African countries were only signatories to
measure a region's progress (or the MDGs.
otherwise) towards achieving the set
health & politics today, 1st quarter, 2015
Born at the Dawn of a New Millennium:
”“
Expecting every one of the billions of people in the world living in widely varying economic, political and socio-cultural contexts to attain an optimal level of all-round, comprehensive health in just a little over two decades (1978-2000) was quite an ambition.
How We Got the MDGs
tweet
THE CONCERN FOR AFRICAAS A REGION WAS CENTRAL
TO THE ADOPTION OF THE MDGS
Cover storyHealthHealth &Safety
Cover story
19
Although the MDGs were formulated in 2000, the year 2000 was not the first time
that countries of the world would set ambitious goals. From 6-12th September
1978, the International Conference on Primary Health Care was held in the
defunct USSR's Alma-Ata where 10 declarations were made.
At the historic conference, the issue of health was made a political one; and
health was given a comprehensive definition as contained in the first
Declaration of Alma-Ata. Departing from the traditional biomedical model,
health was defined as not just the absence of disease but also psychosocial
wellness.
Having given a broad definition of health, the conference then set an ambitious
but vague goal in its fifth declaration: “...the attainment by all peoples of the
world by the year 2000 of a level of health that will permit them to lead a socially
and economically productive life.”
Expecting every one of the billions of people in the world living in widely varying
economic, political and socio-cultural contexts to attain an optimal level of all-
round, comprehensive health in just a little over two decades (1978-2000) was
quite an ambition. Moreover, the set goal was vague in the sense that the Alma-
Ata Declaration did not precisely pin down what things constitute 'to lead a
socially and economically productive life'. Even if all the human and financial
resources required by every country of the world to achieve the lofty goal were
available at the time, the global events following 1978 would still have caused
enormous humanitarian crisis as to impede the realisation of it nonetheless.
The Shah revolution of 1979 which toppled the Iranian monarchy was soon
followed by Iraq's invasion of oil-rich Kuwait. That also was followed by the
military involvement of the United States and her allies in the Iraqi war and the
attendant arms proliferation in the region. Combined with the activities of
Somali pirates, the war in the Middle East affected the oil market and the price
went up. Sudan was still fighting a bitter civil war inflicting deaths and
deformities on civilian population. In Europe, political and ethnic tensions
continued to rise within the socialist USSR leading to its eventual dissolution
under the leadership of Mikhail Gobachev on 25 December, 1991. Brutal wars
and ethnic cleansing soon broke out among countries that emerged from the
erstwhile USSR, notably Yugoslavia. All these events and a host of other factors
clearly setback the realisation of the Alma-Ata agenda.
That “all peoples of the world by the year 2000" did not attain the desired level of
health is now a fact of history. Therefore, at the dawn of this millennium the UN
deemed it fit to adopt pragmatic resolutions by which governments can be held
accountable and responsible for the development of their country and people.
So, the Millennial Declaration gave birth to the MDGs. While the MDGs (with a 15-
year time frame for their actualisation) were equally ambitious like the Alma-Ata
Declaration, their targets are more specific with a long list of carefully selected
specific and measurable indicators.
Before the Beginning:Revisiting the Russian Alma-Ata
Declaration V
“Governments have a responsibility for the health of their people… A main social target of governments, should be the attainment by all peoples of the world by the year 2000 of a level of health that will permit them to lead a socially a n d e c o n o m i c a l l y productive life. Primary health care is the key to attaining this target as part of development in the spir it of social justice.”
health & politics today, 1st quarter, 2015
Declaration I
The Conference strongly reaffirms that health, [which is a state of c o m p l e t e p h y s i c a l , m e n t a l a n d s o c i a l wellbeing, and not merely the absence of disease or i n f i r m i t y ] , i s a fundamental human r i g h t a n d t h a t t h e attainment of the highest possible level of health is a most important world-wide social goal whose realization requires the action of many other social and economic sectors in addition to the health sector.
18
HealthCover story
On 8th September 2000, at the United goals. For example, the indicator for
Nations (UN) 8th plenary session, 189 measuring progress towards achieving
world leaders gathered at the UN Goal 4 (Reduce child mortality) was 'under-
headquarters, New York, to affirm the five mortality rate' of which the target was
Millennium Declaration. The 'Reduce by two-thirds, between 1990 and
Millennium Declaration was a 2015, the under-five mortality rate'. Thus,
document which highlighted the regional and national development can be
resolutions of the heads of states on appraised within the framework of the
their commitment to solving key MDGs since they provide specific,
problems confronting humanity: measurable targets against which global or
poverty, preventable deaths, regional progress can be gauged.
insecurity and illiteracy. Population health was recognised as
crucial to human development. Thus, three
That the concern for Africa [as a of the MDGs (4, 5, and 6) were directly
region] was central to the adoption of related to health: Reduce child mortality;
the MDGs was reflected in the special Improve maternal health; and Combat
attention given to Africa in the historic HIV/AIDS, malaria and tuberculosis
resolution. The 30-point Declaration respectively. Some MDGs also have a lot to
was divided into VIII sections, of which do with health: MDG1 was set to eradicate
section VII (resolutions 27 & 28) was extreme poverty and hunger; MDG7
dedicated to 'Meeting the special targeted environmental health and
needs of Africa'. sustainability; and one of the key indicators
of MDG8 was 'Proportion of population with
“We will support the consolidation of access to affordable essential drugs on a
democracy in Africa and assist sustainable basis'.
Africans in their struggle for lasting
peace, poverty eradication and An important criticism of the MDGs is that
sustainable development, thereby African countries had minimal input when
bringing Africa into the mainstream of the MDGs that are now used as yardsticks to
the world economy.” measure their success or failure were being
formulated. Ordinarily, African countries
Therefore from the outset, it appeared (and other developing countries) should
that meeting the MDGs was more an have made substantial contribution to
issue for Africa (and the rest of the devising the yardsticks for measuring
developing countries than it is for developmental issues affecting them,
developed economies. based on an objective appraisal of their
human and financial capacity and what
In 2001, eight Mil lennium they could possibly achieve with
Development Goals (MDGs) to be supplementary foreign aids and
achieved by the year 2015 were assistance. However, the main actors
worked out based on the broad involved in designing the MDGs were
principles of the Millennial members of the UN secretariat and
Declaration and as specifically representatives of the International
delineated in section III (Development Monetary Fund (IMF), the World Bank and
and poverty eradication). The 8 MDGs the Organisation for Economic Co-
were subdivided into 18 targets and operation and Development (OECD).
48 indicators which can be used to African countries were only signatories to
measure a region's progress (or the MDGs.
otherwise) towards achieving the set
health & politics today, 1st quarter, 2015
Born at the Dawn of a New Millennium:
”“
Expecting every one of the billions of people in the world living in widely varying economic, political and socio-cultural contexts to attain an optimal level of all-round, comprehensive health in just a little over two decades (1978-2000) was quite an ambition.
How We Got the MDGs
tweet
THE CONCERN FOR AFRICAAS A REGION WAS CENTRAL
TO THE ADOPTION OF THE MDGS
Cover storyHealthHealth &Safety
Cover story
19
From the out set when the MDGs were put forward, predicaments such as weak
health systems, low health professional to population ratio, high women
illiteracy, high rates of early marriage, government corruption and widespread
maternal poverty were pervasive among most African countries, which make it
unrealistic that they would be able to reduce maternal mortality ratio by 75% in
just 15 years.
Undisputably, Africa was in a race in which it started out far behind others.
The MDG target 5A was to reduce MMR by three-quarters, between 1990 and
2015. In 1990, MMR in Austria was 8 and was reduced to 5 by the year 2000 when
the MDGs were launched.
Within the same period, Italy had a low MMR of 7 which was further reduced to 5.
The worst performing European countries Cyprus and Romania had average
MMR of 98 and 92 respectively in 1990 with substantial reduction to 57 and 42
deaths per 100,000 live births in 2000.
Conversely, the best performing African country, South Africa, started out with
MMR 121 in 1990 and which only increased to 155 by the year 2000.
The worst performing African countries, Mauritania and Eritrea, had 1,295 and
1,293 maternal deaths per 100,000 live births respectively in 1990. While both
were able to achieve over 30% decrease by the year 2000 and even further
decrease by 2008, many other African countries have only recorded increased
in maternal mortality or minimal improvement over the years.
By 2008 sub-Sahara Africa's share of global maternal mortality rose to 52%, a
126% rise from 23% in 1980. Increases in MMR recorded in the south African
sub-region (e.g. Botswana and Lesotho have been attributed to high burden of
HIV/AIDS) and while weak health systems and inadequate health work force are
the main drivers of high maternal death in Nigeria, Chad, Gabon, and Central
African Republic.
While it is obvious that Africa is not on track to achieve MDG4 by 2015,
reasonable progress can be made in saving the lives of mothers and intending
mothers by putting efforts in some key areas.
Given the positive correlation between high HIV prevalence and rising maternal
mortality among south African countries, it follows logically governments need
to show stronger commitment to fighting HIV/AIDS. Efforts should be increased
toward prevention of vertical transmission of the virus and reducing the
disproportionate burden of HIV among women. As we enter the post-2015 era,
increased government funding of HIV/AIDS would also help cover deficits
created by declining aid from donor agencies such as PEPFAR, The Global Fund
etc.
Also countries where weak health systems are the key drivers of maternal
mortality (such as Nigeria, Chad etc.) should increase healthcare funding,
recruit more health workers and address the problem of poor access to
antenatal care, essential drugs and surgery especially in under-served
communities.
From The Beginning, We Were Not Equal:
health & politics today, 1st quarter, 2015
A Focus on Maternal Mortality
”“Maternal mortal i t y ratio (MMR) is maternal deaths per 100,000 live births.
tweet
by 2008 sub-Sahara Africa'sshare of global maternal mortality
rose to 52%,a 126% rise from 23% in 1980.
HealthCover story
20
Countdown to 2015 formaternal, newborn, and child survival
30 years ago, WHO declared “health for all”. Where was surgery and
anaesthesia? Not deemed relevant in 1978, that was for sure. But now? I
see no mention of emergency obstetric care in the Countdown Series
on maternal, newborn, and child survival.
The figures are stark. In one
impoverished
Asian country, 80% of district hospitals
do no surgery at all.
In Africa the rate of caesarean
sections is only 1.0–1.5%, despite the
high incidence of obstructed labour.
For 2 years (1993–95), data from the
operations records of 18 African district
hospitals were reported. Among
major operations, 7500 caesarean
sections were done per 10 million
women in labour per year (rate 1.5%).
On the basis of clinical presentations, if those caesarean sections had not
been done, an increased annual fatality of 6750 would have occurred. The
actual number of maternal deaths for this population in 1994 was
2200–2500. It seems from these simple sums that doing no caesarean
sections at all would approximately quadruple maternal mortality, even from
the high mortality that results from operating on only 1.5% of labouring
mothers. The cost of anaesthesia for a 1.5% caesarean rate for sub-
Saharan Africa was US$1.3 million in 1994—a tiny fraction of the costs
talked about for Millennium Development Goal (MDG) 5. So it cannot be
that anaesthesia is too expensive. Until district hospitals provide
comprehensive emergency obstetric care (ie, anaesthesia and surgery),
Countdown will achieve no more than previous attempts to meet MDG5.
www.thelancet.com Vol 372 August 2, 2008
References:
The Countdown Coverage Writing Group, on behalf of the Countdown to 2015 Core Group.
Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking
intervention coverage. Lancet 2008; 371: 1247–58.
Government of Nepal Ministry of Health and Population. Safe motherhood newsletter, vol 9.
Kathmandu: Government of Nepal, 2007.
Fenton PM. Epidemiology of district surgery in Malawi: a 2-year study of surgical rates in rural
Africa. East Cent Afr J Surg 1997; 3: 33–41.
Fenton PM. The cost of third world anaesthesia: an estimate of consumption of drugs and
equipment in anaesthetic practice in Malawi. Cent Afr J Med 1994; 40: 137–39.
Paul M Fenton
The cost of anaesthesia for a 1.5% caesarean rate for sub-Saharan Africa was US$1.3 million in 1994—a tiny fraction of the costs talked about for Millennium Development Goal (MDG) 5. So it cannot be that anaesthesia is too expensive.
HealthHealth &Safety
Commentary
health & politics today, 1st quarter, 2015
tweet
Obstructed labour (OL)=11% maternal deaths in Nigeria: 6,700 women wt OL can be saved annually with CS fund 150,000 naira ($800) each
source: Nigeria MDGs 2013 Report
Causes of maternal deathssource: Nigeria MDGs 2013 Report
21
From the out set when the MDGs were put forward, predicaments such as weak
health systems, low health professional to population ratio, high women
illiteracy, high rates of early marriage, government corruption and widespread
maternal poverty were pervasive among most African countries, which make it
unrealistic that they would be able to reduce maternal mortality ratio by 75% in
just 15 years.
Undisputably, Africa was in a race in which it started out far behind others.
The MDG target 5A was to reduce MMR by three-quarters, between 1990 and
2015. In 1990, MMR in Austria was 8 and was reduced to 5 by the year 2000 when
the MDGs were launched.
Within the same period, Italy had a low MMR of 7 which was further reduced to 5.
The worst performing European countries Cyprus and Romania had average
MMR of 98 and 92 respectively in 1990 with substantial reduction to 57 and 42
deaths per 100,000 live births in 2000.
Conversely, the best performing African country, South Africa, started out with
MMR 121 in 1990 and which only increased to 155 by the year 2000.
The worst performing African countries, Mauritania and Eritrea, had 1,295 and
1,293 maternal deaths per 100,000 live births respectively in 1990. While both
were able to achieve over 30% decrease by the year 2000 and even further
decrease by 2008, many other African countries have only recorded increased
in maternal mortality or minimal improvement over the years.
By 2008 sub-Sahara Africa's share of global maternal mortality rose to 52%, a
126% rise from 23% in 1980. Increases in MMR recorded in the south African
sub-region (e.g. Botswana and Lesotho have been attributed to high burden of
HIV/AIDS) and while weak health systems and inadequate health work force are
the main drivers of high maternal death in Nigeria, Chad, Gabon, and Central
African Republic.
While it is obvious that Africa is not on track to achieve MDG4 by 2015,
reasonable progress can be made in saving the lives of mothers and intending
mothers by putting efforts in some key areas.
Given the positive correlation between high HIV prevalence and rising maternal
mortality among south African countries, it follows logically governments need
to show stronger commitment to fighting HIV/AIDS. Efforts should be increased
toward prevention of vertical transmission of the virus and reducing the
disproportionate burden of HIV among women. As we enter the post-2015 era,
increased government funding of HIV/AIDS would also help cover deficits
created by declining aid from donor agencies such as PEPFAR, The Global Fund
etc.
Also countries where weak health systems are the key drivers of maternal
mortality (such as Nigeria, Chad etc.) should increase healthcare funding,
recruit more health workers and address the problem of poor access to
antenatal care, essential drugs and surgery especially in under-served
communities.
From The Beginning, We Were Not Equal:
health & politics today, 1st quarter, 2015
A Focus on Maternal Mortality
”“Maternal mortal i t y ratio (MMR) is maternal deaths per 100,000 live births.
tweet
by 2008 sub-Sahara Africa'sshare of global maternal mortality
rose to 52%,a 126% rise from 23% in 1980.
HealthCover story
20
Countdown to 2015 formaternal, newborn, and child survival
30 years ago, WHO declared “health for all”. Where was surgery and
anaesthesia? Not deemed relevant in 1978, that was for sure. But now? I
see no mention of emergency obstetric care in the Countdown Series
on maternal, newborn, and child survival.
The figures are stark. In one
impoverished
Asian country, 80% of district hospitals
do no surgery at all.
In Africa the rate of caesarean
sections is only 1.0–1.5%, despite the
high incidence of obstructed labour.
For 2 years (1993–95), data from the
operations records of 18 African district
hospitals were reported. Among
major operations, 7500 caesarean
sections were done per 10 million
women in labour per year (rate 1.5%).
On the basis of clinical presentations, if those caesarean sections had not
been done, an increased annual fatality of 6750 would have occurred. The
actual number of maternal deaths for this population in 1994 was
2200–2500. It seems from these simple sums that doing no caesarean
sections at all would approximately quadruple maternal mortality, even from
the high mortality that results from operating on only 1.5% of labouring
mothers. The cost of anaesthesia for a 1.5% caesarean rate for sub-
Saharan Africa was US$1.3 million in 1994—a tiny fraction of the costs
talked about for Millennium Development Goal (MDG) 5. So it cannot be
that anaesthesia is too expensive. Until district hospitals provide
comprehensive emergency obstetric care (ie, anaesthesia and surgery),
Countdown will achieve no more than previous attempts to meet MDG5.
www.thelancet.com Vol 372 August 2, 2008
References:
The Countdown Coverage Writing Group, on behalf of the Countdown to 2015 Core Group.
Countdown to 2015 for maternal, newborn, and child survival: the 2008 report on tracking
intervention coverage. Lancet 2008; 371: 1247–58.
Government of Nepal Ministry of Health and Population. Safe motherhood newsletter, vol 9.
Kathmandu: Government of Nepal, 2007.
Fenton PM. Epidemiology of district surgery in Malawi: a 2-year study of surgical rates in rural
Africa. East Cent Afr J Surg 1997; 3: 33–41.
Fenton PM. The cost of third world anaesthesia: an estimate of consumption of drugs and
equipment in anaesthetic practice in Malawi. Cent Afr J Med 1994; 40: 137–39.
Paul M Fenton
The cost of anaesthesia for a 1.5% caesarean rate for sub-Saharan Africa was US$1.3 million in 1994—a tiny fraction of the costs talked about for Millennium Development Goal (MDG) 5. So it cannot be that anaesthesia is too expensive.
HealthHealth &Safety
Commentary
health & politics today, 1st quarter, 2015
tweet
Obstructed labour (OL)=11% maternal deaths in Nigeria: 6,700 women wt OL can be saved annually with CS fund 150,000 naira ($800) each
source: Nigeria MDGs 2013 Report
Causes of maternal deathssource: Nigeria MDGs 2013 Report
21
s stated earlier, one merits of the MDGs is that they target specifies; that would still leave that tiny East African
set quantitative and time specific targets which can country with an MMR of 323 maternal deaths per 100,000 live Aserve as incentives or motivations for governments births. In that [hypothetical] case, Eritrea would have met the
and institutions to commit to ending extreme poverty while MGD5. Yet that leaves it with an MMR that is 46 times the
improving human development. In spite of these obvious maternal deaths in Canada, 27 times the United States' and 32
merits, another criticism of the MDGs is their use as times the average for Western Europe as at 1980!
measures of national or regional success or failure when
they were set as global targets ab initio. It therefore follows that a huge difference exists between
merely attaining the MDGs and actually fulfilling the
According to Vandemoortele, a past UN official who played imperatives of human development.
a key role in formulating the MDGs, the intent of the goals was
not to serve as a strict benchmark for every country to attain Defining success or failure using performance on MDG1
to by 2015, but rather as an impetus for “all countries to (poverty eradication) is even more complicated because while
strive for accelerated human development”. But then, sadly sub-Sahara Africa has reduced the proportion of extreme
and slowly, the MDGs and their targets became flawed poverty by 10% over ten years (1999-2010), the actual
indices for judging a country's or region's performances, number of extremely poor people has increased over the
and whether those performances are on track to attain the same period.
set goals. As a result, Africa is often portrayed as a failed
region that is not on track to attain the MDGs. The target of MDG1 was to halve the proportion of the people of
the world living on less than $1.25 per day between 1990 and
The 2013 appraisal of Africa's performance toward 2015. On the whole, the world has met the target since 2010
achieving the MDGs, published by the African Development (five years before the deadline), thanks to China and India's
Bank Group (AfDB), stated that only five countries –Benin, accelerated progress. Increased export of Chinese products
Ethiopia, The Gambia, Malawi and Rwanda- were making and outsourcing of manufacturing and projects to Chinese
accelerated progress on a number of indicators such as and Indian firms mean massive job opportunities for Chinese
primary school enrolment, boys-girl ratio in school, under- men and women skilled, semi-skilled and even unskilled. The
five and maternal mortalities and tuberculosis control. But commitment of the Chinese communist government to
even at that, they are not necessarily going to meet the industrial expansion, capacity building and international
targets by the end of 2015. trade expansion mean that even apart from the MDGs, China
was poised to eradicate extreme poverty and improve the lives
The question then is how should we judge a nation which of more people like never before in the history of the world.
though may not eventually attain the target, but have
nonetheless come a long way in improving their health and According to the AfDB 2013 report on the MDGs in Africa, North
developmental indices? African countries of Algeria, Tunisia, Morocco, and Egypt were
the best performing African countries: they are reducing the
In Eritrea for example, by 2000, approximately 400 more proportion of extremely poor people at a faster rate. On the
lives were saved from maternal complications & death other hand, the larger sub-Saharan Africa region has
causing total MMR to drop below by over 30% relative to consistently increased its number of extremely poor people
1990 when 1293 women died per 100,000 live births. While (living below $1.25) from about 377 million in 1999 to 414
Eritrea is yet to reduce its MMR by the set target of 75%, million in 2010, while the observed proportional reduction
should we say the small African country has failed as a result (from 58% in 1999 to 48.5% in 2010) has been occurring at a
(though it has come a long way)? much slower annual rate of 1.29%.
On the other hand, the United Kingdom has maintained a The implication of this is that while sub-Sahara Africa is the
stagnant MMR of 8 since 1990 (two points down from 10 in fastest growing sub-region in the world, the poverty reduction
1980) rather than reducing it to about 2 in order to meet the among the region's destitute lags far behind the much
75% reduction target. So, if we use proportion (rather than acclaimed growth.
absolute numbers), then Eritrea has performed better than Data on maternal mortality from:the United Kingdom. Yet it would be preposterous to say that Margaret C Hogan et al. (2010) ‘Maternal mortality for 181 countries,
the United Kingdom has “failed” its mandate to meet the 1980–2008: a Systematic Analysis of Progress Towards Millennium
MDG on maternal mortality reduction. Development Goal 5' The Lancet
And even if Eritrea were to achieve a three-quarters
reduction (no small feat) of its 1990 MMR of 1293 as the MDG
The Ambiguity of Defining Success:has Africa ?Failed
A huge difference exists between merely attaining the MDGs and actually fulfilling the imperatives of human development.
HealthCover story
health & politics today, 1st quarter, 2015 22
Tunisia reduced the proportion also vital . Agricultural schoolchildren and needy
of people living on less than $1 development, especially in rural families); and public works
per day from 5.9 per cent in 1990 areas , promoted se l f - programmes that provide short-
to 1.4 per cent in 2005—a 76.3 su f f i c i ency , gene rat i ng term jobs for unskilled workers,
per cent drop. The country’s employment and improving in both urban and rural areas,
consistent economic growth of living conditions. t h ro u g h s e l f - t a rg e t e d
about 5 per cent over the past mechanisms, such as setting
two decades and long-standing Over the years, even during wages below the minimum wage
commitment to social and fiscal austerity, the government and locating the work sites in
physical development have p ro t e c t e d t h e p u b l i c predominantly poor areas.
played an important role. expenditures in social sectors, These interventions have
including welfare for the helped alleviate poverty. But
Commitment to long-term vulnerable and marginalized. despite the progress, the
infrastructure development The government has several interventions need better
across rural and urban areas safety nets, including: food targeting and the programmes
supported better distribution of subsidies targeted to the poor need to be implemented more
the benefits of growth. The t h rough s e l f - s e l e c t i o n efficiently.
promotion of irrigated farming mechanisms using quality Source: 2013 African Development covering more than 4,000 differentiation; direct transfers, Bank MDG Report 2013 (UNSD, n.d.; square kilometres for producing in cash and kind, targeted to the Friedman, 2010; World Bank, 1995.)olive oil, grains and citrus fruits is needy (the elderly, the disabled,
Tunisia’s success in accelerating poverty reduction
Regional Breakdown of Poverty Incidence
HealthCover story
health & politics today, 1st quarter, 201523
s stated earlier, one merits of the MDGs is that they target specifies; that would still leave that tiny East African
set quantitative and time specific targets which can country with an MMR of 323 maternal deaths per 100,000 live Aserve as incentives or motivations for governments births. In that [hypothetical] case, Eritrea would have met the
and institutions to commit to ending extreme poverty while MGD5. Yet that leaves it with an MMR that is 46 times the
improving human development. In spite of these obvious maternal deaths in Canada, 27 times the United States' and 32
merits, another criticism of the MDGs is their use as times the average for Western Europe as at 1980!
measures of national or regional success or failure when
they were set as global targets ab initio. It therefore follows that a huge difference exists between
merely attaining the MDGs and actually fulfilling the
According to Vandemoortele, a past UN official who played imperatives of human development.
a key role in formulating the MDGs, the intent of the goals was
not to serve as a strict benchmark for every country to attain Defining success or failure using performance on MDG1
to by 2015, but rather as an impetus for “all countries to (poverty eradication) is even more complicated because while
strive for accelerated human development”. But then, sadly sub-Sahara Africa has reduced the proportion of extreme
and slowly, the MDGs and their targets became flawed poverty by 10% over ten years (1999-2010), the actual
indices for judging a country's or region's performances, number of extremely poor people has increased over the
and whether those performances are on track to attain the same period.
set goals. As a result, Africa is often portrayed as a failed
region that is not on track to attain the MDGs. The target of MDG1 was to halve the proportion of the people of
the world living on less than $1.25 per day between 1990 and
The 2013 appraisal of Africa's performance toward 2015. On the whole, the world has met the target since 2010
achieving the MDGs, published by the African Development (five years before the deadline), thanks to China and India's
Bank Group (AfDB), stated that only five countries –Benin, accelerated progress. Increased export of Chinese products
Ethiopia, The Gambia, Malawi and Rwanda- were making and outsourcing of manufacturing and projects to Chinese
accelerated progress on a number of indicators such as and Indian firms mean massive job opportunities for Chinese
primary school enrolment, boys-girl ratio in school, under- men and women skilled, semi-skilled and even unskilled. The
five and maternal mortalities and tuberculosis control. But commitment of the Chinese communist government to
even at that, they are not necessarily going to meet the industrial expansion, capacity building and international
targets by the end of 2015. trade expansion mean that even apart from the MDGs, China
was poised to eradicate extreme poverty and improve the lives
The question then is how should we judge a nation which of more people like never before in the history of the world.
though may not eventually attain the target, but have
nonetheless come a long way in improving their health and According to the AfDB 2013 report on the MDGs in Africa, North
developmental indices? African countries of Algeria, Tunisia, Morocco, and Egypt were
the best performing African countries: they are reducing the
In Eritrea for example, by 2000, approximately 400 more proportion of extremely poor people at a faster rate. On the
lives were saved from maternal complications & death other hand, the larger sub-Saharan Africa region has
causing total MMR to drop below by over 30% relative to consistently increased its number of extremely poor people
1990 when 1293 women died per 100,000 live births. While (living below $1.25) from about 377 million in 1999 to 414
Eritrea is yet to reduce its MMR by the set target of 75%, million in 2010, while the observed proportional reduction
should we say the small African country has failed as a result (from 58% in 1999 to 48.5% in 2010) has been occurring at a
(though it has come a long way)? much slower annual rate of 1.29%.
On the other hand, the United Kingdom has maintained a The implication of this is that while sub-Sahara Africa is the
stagnant MMR of 8 since 1990 (two points down from 10 in fastest growing sub-region in the world, the poverty reduction
1980) rather than reducing it to about 2 in order to meet the among the region's destitute lags far behind the much
75% reduction target. So, if we use proportion (rather than acclaimed growth.
absolute numbers), then Eritrea has performed better than Data on maternal mortality from:the United Kingdom. Yet it would be preposterous to say that Margaret C Hogan et al. (2010) ‘Maternal mortality for 181 countries,
the United Kingdom has “failed” its mandate to meet the 1980–2008: a Systematic Analysis of Progress Towards Millennium
MDG on maternal mortality reduction. Development Goal 5' The Lancet
And even if Eritrea were to achieve a three-quarters
reduction (no small feat) of its 1990 MMR of 1293 as the MDG
The Ambiguity of Defining Success:has Africa ?Failed
A huge difference exists between merely attaining the MDGs and actually fulfilling the imperatives of human development.
HealthCover story
health & politics today, 1st quarter, 2015 22
Tunisia reduced the proportion also vital . Agricultural schoolchildren and needy
of people living on less than $1 development, especially in rural families); and public works
per day from 5.9 per cent in 1990 areas , promoted se l f - programmes that provide short-
to 1.4 per cent in 2005—a 76.3 su f f i c i ency , gene rat i ng term jobs for unskilled workers,
per cent drop. The country’s employment and improving in both urban and rural areas,
consistent economic growth of living conditions. t h ro u g h s e l f - t a rg e t e d
about 5 per cent over the past mechanisms, such as setting
two decades and long-standing Over the years, even during wages below the minimum wage
commitment to social and fiscal austerity, the government and locating the work sites in
physical development have p ro t e c t e d t h e p u b l i c predominantly poor areas.
played an important role. expenditures in social sectors, These interventions have
including welfare for the helped alleviate poverty. But
Commitment to long-term vulnerable and marginalized. despite the progress, the
infrastructure development The government has several interventions need better
across rural and urban areas safety nets, including: food targeting and the programmes
supported better distribution of subsidies targeted to the poor need to be implemented more
the benefits of growth. The t h rough s e l f - s e l e c t i o n efficiently.
promotion of irrigated farming mechanisms using quality Source: 2013 African Development covering more than 4,000 differentiation; direct transfers, Bank MDG Report 2013 (UNSD, n.d.; square kilometres for producing in cash and kind, targeted to the Friedman, 2010; World Bank, 1995.)olive oil, grains and citrus fruits is needy (the elderly, the disabled,
Tunisia’s success in accelerating poverty reduction
Regional Breakdown of Poverty Incidence
HealthCover story
health & politics today, 1st quarter, 201523
of its people. Wealth is concentrated in China made an impressive reduction in Nigeria has failed in this regard, the hands of a privileged handful. the proportion of its extremely poor g i v e n h e r p r o s p e r i t y a n d
citizens from 60% in 1990 to 16% in 2005 opportunity…According to the National Bureau of and to a further 12% in 2010. Thus, China Poverty eradication is such an important Statistics, quintile distribution shows the took out three times the entire population aspect of human development that it took poorest 20% of the population of Nigeria out of poverty in 20 years. Over the first place on the UN's development accounted for just 5.5% share of the agenda. Compared to the 1990 level, national consumption expenditure in countries are expected to reduce the 2010, a further decline from 5.9% in number of their extremely poor people by 2004. This brazen inequality by which half by the year 2015. As the largest it is possible for opulence and producer of crude oil in Africa and the destitution to stand cheek by jowl on world's fourth highest exporter of the same street in Nigeria is liquefied natural gas (LNG), it should be aggravated by the anti-development taken for granted that Nigeria would predicament of shamelessly achieve the imperative of the first MDG celebrated or condoned corruption and even more. Now, having failed to both in the public and private sectors. improve remarkably on all the indices of Thus billions of dollars have been lost poverty (absolute poverty, relative to corruption and pathological poverty, Gini index and share of national e x t r a v a g a n c e w i t h i n t h e consumption by the poorest quintile) government.despite having abundant human and
natural resources at its disposal, Nigeria As mentioned earlier, the world has has shown the world that it is possible for a been able to achieve a historic feat of government to squander its golden reducing extreme poverty and opportunity to make real positive hunger by 700 million (more than the difference in the lives of its populace.50% reduction target) 5 years before
the 2015 deadline. This means that Nigeria failed its region and sub-the proportion of extremely poor
region ...people in developing countries fell
Nigeria as the most populous and from 47% in 1990 to 22% in 2010 –a
prosperous African country deserves the same period, Nigeria has plunged feat which would not have been possible special attention because it has failed the more citizens into multi-dimensional had China, the most populous country African region, especially its own sub- poverty than any other country in the and second biggest economy in the world, region –West Africa. The proportion of world, despite her unusual endowment. If not risen up to the task of eradicating children under five years of age who are Nigeria were to lift just 40% (about 80 poverty within its border.underweight is one of three indicators million) of its citizens out of poverty, West used by the International Food Policy Africa's share of global poverty would According to the UN MDG report of 2013, Research Institute to determine a reduce significantly. country's position on the GHI. With a
hunger index score of 15.7, Nigeria is
ranked among countries seriously
suffering from hunger on the Global
Hunger Index (GHI). The West African
sub-region alone accounts for about 40%
of extreme poverty and hunger globally.
Nigeria being the most populous African
country accounts for the lion's share of
that unfortunate statistics. Despite being
the largest economy in Africa and one of
the emerging markets, Nigeria has not
recorded a corresponding improvement
in the lives of the overwhelming majority
overty prevalence in 1992 was 42.70%. On this basis, 21.40% was adopted as that proportion of the people whose income would be less than USD 1 a day which had to be attained by 2015. …poverty prevalence has actually fluctuated over the years – it rose to P
65.60% in 1996, but declined to 51.55% in 2004. The National Bureau of Statistics (NBS) has estimated poverty prevalence for 2010, measured on the USD 1 per day basis, at 61.20%. On the basis of this measure, the country has experienced a regression in its progress towards the target of 21.40%. Other measures have declined only marginally, with the exception of relative poverty which rose to about 69.0%. Both per capita absolute poverty and the 'adult equivalent' absolute poverty declined; per capita poverty declined from 64.20% in 2004 to 62.20% in 2010 and absolute poverty declined from 48.40% in 2004 to 46.0% in 2010. On all measures, however, the gap between the actual figure and the target of 21.40% prevalence still remains wide.
Source: Nigeria MDG Report 2013
Poverty Trend in Nigeria
Focus on Nigeria:Eradication of Extreme Poverty
Despite the expanse of arable and pastoral lands especially in Northern Nigeria(about the size of England, Scotland, Wales and Northern Ireland put together), 24 out of a 100 people or 3 out of 10 people carry through the day without enough food.
HealthCover story
health & politics today, 1st quarter, 2015 24
ph
oto
: Nig
eri
a M
DG
Rep
ort
2013
Nigeria possesses nearly all the factors insurgency which became intensified assistance (ODA) which Nigeria gets from
required to boost the economic since 2010. The insurgents usually target donor countries yearly. Thus, it is clear
prosperity of its citizenry within its rural agricultural communities killing, that a gradual and consistent clamp
borders. While oil-producing Gulf maiming and stealing in the process. down on financial crimes can make
countries such as Saudi Arabia
spend huge sums importing
water and vegetables which
they lack, Nigeria has
abundant fresh water and
vegetables and so do not need
to import these. Despite the
expanse of arable and pastoral
lands especially in Northern
Nigeria (about the size of
England, Scotland, Wales and
Northern Ireland put together),
Nigeria's estimated hunger
rate was 24% in 2011.
P a r a d o x i c a l l y , r u r a l
communities where the main
occupation is farming are more
affected by hunger, with the
proportion of underweight
children under the age of five
estimated at 28% compared to 17% in With little military success in substantial amount of money available
rural areas. This shows that agricultural guaranteeing safety of lives, many which should then be used for building
initiatives of the government do not reach villages have been vacated and farms capital projects and social amenities in
the most deprived farmers, especially abandoned. The collapse of key rural areas.
those living in rural communities. industries like textiles, low female
Farmers have often complained that participation in the labour force, weak Also, in the area of agricultural extension,
financial and material aids released by education and poor infrastructure are deliberate efforts must be made to reach
the government to boost agricultural other reasons for endemic poverty in the poor farmers and improve their
productivity only end up in the hands of north. productivity. Government interventions
politicians and a few privileged persons in livestock production and crop farming
known to them. Nigeria can significantly reduce poverty should not just end with the minority rich
within her borders through political and more privileged commercial farmers
Even more startling is the state-level commitment in a few areas. Firstly, some of who do not even have own a
disparity in poverty: nearly half of children institutional corruption and lavish farm. Rural farmers, especially the
under the age of five in North-eastern spending among public officers must be poorest should be empowered through
Yobe State are underweight compared to curtailed. A recent report of an African training, provision of seedlings, crop
4.5% in the South-eastern state of Union committee on financial fraud led processing equipment etc. Agricultural
Anambra. This evidences uneven by Thabo Mbeki, former president of extension programmes should also go
development across the country resulting South Africa, affirms that Nigeria alone hand in hand with educational initiatives
in widespread poverty in the northern accounts for nearly a third of the $60 for children of poor farmers as a means to
region. One of the key drivers of poverty in billion Africa loses annually. This is more breaking the cycle of poverty.
the northern region is the Boko Haram than all the foreign aids and official direct
HealthCover story
health & politics today, 1st quarter, 201525
10 most hungry states in Nigeria:
Number of hungry children out of every 100
of its people. Wealth is concentrated in China made an impressive reduction in Nigeria has failed in this regard, the hands of a privileged handful. the proportion of its extremely poor g i v e n h e r p r o s p e r i t y a n d
citizens from 60% in 1990 to 16% in 2005 opportunity…According to the National Bureau of and to a further 12% in 2010. Thus, China Poverty eradication is such an important Statistics, quintile distribution shows the took out three times the entire population aspect of human development that it took poorest 20% of the population of Nigeria out of poverty in 20 years. Over the first place on the UN's development accounted for just 5.5% share of the agenda. Compared to the 1990 level, national consumption expenditure in countries are expected to reduce the 2010, a further decline from 5.9% in number of their extremely poor people by 2004. This brazen inequality by which half by the year 2015. As the largest it is possible for opulence and producer of crude oil in Africa and the destitution to stand cheek by jowl on world's fourth highest exporter of the same street in Nigeria is liquefied natural gas (LNG), it should be aggravated by the anti-development taken for granted that Nigeria would predicament of shamelessly achieve the imperative of the first MDG celebrated or condoned corruption and even more. Now, having failed to both in the public and private sectors. improve remarkably on all the indices of Thus billions of dollars have been lost poverty (absolute poverty, relative to corruption and pathological poverty, Gini index and share of national e x t r a v a g a n c e w i t h i n t h e consumption by the poorest quintile) government.despite having abundant human and
natural resources at its disposal, Nigeria As mentioned earlier, the world has has shown the world that it is possible for a been able to achieve a historic feat of government to squander its golden reducing extreme poverty and opportunity to make real positive hunger by 700 million (more than the difference in the lives of its populace.50% reduction target) 5 years before
the 2015 deadline. This means that Nigeria failed its region and sub-the proportion of extremely poor
region ...people in developing countries fell
Nigeria as the most populous and from 47% in 1990 to 22% in 2010 –a
prosperous African country deserves the same period, Nigeria has plunged feat which would not have been possible special attention because it has failed the more citizens into multi-dimensional had China, the most populous country African region, especially its own sub- poverty than any other country in the and second biggest economy in the world, region –West Africa. The proportion of world, despite her unusual endowment. If not risen up to the task of eradicating children under five years of age who are Nigeria were to lift just 40% (about 80 poverty within its border.underweight is one of three indicators million) of its citizens out of poverty, West used by the International Food Policy Africa's share of global poverty would According to the UN MDG report of 2013, Research Institute to determine a reduce significantly. country's position on the GHI. With a
hunger index score of 15.7, Nigeria is
ranked among countries seriously
suffering from hunger on the Global
Hunger Index (GHI). The West African
sub-region alone accounts for about 40%
of extreme poverty and hunger globally.
Nigeria being the most populous African
country accounts for the lion's share of
that unfortunate statistics. Despite being
the largest economy in Africa and one of
the emerging markets, Nigeria has not
recorded a corresponding improvement
in the lives of the overwhelming majority
overty prevalence in 1992 was 42.70%. On this basis, 21.40% was adopted as that proportion of the people whose income would be less than USD 1 a day which had to be attained by 2015. …poverty prevalence has actually fluctuated over the years – it rose to P
65.60% in 1996, but declined to 51.55% in 2004. The National Bureau of Statistics (NBS) has estimated poverty prevalence for 2010, measured on the USD 1 per day basis, at 61.20%. On the basis of this measure, the country has experienced a regression in its progress towards the target of 21.40%. Other measures have declined only marginally, with the exception of relative poverty which rose to about 69.0%. Both per capita absolute poverty and the 'adult equivalent' absolute poverty declined; per capita poverty declined from 64.20% in 2004 to 62.20% in 2010 and absolute poverty declined from 48.40% in 2004 to 46.0% in 2010. On all measures, however, the gap between the actual figure and the target of 21.40% prevalence still remains wide.
Source: Nigeria MDG Report 2013
Poverty Trend in Nigeria
Focus on Nigeria:Eradication of Extreme Poverty
Despite the expanse of arable and pastoral lands especially in Northern Nigeria(about the size of England, Scotland, Wales and Northern Ireland put together), 24 out of a 100 people or 3 out of 10 people carry through the day without enough food.
HealthCover story
health & politics today, 1st quarter, 2015 24
ph
oto
: Nig
eri
a M
DG
Rep
ort
2013
Nigeria possesses nearly all the factors insurgency which became intensified assistance (ODA) which Nigeria gets from
required to boost the economic since 2010. The insurgents usually target donor countries yearly. Thus, it is clear
prosperity of its citizenry within its rural agricultural communities killing, that a gradual and consistent clamp
borders. While oil-producing Gulf maiming and stealing in the process. down on financial crimes can make
countries such as Saudi Arabia
spend huge sums importing
water and vegetables which
they lack, Nigeria has
abundant fresh water and
vegetables and so do not need
to import these. Despite the
expanse of arable and pastoral
lands especially in Northern
Nigeria (about the size of
England, Scotland, Wales and
Northern Ireland put together),
Nigeria's estimated hunger
rate was 24% in 2011.
P a r a d o x i c a l l y , r u r a l
communities where the main
occupation is farming are more
affected by hunger, with the
proportion of underweight
children under the age of five
estimated at 28% compared to 17% in With little military success in substantial amount of money available
rural areas. This shows that agricultural guaranteeing safety of lives, many which should then be used for building
initiatives of the government do not reach villages have been vacated and farms capital projects and social amenities in
the most deprived farmers, especially abandoned. The collapse of key rural areas.
those living in rural communities. industries like textiles, low female
Farmers have often complained that participation in the labour force, weak Also, in the area of agricultural extension,
financial and material aids released by education and poor infrastructure are deliberate efforts must be made to reach
the government to boost agricultural other reasons for endemic poverty in the poor farmers and improve their
productivity only end up in the hands of north. productivity. Government interventions
politicians and a few privileged persons in livestock production and crop farming
known to them. Nigeria can significantly reduce poverty should not just end with the minority rich
within her borders through political and more privileged commercial farmers
Even more startling is the state-level commitment in a few areas. Firstly, some of who do not even have own a
disparity in poverty: nearly half of children institutional corruption and lavish farm. Rural farmers, especially the
under the age of five in North-eastern spending among public officers must be poorest should be empowered through
Yobe State are underweight compared to curtailed. A recent report of an African training, provision of seedlings, crop
4.5% in the South-eastern state of Union committee on financial fraud led processing equipment etc. Agricultural
Anambra. This evidences uneven by Thabo Mbeki, former president of extension programmes should also go
development across the country resulting South Africa, affirms that Nigeria alone hand in hand with educational initiatives
in widespread poverty in the northern accounts for nearly a third of the $60 for children of poor farmers as a means to
region. One of the key drivers of poverty in billion Africa loses annually. This is more breaking the cycle of poverty.
the northern region is the Boko Haram than all the foreign aids and official direct
HealthCover story
health & politics today, 1st quarter, 201525
10 most hungry states in Nigeria:
Number of hungry children out of every 100
health & politics today, 1st quarter, 2015 26
t is far easier to conjure up frantic,
desperate efforts to fight Ebola than it is to Ilead people, manage a multidisciplinary
team and build a responsible health system.
Nigeria's abysmal health outcomes and
horrible patient experience in public hospitals
[despite the level of human and financial
resources available to it] puts the Chukwu-led
health ministry as the most irresponsible in the
whole world.
Chukwu followed the tradition of typical
Nigerian professionals in politics who occupy
offices not primarily to give the best service to
the people but as a means to getting more
power. The body posture of the former health
minister while in “power” shows that he was
not interested in resolving the key issues that
have crippled the wheels of the public health
sector.
Onyebuchi Chukwu: a failed health minister?
HealthCover story
health & politics today, 1st quarter, 201527
health & politics today, 1st quarter, 2015 26
t is far easier to conjure up frantic,
desperate efforts to fight Ebola than it is to Ilead people, manage a multidisciplinary
team and build a responsible health system.
Nigeria's abysmal health outcomes and
horrible patient experience in public hospitals
[despite the level of human and financial
resources available to it] puts the Chukwu-led
health ministry as the most irresponsible in the
whole world.
Chukwu followed the tradition of typical
Nigerian professionals in politics who occupy
offices not primarily to give the best service to
the people but as a means to getting more
power. The body posture of the former health
minister while in “power” shows that he was
not interested in resolving the key issues that
have crippled the wheels of the public health
sector.
Onyebuchi Chukwu: a failed health minister?
HealthCover story
health & politics today, 1st quarter, 201527
uccessful leadership lies in a unions are not on strike, those at a
leader's ability to bridge gaps particular federal or state institution
within his team and coordinate would be on strike due to some local sall players to work effectively and issues with their chief medical
efficiently to attain set objectives. director/hospital management.
Onyebuchi Chukwu seem to have failed Then their heartless, strike-happy
in this regard as a health minister. He colleagues in other parts of the country
met a broken health ministry and left it would abandon their patients and life-
even more decimated. saving duties under the guise of
“showing solidarity” for their striking
There is no other sector of the Nigerian colleagues.
state, however rickety, that has
witnessed an inter-professional And from the comfort of their homes or
wrangling and regular strikes that can private businesses they tweet “Black
come close to that of the public health lives matter”, “We can't breathe”. Yet
sector led by Chukwu. they do not care about babies who
timely surgery could have saved from
Disharmony among unions of health permanent deformity or even needless
professionals in the country took a turn death.
for the worse like never before in the
history of Nigeria; and Onyebuchi Chukwu was They do not care about tens of thousands of mothers who
apportioned blame by all contending unions as the require antenatal care, and which could make a difference
umpire who only stoked the embers of controversy. between dying in labour or surviving it.
Even his own professional constituency for which he was It would simply be impossible to quantify the loss incurred by
often alleged to favour to the detriment of others and the the Nigerian people and government as a result of Chukwu's
health system lambasted and dismissed him as lack of leadership in managing inter-professional disputes in
“irrelevant” for his failure to broker a deal that should the sector throughout his 3 years 6 months 'rule'.
have ended their ruthless, inhumane 55-day strike in
2014. According to the general secretary of the Nigerian Unchallenged Culture of Medical Association (NMA), Mr Adewunmi Alayaki,
As already mentioned, public offices are usually held, not with
the view to give the best service to the system, but rather to “Even when we are at our meetings, the way and manner he exploit it as a means of gaining more power and succulent [Chukwu] speaks, he has been the clog to progress in our
meetings... Everybody will now see [who is] the problem appointments. The CMDs are no exception.between the Federal Ministry of Health and the NMA… Let Chukwu be saying whatever he is saying: you cannot want Generally speaking, the office of the chief medical director solutions to a problem and you are creating more problems.
(CMD) in Nigerian hospitals has become so associated with He shouldn't have done what he did. We are only giving him
brazen abuse of power, financial wantonness and respect as minister of health… But we are still speaking with
administrative pettiness with little or no “medical” role play government at a higher quarter than him.”that professional unions of pharmacists, nurses,
physiotherapists etc. have challenged the claim of the NMA In the 21st century where it is unimaginable in many that only medical doctors have the right and what it takes to countries that health professionals would leave the occupy the post or run a hospital efficiently.dying unattended for even four hours, Nigeria's unions of
health professionals under the deathly watch of the To the shock of the Nigerian Medical Association, their clinical professor of surgery made a competition out of industrial colleagues see nothing “medical” in what CMDs do that the strikes while continuing to earn their salaries.office should be the exclusive preserve of physicians.
It is common knowledge that health workers who own Despite high rates of poverty among patients, CMDs receive private practice or some other businesses rake in more expensive brand new cars and cash from pharmaceutical profits during strike.companies (despite having official cars provided by the You could count how many days Nigerian health government). Typical of any profit-making endeavour theseprofessionals were at work in the year 2014. If national
Corruption
Industrial Crises...
Onyebuchi Chukwu: a failed minister of health?
28health & politics today, 1st quarter, 2015
Onyebuchi Chukwu: a failed minister of health?
companies then increase their mark-up on drugs and Money fails, power too other health products in order to recoup their
There were signs that Onyebuchi Chukwu could have resigned 'investment'. High cost of drugs in public hospitals has
his ministerial post to start pursuing his gubernatorial ambition been part of the problem of poor medication adherence
earlier. However, the outbreak of Ebola delayed the ex-especially among patients with long-term illness like
minister's move.hypertension and diabetes.
That delay perhaps contributed in no small measure to his Nigerian medical directors are more interested in
political misadventure. By the time he left office in October, the awarding contracts for the supply of bricks, gravel and
fluid game of politics had changed faster than he anticipated.sharp sand far more than they are interested in improving
patient experience and staff welfare.Governor Martin Nwancho Elechi of Ebonyi State rubber-
stamped and declared Chukwu as his governorship candidate. It is not unusual for CMDs to deprive health professionals
To win an incumbent's nomination in Nigerian politics means their due allowances, especially junior doctors who are
the gubernatorial aspirant must have paid the outgoing met with fiery threats when they push for their right. As
governor huge sums of money.negotiation often fails due to the dictatorial posture of the
Given this tradition, it is not unlikely that Chukwu's case was any office of the CMD, concerned unions embark on strike in
different.the process to the detriment of patients and clients
seeking medical care.Despite the governor's backing of the former minister of health,
the equally interested Deputy Governor of Ebonyi State, When it comes to patient experience among those who
Engineer Dave Umahi, eventually won the governorship patronise public hospitals in Nigeria, nothing has
primary election of the People's Democratic Party.changed for decades. It is the same story of some
consultants not being available when they should be at Anyim Pius Anyim, Secretary to the Government of the
work. It is the same system whereby points of care, Federation and former Senate President, effectively used his
diagnosis and payments are so badly designed that one superior political clout to thwart the plan of Governor Elechi to
would spend exhaustive hours just to do an X-ray.“enthrone” the erstwhile health minister.
In connivance with other members of the hospital Apart from this, the deputy governor had the advantage of
management, CMDs inflate the cost of purchasing being on ground, meeting people and playing grassroots
medical equipment. And if they procure medical politics. His “indirect incumbency” as deputy governor also
equipment, it would be far from new and would be hardly means that he could use state resources to his own advantage.
available for the use of ordinary patients at a reasonable
price. They have also been alleged to arbitrarily employ So it was that Professor Onyebuchi Chukwu failed to win the
people based on who they know without due process and nomination bid. And we can say without fear of contradiction
transparency.that his political career has come to a logical end.
Rather than working with their colleagues especially at Nigeria needs to build responsible institutions rather than
management level to ensure efficient delivery of extremely powerful individuals. To achieve this, the culture of
qualitative surgical, clinical, nursing, dental and using the privilege of a public office to bid for more power and
pharmaceutical services, medical directors are more appointments at the expense of the system must stop.
concerned with settling politicians who can help them get
higher appointment or who can mediate for them should For Nigeria, a successful health minister would be the man or
their high-handedness be reported.woman who will harmonise the sector and take personal
interest in ensuring hospitals work effectively and efficiently, The former minister of health himself emerged from this
delivering good quality health service for Nigerians.distasteful tradition, being the former Chief Medical
Officer of Ebonyi University Teaching Hospital where he
was allegedly dismissed for a fraud (over 36million naira,
about 200,000 USD) padded into the arrears which the
state government was to pay resident doctors working at
the hospital.
So how can he unsettle a system he also exploited with
reforms?
eludes…
tweet
Nigerian medical directors are more interested in awarding contracts for the supply of bricks, gravel and sharp sand far more than they are interested in improving patient experience and staff welfare.
health & politics today, 1st quarter, 201529
uccessful leadership lies in a unions are not on strike, those at a
leader's ability to bridge gaps particular federal or state institution
within his team and coordinate would be on strike due to some local sall players to work effectively and issues with their chief medical
efficiently to attain set objectives. director/hospital management.
Onyebuchi Chukwu seem to have failed Then their heartless, strike-happy
in this regard as a health minister. He colleagues in other parts of the country
met a broken health ministry and left it would abandon their patients and life-
even more decimated. saving duties under the guise of
“showing solidarity” for their striking
There is no other sector of the Nigerian colleagues.
state, however rickety, that has
witnessed an inter-professional And from the comfort of their homes or
wrangling and regular strikes that can private businesses they tweet “Black
come close to that of the public health lives matter”, “We can't breathe”. Yet
sector led by Chukwu. they do not care about babies who
timely surgery could have saved from
Disharmony among unions of health permanent deformity or even needless
professionals in the country took a turn death.
for the worse like never before in the
history of Nigeria; and Onyebuchi Chukwu was They do not care about tens of thousands of mothers who
apportioned blame by all contending unions as the require antenatal care, and which could make a difference
umpire who only stoked the embers of controversy. between dying in labour or surviving it.
Even his own professional constituency for which he was It would simply be impossible to quantify the loss incurred by
often alleged to favour to the detriment of others and the the Nigerian people and government as a result of Chukwu's
health system lambasted and dismissed him as lack of leadership in managing inter-professional disputes in
“irrelevant” for his failure to broker a deal that should the sector throughout his 3 years 6 months 'rule'.
have ended their ruthless, inhumane 55-day strike in
2014. According to the general secretary of the Nigerian Unchallenged Culture of Medical Association (NMA), Mr Adewunmi Alayaki,
As already mentioned, public offices are usually held, not with
the view to give the best service to the system, but rather to “Even when we are at our meetings, the way and manner he exploit it as a means of gaining more power and succulent [Chukwu] speaks, he has been the clog to progress in our
meetings... Everybody will now see [who is] the problem appointments. The CMDs are no exception.between the Federal Ministry of Health and the NMA… Let Chukwu be saying whatever he is saying: you cannot want Generally speaking, the office of the chief medical director solutions to a problem and you are creating more problems.
(CMD) in Nigerian hospitals has become so associated with He shouldn't have done what he did. We are only giving him
brazen abuse of power, financial wantonness and respect as minister of health… But we are still speaking with
administrative pettiness with little or no “medical” role play government at a higher quarter than him.”that professional unions of pharmacists, nurses,
physiotherapists etc. have challenged the claim of the NMA In the 21st century where it is unimaginable in many that only medical doctors have the right and what it takes to countries that health professionals would leave the occupy the post or run a hospital efficiently.dying unattended for even four hours, Nigeria's unions of
health professionals under the deathly watch of the To the shock of the Nigerian Medical Association, their clinical professor of surgery made a competition out of industrial colleagues see nothing “medical” in what CMDs do that the strikes while continuing to earn their salaries.office should be the exclusive preserve of physicians.
It is common knowledge that health workers who own Despite high rates of poverty among patients, CMDs receive private practice or some other businesses rake in more expensive brand new cars and cash from pharmaceutical profits during strike.companies (despite having official cars provided by the You could count how many days Nigerian health government). Typical of any profit-making endeavour theseprofessionals were at work in the year 2014. If national
Corruption
Industrial Crises...
Onyebuchi Chukwu: a failed minister of health?
28health & politics today, 1st quarter, 2015
Onyebuchi Chukwu: a failed minister of health?
companies then increase their mark-up on drugs and Money fails, power too other health products in order to recoup their
There were signs that Onyebuchi Chukwu could have resigned 'investment'. High cost of drugs in public hospitals has
his ministerial post to start pursuing his gubernatorial ambition been part of the problem of poor medication adherence
earlier. However, the outbreak of Ebola delayed the ex-especially among patients with long-term illness like
minister's move.hypertension and diabetes.
That delay perhaps contributed in no small measure to his Nigerian medical directors are more interested in
political misadventure. By the time he left office in October, the awarding contracts for the supply of bricks, gravel and
fluid game of politics had changed faster than he anticipated.sharp sand far more than they are interested in improving
patient experience and staff welfare.Governor Martin Nwancho Elechi of Ebonyi State rubber-
stamped and declared Chukwu as his governorship candidate. It is not unusual for CMDs to deprive health professionals
To win an incumbent's nomination in Nigerian politics means their due allowances, especially junior doctors who are
the gubernatorial aspirant must have paid the outgoing met with fiery threats when they push for their right. As
governor huge sums of money.negotiation often fails due to the dictatorial posture of the
Given this tradition, it is not unlikely that Chukwu's case was any office of the CMD, concerned unions embark on strike in
different.the process to the detriment of patients and clients
seeking medical care.Despite the governor's backing of the former minister of health,
the equally interested Deputy Governor of Ebonyi State, When it comes to patient experience among those who
Engineer Dave Umahi, eventually won the governorship patronise public hospitals in Nigeria, nothing has
primary election of the People's Democratic Party.changed for decades. It is the same story of some
consultants not being available when they should be at Anyim Pius Anyim, Secretary to the Government of the
work. It is the same system whereby points of care, Federation and former Senate President, effectively used his
diagnosis and payments are so badly designed that one superior political clout to thwart the plan of Governor Elechi to
would spend exhaustive hours just to do an X-ray.“enthrone” the erstwhile health minister.
In connivance with other members of the hospital Apart from this, the deputy governor had the advantage of
management, CMDs inflate the cost of purchasing being on ground, meeting people and playing grassroots
medical equipment. And if they procure medical politics. His “indirect incumbency” as deputy governor also
equipment, it would be far from new and would be hardly means that he could use state resources to his own advantage.
available for the use of ordinary patients at a reasonable
price. They have also been alleged to arbitrarily employ So it was that Professor Onyebuchi Chukwu failed to win the
people based on who they know without due process and nomination bid. And we can say without fear of contradiction
transparency.that his political career has come to a logical end.
Rather than working with their colleagues especially at Nigeria needs to build responsible institutions rather than
management level to ensure efficient delivery of extremely powerful individuals. To achieve this, the culture of
qualitative surgical, clinical, nursing, dental and using the privilege of a public office to bid for more power and
pharmaceutical services, medical directors are more appointments at the expense of the system must stop.
concerned with settling politicians who can help them get
higher appointment or who can mediate for them should For Nigeria, a successful health minister would be the man or
their high-handedness be reported.woman who will harmonise the sector and take personal
interest in ensuring hospitals work effectively and efficiently, The former minister of health himself emerged from this
delivering good quality health service for Nigerians.distasteful tradition, being the former Chief Medical
Officer of Ebonyi University Teaching Hospital where he
was allegedly dismissed for a fraud (over 36million naira,
about 200,000 USD) padded into the arrears which the
state government was to pay resident doctors working at
the hospital.
So how can he unsettle a system he also exploited with
reforms?
eludes…
tweet
Nigerian medical directors are more interested in awarding contracts for the supply of bricks, gravel and sharp sand far more than they are interested in improving patient experience and staff welfare.
health & politics today, 1st quarter, 201529
Health & Politics Today is published by
Litera Media Network Ltd., UK
Litera Media
Network