2018 NDHS: Nigeria Is Making Improvement Towards MDGs

The 2018 Nigeria Demographic and Health Survey (NDHS) revealed gaps in Nigeria’s performance on the SDGs targets and indicators that would be used by United Nations (UN) member states to set their agenda of political policies over the next 10 years.

 The SDGs are collections of 17 global goals designed to be a “blueprint to achieve a better and more sustainable future for all.” The SDGs, set in 2015 by the United Nations General Assembly and intended to be achieved by the year 2030, are part of UN Resolution 70/1, the 2030 Agenda.

However, the information provided by the 2018 NDHS is essential for programme managers and policymakers to evaluate and design strategies for improving the health of Nigerians.

Regrettably, the estimates of the latest survey on fertility levels, marriage, sexual activity, family planning, breastfeeding practices and nutrition, despite certain marginal progress, fell below expectations of SDGs after five years of initiation.

Similarly, its evaluation of childhood and maternal mortality, maternal and child health, malaria, domestic violence, disability and female genital mutilation leaves much to be desired.

Nigeria Needs N126 trillion For SDGs

Commenting on the gaps revealed by the 2018 NDHS on the state of children, women and general human development against the SDGs, Dr. Davis Omotola, Independent Development Consultant, said that Nigeria requires N126 trillion ($350 billion) to meet the SDGs set for 2030.

Omotola said the NDHS further showed that the current public sector gap was estimated at 36.7 trillion ($100 billion) after all other possible incomes, including oil revenue and the Abacha loot, have been pooled together.

The Independent Development Consultant spoke during during a two-day workshop on Media Dialogue for Editors and Reporters on Data-Driven Reporting and Dissemination of NDHS 2018 Result and SDGs in Port Harcourt, River State, organised by the Child Rights Information Bureau and the Federal Ministry of Information, recently.

In his presentation, titled; ‘Nigeria’s Progress towards the SDGs: Why Nigeria may not meet the SDGs,’ he bemoaned growing poverty amid population explosion and insecurity.

He lamented that 70 per cent of the poor people in Nigeria was found in 10 states which all happen to be in the North.

Visibly worried that lack of effective policies and budget constraints could serve as barriers for achieving the SDGs in the next 10 years, Omotola maintained that Nigeria needs a large chunk of money to achieve the 17 SDG goals.

“We have 10 years, but Nigeria does not plan. We are in a country where people just wake up and whatever happens, is what we do. We have been talking about insecurity, what is the plan to solve it? We should have a robust plan.

“There are so many plans and policies; we have even the national population policy which proposes four children per family.

We are talking about quality education for all, but we have different definitions of education in different parts of Nigeria.

“We just developed the Economic Recovery and Growth Plan (ERGP) by 2017, the SDG has been on since 2016, the discussion started from 2012 yet when we were doing ERGP, we didn’t factor in the SDGs except we now begin to realign the ERGP into the SDGs.

“The SDG is about leaving no one behind and to achieve that we need N126 trillion ($350 billion) and our total income in 2018 was N146 trillion ($398 billion) so it means that we should just spend all that money to achieve the SDGs.”

He asked rhetorically; “The President said he wants to lift 100 million people out of poverty, we already have 98 million poor people as at 2018 and 70 per cent of them we know where they are, so what programme are we putting in place for them?

“Most of our children do not have an education that is skill-based that will make them to get the right employment.

“It’s not all these small intervention programmes, we must have policies that are effective, policies that are implemented and of wide coverage.”

Immunisation

Maureen Zubie-Okolo, United Nations Children’s Fund, (UNICEF) Monitoring and Evaluation Specialist, while reviewing the 2018 NDHS figures on immunisation at the event decried the percentage of children that have received all-round immunisation in Nigeria between 2008 and 2018, noting; “It remains very low at 31 per cent.”

Zubie-Okolo said; “The percentage of children who received none of the basic vaccinations declined from 29 percent to 19 percent during the same period in review.

“But, the percentage of children age between 12 and 23 months who received all basic vaccinations increased from 23 percent in 2008 to 31 percent in 2018.”

She explained that immunisation coverage was one of the indicators used to monitor progress towards a reduction in child morbidity and mortality as it was one of the most cost-effective public health intervention.

The Monitoring and Evaluation Specialist said that the objective of the NDHS was to provide estimates on fertility levels, marriage, sexual activity, family planning, breastfeeding practices and nutrition.

Others she said were childhood and maternal mortality, maternal and child health, malaria, domestic violence, disability, and female genital mutilation.

“This information is essential for programme managers and policymakers to evaluate and design programmes and strategies for improving the health of Nigerians,” she said.

Elaborating, she noted that the latest NDHS (2018) was the sixth one in Nigeria since 1990 as part of the Demographic Health Survey programme.

According to her, the sample design for 2018 NDHS is to provide estimates at the national level, for six zones, for 36 states, the Federal Capital Territory (FCT), and for urban and rural dwellers.

She, however, stressed that while the 2018 NDHS trends showed an improvement, they still fell short of SDGs Three which the target is for more than 90 per cent coverage of all basic vaccination among children age 12 to 23 months.

Breastfeeding Within One Hour Of Birth Records Nine Percent Increase In Five Years

According to the 2018 NDHS, the percentage of Nigerian children who started breastfeeding within one hour of their birth only increased by nine percentage points since 2013, from 33 percent to 42 percent.

Experts say that initiation of breastfeeding within the first hour of life is important for both the mother and the child.

Coronavirus: PSN President Urges The Govts To Show More Interest In Drug Research

Due to Coronavirus and the fact that sizeable proportion of the drugs come from China and India, and the difficulty in trading with these countries, Mazi Sam Ohuabunwa, President, Pharmaceutical Society of Nigeria (PSN) has urged the Nigerian governments to see the imperative of investing heavily in research and production of local drugs. She spoke with our source on the deadly disease ravaging countries of the world. Excerpts:

 Are we well prepared to contain the menace of Coronanvirus now threatening humanity including Nigeria? Will you say we are much better prepared with regards to the case of Ebola virus?

I believe that the level of preparedness should have been better than it is now. The saving grace that we have is that we have had an experience in managing crisis like this, which is the Ebola crisis. That has given us residual experience, but beyond that we ought to have done a lot better. I believe that when the first signs came, when the first news broke, I expected that efforts should have been made especially with acquiring medical equipment that would have been used for managing the illness.

We were certain that if such an epidemic had opened the world that Nigeria was going to be part of it, given our level of interaction with China. In fact, given our involvement with global trade and the fact that Nigerians travel all over the world our level of preparedness should have been better.

We need to be more proactive than we have been but I think that the Ebola and some of the residual incidences have been helpful here.

What is your reaction to the FG’s clamping down of some pharmacy outlets, accusing them of hiking prices of hand sanitisers and all that?

It doesn’t make sense; we are not a country with controlled price regime. It is a free market and there is a natural market response to scarcity, you can’t dictate it. When there is a high demand for any product the price would change. It is standard; not only would it change from the retail point, it would also change from the source, the producers, manufacturers and even distributors.

So it is not the right thing to do to pursue people and all that. We are not in a price controlled regime. Of course, as pharmacists we have already advised our colleagues to do the utmost they can to ensure that they do not profiteer from the misery and problem we are facing in the country. The much we can do is moral persuasion. We cannot legislate it because the response to demand everywhere in the world is that prices change when the demand changes. So using consumer protection agency is very primitive in this circumstance; you might even cause more problems.

Suppose the guys don’t even bring it to sell at all because they are afraid you are going to come and hold them. We shouldn’t add salt to injury. I think the issue is about increasing availability of the product and this is why I said part of our preparation was lackluster.

We ought to have anticipated this. In America, they have everything on ground; they didn’t wait for the issue to arise before buying the masks and gloves.

So government ought to have anticipated this. The pharmaceutical companies are primes right now as I speak to you based on advice to increase production of these things but some of them don’t happen overnight. What is worse is that the sizeable proportion of the materials we need come from China and the counry has become a difficult place to trade and that has complicated the issue a little bit.

What role should the pharmaceutical companies play in providing some sort of moral support?

I think that is the role all the professional pharmacists should play. They should appreciate the fact that there are some of the closest neighbours, first line of touch to many people who need medical help and advice in many climes, not just in Nigeria. Therefore they take that responsibility seriously. So one of the first advice we issued when I became president was that no patient should be coming to your pharmacy without getting an opportunity to interact with you. You shouldn’t sell a medicine because someone asked for it. You must find out why the person needs the medicine and know if it is OTC medicine. Even for OTC medicine, doctors may not prescribe the medicine but you must talk to your pharmacist for every medicine, whether it is ethical or OTC; you need the counseling for each one of them.

We have also asked them to get flyers that people can take away so that they can be educated, even if what they came for didn’t have to do with any infections at all. It is part of the primary duties, because that pharmacist is the first line especially in primary health care.

There are serious concerns globally about finding a cure for Coronavirus. Here in Nigeria, Prof. Umaru who is a virologist and head of the BIO Resources Centre, claims that he has found a cure for it and I saw a picture showing his meeting with the Minister of State for Health, the Minister of Science and Technology and some other federal officials. Is the PSN involved in this process of finding a cure?

First with due respect, research is slow in our country and it is an expensive thing to do. Nigeria governments have not come to the full realisation of the need to invest in research in our country. How do I know? I have served in the board of several researches in Nigeria including National Institution of Research and Development. If you walk into that place, you will be sorry for the institution because the walls are broken, not to talk of equipment or funding. It is a shame. Go to our universities; there is not enough in research and development and so we have to depend on the rest of the world; what a shame! But having said that, there are a few pharmaceutical companies with due respect and modesty, mine included, doing research and development.

NEIMETH was the first pharmaceutical company to come up with local remedy for sickle cell anemia which is one of the neglected diseases of the black man. And in this other area we are in, Professor Maurice Iwu who is in the board of NEIMETH Pharmaceuticals right from when he was in the universities and after we have related with him because he is a research guy and even when he was in the United States we have tried to develop some of his work to bring them to market. So we are working with him on these other areas and we are asking that the government should show more interest because investment in research is a long term. And what does it take, first is that for every product that comes to the market, you have spent about 500 million dollars to get a product to the market; 10 others have failed after you spent so much money on them.

The reason is that, first you have to go through several trials, Phase 1 and Phase 2 etc. The moment you realise that the product is effective you then have to prove its effectiveness. You then have to prove it effectively. If it is very effective and unsafe then you can’t use. There must be a balance where the effectiveness overrides the safety. So you do Phase 1 to Phase 4, starting from lower animals like rats and cats and then you move to human being. When you get to human being you do trials, control clinical trials, no matter how good the medication is.

The product can be useful on day one but on day 50 it could cause you problem. You will have to allow the product a number of days to see its shorter and longer medium toxicity. Even when a product is in the market, there is what we call post long surveillance pharmaceutical vigilance. You are still monitoring the efficacy and side effects because some of them show up at chronic injection, not at acute injection and that is why National Agency for Food and Drug Administration and Control (NAFDAC) and those agencies set up surveillance for these things.

Many of world ingredients came from China. Now India is saying they may not be able to serve more export, what does that portend for Nigeria?

Well, it is a wake-up call for us. I just wish that Nigeria will just listen and take a cue. In this country where there is a lot of flora and fauna that have pharmaceutical uses; indeed what they bring out of China exist here. It a matter of processing them and put them in manner that they can be marketed.

We have the potential to build up a formidable pharmaceutical subsector, building from areas of competence and areas of endowment that is manufacture medicines from things that are available in our clime. We don’t need to go to China, but the point is that pharmaceutical companies need to go to the bank to borrow money at double digit. Then you invest it in ten years or five years of research and the research is not bringing in money; it may even fail. So part of the reason why our companies with due modesty haven’t done as well as others is that we are investing in research. You take short term money and put in long term investment, it doesn’t work like that.

So every once in a while you feel like you are burning your fingers. The sustainability of every pharmaceutical anywhere in the world is innovation, research and development. So, I think that our Nigeria should take a decision now because there will be another virus. I don’t know the name and I am not prophesying. Why don’t we start preparing now, get the pharmaceuticals and give them a mandate, get the teaching hospitals, industries and give them a mandate so that by the time the next illness breaks we would have got some level of preparedness of what medications to use.

Coronavirus: PSN President Urges The Govts To Show More Interest In Drug Research

Due to Coronavirus and the fact that sizeable proportion of the drugs come from China and India, and the difficulty in trading with these countries, Mazi Sam Ohuabunwa, President, Pharmaceutical Society of Nigeria (PSN) has urged the Nigerian governments to see the imperative of investing heavily in research and production of local drugs. She spoke with our source on the deadly disease ravaging countries of the world. Excerpts:

 Are we well prepared to contain the menace of Coronanvirus now threatening humanity including Nigeria? Will you say we are much better prepared with regards to the case of Ebola virus?

I believe that the level of preparedness should have been better than it is now. The saving grace that we have is that we have had an experience in managing crisis like this, which is the Ebola crisis. That has given us residual experience, but beyond that we ought to have done a lot better. I believe that when the first signs came, when the first news broke, I expected that efforts should have been made especially with acquiring medical equipment that would have been used for managing the illness.

We were certain that if such an epidemic had opened the world that Nigeria was going to be part of it, given our level of interaction with China. In fact, given our involvement with global trade and the fact that Nigerians travel all over the world our level of preparedness should have been better.

We need to be more proactive than we have been but I think that the Ebola and some of the residual incidences have been helpful here.

What is your reaction to the FG’s clamping down of some pharmacy outlets, accusing them of hiking prices of hand sanitisers and all that?

It doesn’t make sense; we are not a country with controlled price regime. It is a free market and there is a natural market response to scarcity, you can’t dictate it. When there is a high demand for any product the price would change. It is standard; not only would it change from the retail point, it would also change from the source, the producers, manufacturers and even distributors.

So it is not the right thing to do to pursue people and all that. We are not in a price controlled regime. Of course, as pharmacists we have already advised our colleagues to do the utmost they can to ensure that they do not profiteer from the misery and problem we are facing in the country. The much we can do is moral persuasion. We cannot legislate it because the response to demand everywhere in the world is that prices change when the demand changes. So using consumer protection agency is very primitive in this circumstance; you might even cause more problems.

Suppose the guys don’t even bring it to sell at all because they are afraid you are going to come and hold them. We shouldn’t add salt to injury. I think the issue is about increasing availability of the product and this is why I said part of our preparation was lackluster.

We ought to have anticipated this. In America, they have everything on ground; they didn’t wait for the issue to arise before buying the masks and gloves.

So government ought to have anticipated this. The pharmaceutical companies are primes right now as I speak to you based on advice to increase production of these things but some of them don’t happen overnight. What is worse is that the sizeable proportion of the materials we need come from China and the counry has become a difficult place to trade and that has complicated the issue a little bit.

What role should the pharmaceutical companies play in providing some sort of moral support?

I think that is the role all the professional pharmacists should play. They should appreciate the fact that there are some of the closest neighbours, first line of touch to many people who need medical help and advice in many climes, not just in Nigeria. Therefore they take that responsibility seriously. So one of the first advice we issued when I became president was that no patient should be coming to your pharmacy without getting an opportunity to interact with you. You shouldn’t sell a medicine because someone asked for it. You must find out why the person needs the medicine and know if it is OTC medicine. Even for OTC medicine, doctors may not prescribe the medicine but you must talk to your pharmacist for every medicine, whether it is ethical or OTC; you need the counseling for each one of them.

We have also asked them to get flyers that people can take away so that they can be educated, even if what they came for didn’t have to do with any infections at all. It is part of the primary duties, because that pharmacist is the first line especially in primary health care.

There are serious concerns globally about finding a cure for Coronavirus. Here in Nigeria, Prof. Umaru who is a virologist and head of the BIO Resources Centre, claims that he has found a cure for it and I saw a picture showing his meeting with the Minister of State for Health, the Minister of Science and Technology and some other federal officials. Is the PSN involved in this process of finding a cure?

First, with due respect, research is slow in our country and it is an expensive thing to do. Nigeria governments have not come to the full realisation of the need to invest in research in our country.

How do I know? I have served on the board of several types of research in Nigeria including the National Institution of Research and Development. 

If you walk into that place, you will be sorry for the institution because the walls are broken, not to talk of equipment or funding. It is a shame. Go to our universities; there is not enough in research and development and so we have to depend on the rest of the world; what a shame! But having said that, there are a few pharmaceutical companies with due respect and modesty, mine included, doing research and development.

NEIMETH was the first pharmaceutical company to come up with a local remedy for sickle cell anaemia which is one of the neglected diseases of the black man. And in this other area we are in, Professor Maurice Iwu who is in the board of NEIMETH Pharmaceuticals right from when he was in the universities and after we have related to him because he is a research guy and even when he was in the United States we have tried to develop some of his work to bring them to market. 

So we are working with him on these other areas and we are asking that the government should show more interest because investment in research is a long term. And what does it take, first is that for every product that comes to the market, you have spent about 500 million dollars to get a product to the market; 10 others have failed after you spent so much money on them.

The reason is that, first you have to go through several trials, Phase 1 and Phase 2 etc. The moment you realise that the product is effective you then have to prove its effectiveness. You then have to prove it effectively. If it is very effective and unsafe then you can’t use. There must be a balance where the effectiveness of overrides safety. So you do Phase 1 to Phase 4, starting from lower animals like rats and cats and then you move to a human being. When you get to human being you do trials, controlled clinical trials, no matter how good the medication is.

The product can be useful on day one but on day 50 it could cause you problem. You will have to allow the product a number of days to see its shorter and longer medium toxicity. Even when a product is in the market, there is what we call post long surveillance pharmaceutical vigilance. You are still monitoring the efficacy and side effects because some of them show up at chronic injection, not at acute injection and that is why National Agency for Food and Drug Administration and Control (NAFDAC) and those agencies set up surveillance for these things.

Many of world, ingredients came from China. Now India is saying they may not be able to serve more export, what does that portend for Nigeria?

Well, it is a wake-up call for us. I just wish that Nigeria will just listen and take a cue. In this country where there is a lot of flora and fauna that have pharmaceutical uses; indeed what they bring out of China exists here. It a matter of processing them and put them in a manner that they can be marketed.

We have the potential to build up a formidable pharmaceutical subsector, building from areas of competence and areas of endowment that is manufacture medicines from things that are available in our clime. We don’t need to go to China, but the point is that pharmaceutical companies need to go to the bank to borrow money at double-digit. 

Then you invest it in ten years or five years of research and the research is not bringing in money; it may even fail. So part of the reason why our companies with due modesty haven’t done as well as others are that we are investing in research. You take short term money and put in long term investment, it doesn’t work like that.

So every once in a while you feel like you are burning your fingers. The sustainability of every pharmaceutical anywhere in the world is innovation, research and development. So, I think that our Nigeria should take a decision now because there will be another virus. I don’t know the name and I am not prophesying. 

Why don’t we start preparing now, get the pharmaceuticals and give them a mandate, get the teaching hospitals, industries and give them a mandate so that by the time the next illness breaks we would have got some level of preparedness of what medications to use?

PSN, NMA Collaborate To End Conflict In Health Sector

In the bid to end the discord between Nigeria Medical Association, (NMA) and Pharmaceutical Society of Nigeria, (PSN) both health professional bodies have agreed in an implementation plan to forge ahead.

While presenting the plan to find a lasting solution to the bickering between doctors and pharmacists Tuesday in Lagos, both bodies agree that the move will help improve the health indices of Nigeria.

Speaking with newsmen, the NMA President, Dr. Francis Faduyile said; “When I was in NMA in Lagos State as the chairman, I inherited over 12 court cases and brought all of them out of court.

“We brought all the factions of health under one roof, we believe we are here in the world to improve the health of patients, adding that, the more we talk to our self, the more we understand ourselves and also, stick to international best practices for the better of all.”

Faduyile said; “We don’t need to reinvent the will in Nigeria and that is why we stick to international best practices that can move the health sector forward. But most importantly, my message to every the health sector is for us to think of the patients first because any of us at any given time can be a patient.”

He added; “If health professionals have that at the back of our mind, I am sure we will all see the improvements in the health sector. One of the questions rolled out during the response in the questionnaire, it states that pharmacists believe that doctors are working against them while doctors believe that pharmacist hate them. This is shocking because we don’t talk with ourselves. I believe, the more we know ourselves, the better the decision we make in wade off disharmony amongst ourselves.”

The NMA boss, however, spoke on Coronavirus, (COVID-19) resolved that, it is time for Nigeria to take decisive action, ” I can tell you, if Coronavirus virus gets loose in this country, the country will suffer for it. My own view and that of the NMA is that, we think it is high time the Nigerian government took that decision of closing the border to those countries that have serious high level of Coronavirus.”

Mazi Sam Ohuabunwa, PSN President, however, said, today is a good day for Nigeria healthcare because as we know, medical doctors and pharmacists that represent the health care team has decided to embrace harmony to implement strategies and working relationship that would create greater relationship.

Ohuabunwa thinks that this partnership would be a major output and development in good health care outcomes for Nigerians.

He said, both the NMA and PSN believe that “If the members of the healthcare team put away anything that would cause disharmony or suspicion, they should work together and then the output will be better, the healthcare system will be better and Nigeria will be better.”

Also speaking on Coronavirus, the PSN President said, we need to intensify the measures we have taken because from the report it means that this 3rd patient flew into the country and it was recommended that she should do a self-quarantine and she then reported when she saw the symptoms.

“For me, I believe that it has worked well but I think we need to look at the point where people come from this country where the virus is because many might no longer want to do voluntary quarantine or self-quarantine so it should be compulsory.

“Supposed the people that are meant to quarantine refuse to, then what will happen, they will go about and spread the virus in the community and that can be dangerous.

So the time has come where we should demand compulsory quarantine,” Ohuabunwa added.

Osinbajo Emphasizes On Importance Of Exact Laboratory Diagnosis

To gain accurate and quality diagnostics practices, Professor Yemi Osinbajo, Vice President, has admonished West African Postgraduate College of Medical Laboratory Science and the Nigerian Medical Laboratory scientists, to ensure conducive laboratory environment in West Africa the region as well as provide highly skilled professionals.

Affirming the charge recently, was Professor Osinbajo, while announcing open the 2020 Congress of the West African Postgraduate College of Medical Laboratory Science (WAPCMLS) and induction/investiture of its Fellows in Lagos.

Osinbajo emphasised on the importance of accurate and reliable laboratory diagnosis in the prevention and control of diseases.

Represented by Dr Olorunnimbe Mamora, Minister of State for Health, he noted that medical laboratory services are vital components of a quality healthcare system and continues to play a vital role in disease prevention, detection, surveillance and patient management.

“The medical laboratory professional is an indispensable partner in providing and ensuring optimal health care. As this a new cadre of laboratory professionals is birthed in the country, I am expecting it will not only ensure the availability of highly skilled professionals but I also expect them to ensure the laboratory environment is peaceful.”

While commending West African Health Organisation (WAHO) for the establishment of West African Postgraduate College of Medical Laboratory Science, he added that it would harmonise the development of medical laboratory human resources across the ECOWAS region and Cameroon.

The theme of the Congress was; “The role of Medical Laboratory Professionals in the Successful Implementation of Universal Health Coverage in the ECOWAS region.”

In his address, Prof. Stanley Okolo, Director-General of WAHO, said Nigeria and other African countries should intensify efforts to make medical laboratory services accessible through public-funded health insurance schemes, as the countries move towards universal coverage of health services.

Okolo added that with a strong political will, the combination of diagnostic capacity, access to essential healthcare services will become available in low and middle-income countries like ours.

He called on development partners to collaborate with the government of Member States and especially the West African Postgraduate College of Medical Laboratory Science and other similar postgraduate and research institutions to carry out further specific researches on arresting the progressing cases of emerging and re-emerging diseases like Coronavirus, cancer and neglected tropical diseases in order to reduce the case fatality rate of this disease conditions.

“When diagnostics are not acknowledged as an essential component of the healthcare system, they get little attention, budget, and support for implementation.

If tests are not explicitly listed in national health plans or benefits packages, there is no mechanism for procurement, supply, and reimbursement. The consequences of underinvestment in diagnostics and laboratories are clear.”

Contributing, Mr Lawrence Lawson, Director-General of the Ghana Health Service, said without quality laboratory services, no the health system can be resilient.

“A health system without adequate and quality laboratory service is like a tree without root and a hospital without a the well-equipped laboratory is incomplete and cannot be considered a hospital.

There can be no universal health coverage without the appropriate investment in quality laboratory service and that includes investing in the human resource, their liberty and independence to be innovative.”

While addressing newsmen shortly after the congress, Dr. Godswill Okara, Registrar of the college, expressed the preparedness of the college to collaborate with the Economic Community of West African States, ECOWAS, to tackle quackery in the profession.

Okara, who said 216 Foundation Fellows of the College was inducted, observed that for the African region to standardise the practice of the profession, the collaboration cannot be over-emphasised.

Okara said fake laboratory scientists are everywhere in Nigeria, adding that the Association of Medical Laboratory Scientists of Nigeria (AMLSN) has tried severally to carry out an inspection on all laboratory facilities in Nigeria, but there has been some form of resistance.

“We have noticed that if 10 people go to a laboratory to test for malaria, nine persons out of the 10, would be diagnosed with malaria and typhoid. Malaria and Typhoid are over-diagnosed; over-treated in Nigeria.

“To tackle that issue, there was a time when the AMLSN taskforce went on an inspection of laboratory facilities in Nigeria, which is in line with the law, but many private clinics resisted them. They started calling the federal ministry of health, and before we knew, the special team was asked to step down.

“So with that kind of situation, when authorities who are supposed to hold these people accountable of their actions, are the ones protecting them, the innocent public will be at the receiving end,” he added. The 216 foundation fellows were drawn from Nigeria, Ghana, Cote d’Ivoire, Liberia, Togo, Gambia and Cameroon.

COVID-19: What You Must Know About Personal Hygiene, Hand Sanitizers

Numerous Nigerians rushed to buy hand sanitizer and face masks at the wake of the announcement of the countries confirmed case of coronavirus disease (COVID-19) on the weekend, as part of personal hygiene and sanitary measures to protect themselves from a deadly infection.

It is stylish to see people wearing facemask as a form of protection against the dreaded virus across the country. However, Prof. Dimie Ogoina, a Professor of Medicine and Consultant, Infectious Diseases at the Niger Delta University and Teaching Hospital (NDUTH), Bayelsa State, has advised that people should only use a face mask if they have respiratory symptoms.

Prof. Ogoina, who spoke in a recent chat room organised by the Nigeria Association of Women Journalists (NAWOJ) said, people don’t need face masks except if they have respiratory symptoms to protect disposal of droplets during coughing or sneezing.

He advised; “If you have someone who has been coughing or sneezing and you need to assist that person, ask the person to wear face mask if available and you should also wear a face mask if available.”

The Professor of Medicine who is also the current Chief Medical Director of the NDUTH said facemask was not a dress code, adding that it should be worn if you are in the same room or within six feet of someone suspected to have coronavirus.

He said a face mask should not be reused and that anyone wearing it should not touch the front of the face mask pull it down intermittently to breathe or talk or hang it under the mouth or jaw to pull it over the nose later.

The Consultant in infectious diseases said if any of these is done, then you are already exposed if your face mask was contaminated.

The Professor of Medicine, who is also President of the Nigeria Infectious Diseases Society (NIDS), said the use of face mask by the general public is not recommended by the World Health Organisation (WHO).

Prof. Ogoina also said it is difficult to describe original or fake face mask without visual inspection, adding that it is better to buy from established shops.

“If people continue to buy everything in stores at this rate, those treating cases will not find face masks to use!” 

The consultant responded to some questions thus: Is it only alcoholic hand wash and sanitizers that can protect people from contracting the virus?

Prof. Ogoina explained that simple soap and water can kill the virus on our hands and on surfaces.

He said; “The hands are one of the most common sources of disease transmission. Let’s all protect our hands always.”

He also warned;” The disease is new, there is yet no evidence that garlic, ginger or hot lemon juice protects against coronavirus. Can regular intake of vitamin C, fruits and vegetables boost immunity against COVID- 9?

He also said; “There are a lot of things that could help our immune system, especially good rest, food and water in right quantities and quality. “Vitamin C, cod liver oil, fruits and vegetables have no specific benefit against COVID-19. However, fruits and vegetables are part of a nutritious diet.”

On what to do if someone around sneezes or coughs without covering their mouth, he said; “People must all be extra vigilant to avoid close contact with someone coughing or sneezing. 

If that is not possible, first, keep a distance and ensure you protect your hands, nose, mouth and eyes from contact with droplets by whatever means possible.

“Face masks may be counter-productive not because they are not useful but because most people don’t know how to use them. Don’t forget to wash your hands when you have the chance,” he said.

Responding to if anyone who coughs or has running nose should report to the hospital for a confirmation test. Prof. Ogoina said first, avoid self-medication and ensure you seek medical attention when you have coughed and fever.

He counselled the public to always seek the advice of a doctor to review their history.

“If you have a travel history to places with COVID-19 or contact with someone suspected to have the disease, then you should immediately notify authorities via NCDC toll-free phone numbers. 

“Meanwhile, it is important to note that catarrh and cough are common and most people who have these symptoms don’t have COVID-19.”

On providing assistance to a sick person to visit the hospital without getting infected, he said when assisting a person with cough and sneezing, it is important to protect your hands, nose, mouth and eyes as much as possible.

The Professor of Medicine said; “First ask for help if you are unsure. Then inform relevant authorities if you strongly suspect COVID-19. Use a face mask and the sick person should use it too.

If not available, ask the person to cover his/her mouth, cough into a flexed elbow or into a disposable tissue. Avoid touching your own mouth, nose and eyes. Wash your hands with soap and water as soon as you have the chance.

“Please note that catarrh, fever and cough are common in our environment. Many people with these symptoms don’t have COVID-19.”

Ogoina said though routinely screens are being done on travellers in the major international airports by checking for fever and asking for symptoms such as cough, it is neither feasible nor evidence-based to test everyone for the virus even if they have no symptoms.

“The Ports Health Authority is expected to be extra vigilant. However, I observed a knowledge gap as most of them don’t use face mask appropriately,” he added.

He said the incubation period of COVID-19 is one to 15 days. Prof. Ogoina said the transmission of the virus causing COVID-19 could be by an animal to human or through human to human transmission. He said animal to the human transmission could be when undercooked or raw animals are eaten.

He said although the virus is thought to originate from bats, the exact animal host responsible for the disease is still unknown. He said human to the human transmission could be from respiratory droplets with close contact with someone infected especially when they cough and sneeze.

When these droplets touch the eyes, nose and mouth, then infection is possible. He also said airborne transmission occurs when infective agents are inhaled. COVID-19 is not transmitted by inhalation, except under certain procedures undertaken in the hospital settings.

On environment to human transmission, he said COVID-19 could be acquired if infected droplets from coughing and sneezing contaminate surfaces.

“This is what we call formites. When you touch these fomites and then touch your nose, mouth or eyes, then you can become infected.”

Asked if it is safe to buy made in China products at the moment, the expert said there was no evidence that COVID-19 could be transmitted from imported goods.

“Besides, the virus cannot survive in inanimate objects for long especially when exposed to high temperatures common with ferry of some imported goods,” he said.

Revamping Primary Health Care, A Call For Legislative Action

To guarantee the fundamental right of every Nigerian in accessing the highest attainable standard of health, stakeholders have called for urgent revitalisation of the Primary Healthcare Centres (PHCs) across the country, noting that this will drive socio-economic development.

The call came after a facility visit of some lawmakers and Civil Society Organisation (CSO) activists to Powerline Primary Healthcare Centre and Soretire Orile-Agege Primary Healthcare Centre, both at Agege Local Government Area, Lagos State, recently.

The site visit was part of the ‘South West Policy Dialogue on Revitalisation of Primary Healthcare.’ It was organised under a project titled, “Reinvestment: Increasing Legislative Oversight on Primary Health Care in Nigeria,” by CISLAC in Lagos.

The dialogue was aimed at providing enabling platform for all-inclusive recommendations in revitalising PHCs to ensure appropriate legislations and policy directions in the country, after first-hand visits to PHC sites.

Article 25 of the Universal Declaration on Human Rights states, “Everyone has the right to a standard of living adequate for the health and wellbeing of himself and of his family, including food, clothing, housing and medical care and necessary social services.”

To this effect, the legislators, members of House of Representatives and activists from Civil Society Legislative Advocacy Centre (CISLAC) stressed that revitalisation of PHCs’ goes beyond refurbishing of old buildings and buying new equipment.

According to them, this is an important first step in setting up health systems that work, though, it is not the only step needed.

However, they lamented that paucity of funding is affecting PHC revitalisation in the country which is worsened by poor budgetary allocation to health.

For instance, the budget allocated to health which was four per cent in 2016 and 2017 only increased marginally from 4.4 to 4.75 per cent in 2018 and 2019 respectively, but shows a sharp drop at 4.14 per cent in the 2020 proposal.

Similarly, the commencement of Basic Health Care Provision Fund (BHCPF) implementation in 2019 put at N51.22 billion also shows a sharp decline to N44.50 billion in the 2020 budget proposal.

Making his presentation at the occasion, Dr Francis Ahanyido, a public health physician, in his presentation stated there is a correlation between healthy citizenry and wealthy nations; even as he called for urgent revitalisation of the primary healthcare system.

Ahanyido further stated that workable machinery such as comprehensive insurance scheme needed to be in place, a structure that protects everybody, both the rich and the poor.

For example, if a street cleaner gets sick, she might not be able to pay for her treatment.

And even if she goes for a loan to treat herself or her child, paying back such loans would mean her entire family has to go without food and other needs for a very long period.

And therefore, it is very necessary to put in place a scheme that gives everybody protection, he insisted.

He further stated that CISLAC has been able to activate the passage of national health act of one per cent Consolidated Revenue which has been included in the budget.

According to Ohanyido, the money may not be much, but at least it shows commitment on the side of the federal government.

The States and local governments also need to play their own part because the federal government can’t do everything, he added.

Prof. Akin Abayomi, the Lagos State Commissioner for Health, reiterated the government’s plan to restructure healthcare in order to restore public confidence.

The Commissioner who was represented by the Permanent Secretary of Lagos State Primary Health Care Board, Dr. Tayo Lawal also said that poor funding and medical personnel are major challenges facing effective primary healthcare in the country.

The Ministry of health boss said, “Lagos states has like 360 primary healthcare centres, the role of maintaining and managing these centres is very critical.”

According to Dr. Samuel Adejare, the Deputy Chairman, House Committee on Health, representing Agege constituency said, “We as Legislators make laws that would support health workers in PHC’s to be mobilised to work effectively and functionally. If we should have a concise number of PHC’s that are highly functional, it will help Nigeria a whole lot.”

The Deputy Chairman, House Committee on Health, however tasked his colleagues to sponsor bills that will help improve PHC’s in the country, to better the lives of Nigerians and avoid needless deaths from preventable as well as avoidable diseases.

Also speaking, Dr. Jubril Bashar from the Health Policy and System Development Unit, Ahmadu Bello University, Zaria, said the minimum standard for primary healthcare in Nigeria which has been in existence was revised some time in 2006, but a number of people are not aware of it.

He said, “The programme is aimed at sensitising especially, the legislative arm of government to see that the need for a functional primary healthcare was achieved. This is particularly so now that we are talking about revitalising healthcare and actualising functional primary healthcare in the country – that is the concept of a standard primary healthcare.

Bashar said, “It is not rocket science. If the political will is there, it will not be a difficult thing to do. Revitalising the primary healthcare is possible. Already, many things are coming on board, State are signing, funds are being made available some States are going into partnerships with private sectors and are preparing analysis. Some States are even talking about the contributory state healthcare financing – these are other sources of income and with the federal declaration of minimum of 15 per cent of the annual budget to be allocated to health, it will go a long way if there is compliance.”

He added that primary healthcare in Nigeria is less than what is expected even for the downtrodden, the poor and those that cannot afford standard quality healthcare.

“If everyone is aware that primary healthcare is not just for the poor, but everyone, they would start accessing primary healthcare before going to the higher levels of secondary and tertiary healthcare.”

Chioma Kanu, Programme Manager For Health with CISLAC, said, “That the essence of this retreat is for the Legislative members to start thinking about how they can actually move the health sector forward from where it is. Actually, primary health care is the first point of call for all the masses. The Secondary and Tertiary health care are known majorly for specific big health issues.

“The site seeing is for our law makers to come and see what these PHC’s look like and make serious commitment to putting things in place. At least, let us have some primary healthcare centres if not all that are up to the minimum standard of primary healthcare.”

Kanu said, “with the national assembly and representatives on revitalizing health care. Two regions among the six geopolitical zones in Nigeria, have been visited like the South-east and south-south and then this is the south-west part.

“We still have North-east, North central and North West; normally we take these law makers to some primary health care facilities so they can have a feel of what the places look like so that they will be able to perform their oversight function in the relevant department and ministries with the hope to raise the standard of primary health care in Nigeria.”

Enforcing Laws On Violence Against Nigerian Women, Girls

There is growing concern among stakeholders on how to achieve full implementation of laws which protect Nigerian women and girls against abuse from rising Violence Against Women and Girls (VAWG) which many have said is assuming, ‘epidemic proportions.’

Nigeria has the largest number of child brides in Africa. Nigeria has the third-largest number of women and girls who have undergone FGM in the world. Girls and boys are raised, treated and valued differently from birth to adulthood. Women and girls are solely responsible for caregiving and household chores and this has implications for girls’ school attendance.

Also, unfortunately, the country has achieved less than 20 percent implementation of the Child Rights Act, CRA since its adoption 20 years ago, while the prevalence of violence against women and girls still on the rise.

Revealing this to journalists at recent two-day Media Dialogue in Ibadan, Oyo State on “End Violence Against Women and Girls in Nigeria” James Ibor, a legal practitioner, human rights activist said according to Violence Against Children (VAC) report one in four girls and 10 percent of boys reported having suffered sexual violence in Nigeria. Of the children who reported violence, less than five out of 100 receive support.

Ibor who is also the Chairperson, Child Protection Cross River State said that the VAC report revealed, six out of every 10 Nigerian children experience some form of violence before the age of 18.

According to him, Nigeria has positive legislations that support the protection of women and children. For instance, “We have the Violence Against Person Prohibition Act (VAPP Act) but the implementation is less than five per cent because we still have cases of violence being reported, but little or nothing is done about them,” said Ibor.

Nigeria ratified the Convention for the Elimination of Discrimination Against Women (CEDAW) in 1985, but international treaties can only go into effect when parliament has put in place a corresponding domesticated law thereby limiting the international treaties to disuse.

Ibor added that violence against women and girls is against the law and survivors do not usually receive full legal support, as they may prefer to stay in abusive relationships than leave to face the ridicule of living outside relationships and/ or wedlock.

The human rights activist said, women and girls subjected to violence are unwilling to lodge formal complaints due to lack of trust in the police force and stigmatisation in society.

He counselled that the government should build up a the collaboration that seeks to focus on the legislation policy framework, building institutions, prevention efforts and particularly addressing root causes of gender-based violence and harmful practices; and also ensuring access to inclusive, timely, and affordable, quality service.

He said, based on the consultation on the prevalence of violence, as well as data management, the programme focuses on five high burden states across Nigeria namely: Lagos, Adamawa, Sokoto, Cross-River and Ebonyi, plus the Federal Capital Territory, Abuja.

Speaking also at the event organised by the European Union and United Nations Spotlight Initiative, Dr Olasumbo Odebode, Child Protection Specialist for the United Nations Children’s Fund, UNICEF said “International donors are doing a lot to tackle the issue of Violence Against Women and Girls in Nigeria. The EU-UN doled out $40 million to support the initiative for four years in Nigeria.

“All these are geared towards eliminating all forms of violence against women and girls and all harmful practices in support of the 2030 Agenda on Sustainable Development Goals.”

She further explained that to achieve 2030 Agenda on Sustainable Development Goals, a six comprehensive pillar approach were developed and they are: legislation and policy framework; institution capacity building; prevention and social norms; delivery of quality services by health professionals; data availability and capacities, and supporting the woman movement.

Odebode added that the six pillars are interrelated and when it is holistically tackled, the target of ending violence against women and girls would be achieved in the country.

She said, “So the idea is to attack it from different directions so that it can have a direct impact. We need to create sensitisation in the mind of people and the society at large and also to disabuse the mind of people against discrimination and stigmatisation. We need to create awareness because people need to speak out. It goes beyond the way the people are dressed. Every woman and girl must be free from violence that is the essence of this workshop.”

She said, “When the media is involved, all forms of violence against women and the girl child that had eaten deeply into the fabrics of society can be reduced or totally eradicated.

“The discrimination and stigmatisation of survivors must also stop. People must realise that they should not keep quiet because keeping quiet will make the perpetrators continue.”

Odebode said that the government needs to create an enabling environment so that the laws already in place are implemented and acted upon.

On her part, the Executive Director, Always Sisters Foundation for Care and Support, Mrs Chika Obiechina said carrying out an extensive media campaign in partnership with CSOs and the NGO’s with effective community mobilisation on the issues of violence against women and girls would contribute to ending the menace.