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Tuesday, August 7, 2018

Expert tasks FG on primary healthcare expansion


By Matthew Denis

The Founder of West Africa’s leading air ambulance service, Flying Doctors Nigeria, Dr Ola Brown Orekunrin have called on the Federal government to focus in expansion and provision of efficient primary healthcare delivery to save more lives in the country.

She made the disclosure while being featured as Guest Appearance in a conference organized by ThisDay Newspaper on the theme 'Funding Healthcare for All' held at Musa Yar'adua Conference Centre, Abuja at the weekend.

The Doctor said "Nigeria has some of the poorest healthcare outcomes in the world. For example, the under-five mortality rate has been reported by the World Health Organization at 117 per 1000 live births. In other words, 1 in 10 Nigerian children under the age of 5 die annually.

She revealed that the stratification of the causes of mortality amongst them reveals some of the chief causes which are as follows — Malaria, Acute Respiratory Infections and Diarrhoea. These causes of mortality are worth deliberating, as they are
preventable .

"as our population continues to grow at rates as high as 4% the need for healthcare reform has never been more urgent. Hospitals are a big part of Nigeria’s problem. Our politicians love to launch them, celebrate them, we are sentimental about them, we constantly order expensive equipment for them, but in the grand scheme of things; they don’t really matter.

The expert noted that as a developing country, Nigeria has much untapped potential with regard to social reforms. Comprehensive vaccination programmes, health education, institution of basic sanitation and waters provision infrastructure are not novel ideas and have been employed with great success in other developing countries.

Dr. Orekunrin emphasized that Our focus should be on emerging technologies and social reforms which Nigeria can tap on even at this stage to achieve modest morbidity and mortality rates.

"These include telemedicine, remote support for para clinical healthcare staff, institution of robust systems to manage patient journeys, protocolization of common and easily preventable disease management guidelines and efficient referral systems.

"A preventative health system would be primary and community based, and hinge on the shift in resource allocation from tertiary institutions (hospitals) to community and primary care facilities.

The medical expert argued that the number of hospitals in Nigeria need to reduce, not increase but the focus to be on expansion of primary care centers.

She said " as healthcare advances, more can be done to treat patients that have what were previously disabling or life threatening conditions like burns, severe injuries or strokes. But, in order to provide complex healthcare safely, professional teams need to see sufficient volumes of patients with a particular condition.

"The potential benefits from specialisation are greater for some life  threatening conditions like heart attacks and major injuries, but the safest treatments cannot be provided at small general hospitals because there are not enough patients for teams to maintain their skills. More lives can be saved if advanced services are centralised in more specialist hospitals.

She noted that the importance of focusing on determinants of health that lie upstream from hospitals cannot be overstated as Health systems in Nigeria should focus on optimising resource allocation to focus on reducing the disparity in healthy access and quality of health within the majority, rather than extending life for the minority.

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