Thursday, 21 February 2019

Adelusi-Adeluyi To Address Executive Dialogue On Ecomony, Pharmacy Growth

Prince Julius Adelusi-Adeluyi, former Nigerian Minister of Health and president of the Nigeria Academy of Pharmacy, is billed to address an Executive Dialogue on Public and Private Sector Collaboration for Economic Growth in the Pharmaceutical Sector. This dialogue will hold in Sandton, South Africa, on February 14.
Prince Adelusi-Adeluyi who is also the founder and Chairman of Juli PLC will speak on “Solutions and measures to combat counterfeit medicines”. The problem of fake and counterfeit medicines has plagued Nigeria and many developing countries for decades.
According to Adelusi-Adeluyi, “the problem of fake and counterfeit medicines has grown increasingly complex over the years and only a multi-pronged approach that has both the private and public sectors acting in concert is best placed to address it effectively.” He added that “an executive dialogue of this nature that seeks to inspire multi-sector collaboration, therefore, is clearly in the right direction as the plague of fake and counterfeit medicines impacts considerably on the economic growth of the pharmaceutical industry.”
Other speakers expected to grace the high level Executive Dialogue include Professor Helen Reese, Chair of the South African Health Products Regulatory Authority, Ms. Precious Matsoso, Director General of the South African Department of Health, Dr. Timothy Kedijang, Chairperson of the Pharmaceutical Industry Association of South Africa,Dr. GustaafWolvaardt, Managing Director of the Foundation of Professional Development among many others.
The Executive Dialogue, by bringing experts from both the public and private sectors together is expected to unravel key policy approaches that will facilitate more result-oriented collaboration between governments at different level and the extended pharmaceutical value chain. Policy proposals arising from the discourse will be made available to national governments in key emerging markets.
The Executive Dialogue is organized by Inspirational Development Group of South Africa in association with the Foundation for Professional Development.

Index Case Finding, A New Way To Identify Adolescents With HIV

Chioma Umeha

Research has shown that knowing one’s HIV status can help in making healthy decisions to prevent acquiring or transmitting the Human Immune Virus (HIV).
Nigeria is home to 10 per cent of Adolescents Living With HIV(ALHIV) globally, that is about 240,000, according to a project initiated in response to the 2016 National Adolescents and Young Peoples (AYP) HIV strategy.
However, this number is not reflected in HIV Testing Services (HTS) and Antiretroviral Therapy (ART) services, hence the need to identify Adolescents Living With HIV and put them on treatment.
To this effect, a new study seeks to find adolescents living with HIV, link them to treatment, and ensure they remain in treatment.
It also seeks to observe and document factors that facilitate successful scale - up in identification and treatment of AYP living with HIV in service programmes in three States in Nigeria including, Lagos State.
However, the study uses family-based and index case finding approaches as an entry point to identify AYP aged from 10 to 24 years.
The methods include family attending HIV treatment sites, support groups as well as Orphan and Vulnerable Children’s (OVC) programmes.
These approaches involved determining HIV prevalence of persons from age 10 to 24 recruited through family attending treatment and support sites.
It further entailed ascertaining predictive factors for identifying AYP living with HIV who were recruited through family attending HIV treatment and support sites within Lagos State.
The review of the study carried out with the support of Lagos State Aids Control Agency (LSACA) in collaboration with Positive Action for Treatment Access (PATA) and United Nations Children’s Fund (UNICEF) in Lagos was a major agenda recently, in the state.
The review was aimed at intensifying HIV response for adolescents and young people in the state.
Speaking at the event, Mrs. Victoria Isiramen, UNICEF HIV Specialist said, “Young people are the present, and we need to engage them. Many say it is not easy finding young people; maybe because they do not come out.
“The index finding is a way of identifying adolescents with this virus and putting them on treatment. This work was done in Benue, Federal Capital Territory and now Lagos.
“UNAIDS believes that our children should be born free and live free of HIV, and we at UNICEF promise to give in our best.”
Isiramen said, “It has identified that we have more females with this virus than males.The partnership keeps HIV response for adolescents and young people (AYP) in focus and together we can find and save adolescents and young people living with HIV.What we are doing is to ensure that the AYP have a friendly and welcoming service so as to keep preventing this ailment.”
Giving the breakdown of the index case she said; “8525 index cases were identified; 105 known positives; 42 per cent aged between 10 and14-years-old tested positive; 10156 adolescents and young people traced and tested; 36 per cent adolescents and young people tested positive.
She added that 50 per cent aged 10-14 years tested positive and 8 percent adolescents and young people aged 20-24 years tested positive.
The UNICEF HIV Specialist said the index adult cases were identified through support groups and anti retroviral clinics located in public health facilities.
She said while the index sibling cases were identified through the ART clinics and, Orphan and Vulnerable Children (OVC) programmes run by non-government organisations located in Lagos State.
Isiramen said that the index-case finding tool was used to collect details of children and AYP in the care of the index adults and index siblings.
She however said that the National Client Intake Form was administered to children and AYP identified through the index cases that were tested for HIV through this project, adding that a questionnaire was also administered to the AYP identified, to assess their socio-demographic information, sexual behaviour and practices.
According to her, “Data collection was monitored to assure quality. Data was analysed to determine the HIV sero-discordancy rate; differences in HIV sexual risk behaviour and practices of HIV-positive and HIV-negative AYP; and predictors for HIV positivity.
“Ethical clearance of the study was obtained from the Nigeria Institute of Medical Research Institutional Review Board.”
Making his presentation, Isaac Moses in a Project Review of PATA said, “It was found that index case finding was more efficient for recruiting children and younger adolescents than older adolescents and young persons.
“That the approach increased the number and proportion of AYP accessing HIV testing and ART services at facilities. A large proportion of children and siblings 57.3 per cent of index cases did not know their HIV status.”
Moses said 36 HIV positive AYP were identified, equally spread between males and females.
He said, study also found a proportion of wards/children of index cases practicing unprotected vaginal sexual intercourse.
Significantly, he said, more HIV-positive than HIV-negative AYP use condoms during vaginal sexual intercourse.
Moses said “the highest rates of HIV positivity yield was found within the AYP aged 10-14 year-old: 42 percent. In the overall study, as high as 5.7 per cent of HIV-negative AYP are eligible for Pre -exposure Prophylaxis, (PrEP).”
On recommendations, Moses said the study posits that index case finding through family approach is an efficient way of generating high yield rates for HIV testing for AYP.
He said that targeted HIV testing of AYPs who are married, have a positive history of sexually transmitted infection, symptoms of tuberculosis, and or are aged 20-24-year-olds will likely yield high HIV positivity rates.
He states, “When index case finding approach is to be used; recruitment of the first to fourth children of index cases will likely yield more HIV positivity cases.
“Access to pre-exposure prophylaxis (PrEP) needs to be prioritised for sexually active HIV-negative AYP.
“Studies need to be conducted to learn how to best reach HIV-positive AYP through messaging on protected sexual intercourse, the value of accessible treatment, viral suppression, and non-transmission of HIV infection.”
Studies should include filter questions, as non-respondents to questions on age of sexual debut and history of sexual intercourse are more likely to have high risk sexual behaviour, a history of sexual assault or be HIV positive, he explained.

Improving Maternal Care Through Health Insurance

Nursing and pregnant women waiting to receive care at  Agbongbon Primary Health Centre, Ibadan Oyo State, recently.

Efforts to reduce out-of-pocket payments for healthcare, a huge burden on households and individuals remain a mirage in view of the poverty level of Nigerians which is put at 70 per cent. However, health insurance provides financial protection for pregnant women, spreading risks and pooling funds which would make maternal healthcare affordable and accessible, writes CHIOMA UMEHA.

Every day, Nigeria loses about 145 women of childbearing age, making her the second largest contributor to the maternal mortality rate in the world, according to United Nations Children’s Fund (UNICEF). When this statistic was released in 2017, it generated different responses from different people even as many disputed the figure.
Though pregnancy and child birth supposed to be safe and normal, so many women and their new born die due to pregnancy and child birth related reasons, those who survive end up with complications. Here lies the need to increase access of antenatal care for pregnant women.
Antenatal care, also known as prenatal care, is a type of preventive healthcare. The goal is to provide regular check-ups that allow doctors or midwives to treat and prevent potential health problems throughout the course of the pregnancy and to promote healthy lifestyles that benefit both mother and child.
Despite that antenatal care increases the chances of the survival of mothers and babies, the cost of accessing the ‘life-saving’ procedure makes it unaffordable to many poor families in the country. While some pregnant women resort to accessing care from unskilled attendants, some deliberately request family members to take the delivery evade payment of antenatal care from skilled attendants in health facilities.
Research has also shown that why many poor women and their families shun antenatal care is due to out-of-pocket payment, a barrier to accessing healthcare globally.
To tackle the issue of out-of-pocket payment and remove the  barrier it poses to many poor pregnant women from accessing antenatal care, the Oyo State Government recently initiated what it tagged, the Oyo State Health Insurance Agency (OYSHIA). This may be just a measure from the south west; it
OYSHIA intervention is in line with the global strategy to achieve Universal Health Coverage (UHC).
The UHC means that all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services do not expose the user to financial hardship.
At least half of the world’s population still do not have full coverage of essential health services and based on this, all United Nations (UN) member states have agreed to try to achieve UHC by 2030, as part of the Sustainable Development Goals (SDGs).
It was on this basis that the National Health Insurance Scheme (NHIS) established under Act 35 of 1999, was established by the Federal Government to provide easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems. However, 14 years after, less than five per cent of Nigerians are covered by NHIS.
OYSHIA, established 18 months ago is improving health service utilisation and providing financial protection against huge medical bills, according to Dr. Olusola Akande, its Executive Secretary.
He explained that the scheme in Oyo State would protect citizens of Oyo State from financial hazard, spreads the risk among every enrolee, pool the resources and consequently make it available to enrolees that become ill and need treatment.
The good news about OYSHIA is that the services have been made compulsory for all citizens of Oyo State. Akande, said the scheme was targeting 450,000 residents of the state with two per cent of its consolidated fund from the state internal revenue.
In less than two years, the scheme is reported to have made remarkable achievements, which includes over 80,000 enrolees from 33 local government areas (LGAs), 350 vaginal deliveries and 78 caesarian sessions, over 10,000 children under five years and pregnant women covered, creating employment opportunities for residents, upgrading three fully accredited PHCs and seven others at various stages of completion, as well as institutionalisation of engagement platforms for various stakeholders.
The need to use the services from OYSHIA to bridge the gap created by the out-of-pocket payment by pregnant women cannot be over-emphasised in view of the state’s infant mortality rate.
Dr. Adebola O. Hassan, UNICEF’s Health Specialist, said Oyo State is the third largest contributor of new born mortality rate in the whole of the south west.
Explaining why new born in the state were dying, she said although, there was a total of 33 LGAs and 351 wards in the state, overwhelming majority of the nurses and midwives were in urban LGAs and there was no single doctor in three LGAs: Egbeda, Ona Ara, Ogo Oluwa.
Also, she lamented that many citizens demonstrated poor health seeking behaviour, facility utilisation rate for children under five years across all LGAs, adding that only 10 LGAs have more than one per cent utilisation rate.
With the introduction of OYSHIA, Hassan said access to healthcare would be made convenient for citizens because of the method of payment. Apart from making the services mandatory for citizens, accessing health care is also perceived as the human right of people in Oyo State.
Akande further said 100,000 civil servants had been captured, but regretted that despite the success so far, there were still challenges such as negative beliefs, attitudes and customs of people on insurance policies, adverse selection and attitude of health-workers.
Other challenges are enrollees, subsidy and cross-subsidy for the vulnerable groups and the poor, limited resources for advocacy, inadequate and untrained manpower logistics and publicity and enlightenment.
He disclosed that even farmers and others who cannot afford to pay the N8, 000 were encouraged to pay with their farm produce to the agency in lieu of cash. “Many people who would have loved to enrol in our health insurance programme, but lack the financial capacity to pay the premium voluntarily agreed to give us yams and palm oil and other farm produce in lieu of cash to be paid for the premium,” he said.
“In the agency, we have set up a marketing section that is helping us to sell the yams and palm oil and other farm produce and when we sell them, we help the owners to keep the money until it is enough to pay the premium and enrol them.”
Akande said the goal of health insurance was to provide quality healthcare services for the people of the state without experiencing catastrophic health expenditure. Regretting that many people were still not aware of the activities of OYSHIA, he encouraged the media to support the initiative and boost enrolees by creating awareness on the importance of health insurance.

Tuesday, 12 February 2019

Nutrition: Lagos Moves To Scale Up Action, Develops Five-Year Policy

Chioma Umeha
The Lagos State Committee on Food and Nutrition in conjunction with Civil Society Scaling-Up Nutrition in Nigeria (CS-SUNN) have domesticated the National Policy on Food and Nutrition to Lagos specific.
Speaking during the opening remark of the validation meeting of the Lagos State Specific Plan on Food and Nutrition (SSPFN) and State Multi-Sectorial Plan of Action for Nutrition (SMSPAN), Mr Shola Fadorun, representing the State’s Permanent Secretary,  Ministry of Economy Planning and Budget, Abayomi Adebisi Kadiri said malnutrition is a key health challenge in the State.
He said the validated policy will serve as a direction for the execution of programmes and projects that will address nutrition matters in the State.
Kadiri said the main objective of the validation exercise is to cross the‘t’s, dot the ‘I’s and confirm the data referred to in the document, adding that the exercise will address the cross cutting issues among the lines Ministry, Department and Agencies, (MDAs).
Giving further insights, he said that the domesticated policy document is accompanied with strategic five-year costed work plan that will be used as a guide in the execution of Food and Nutrition programmes in the State by harnessing available resources from Government budgets, as well as from development partners to support a harmonized, strategic and costed work plan for effective implementation.
He said malnutrition is widespread in the entire country, although the scale and scope varies between regions and states, adding that it manifests mainly as under nutrition, over nutrition and micronutrient deficiencies.
According to the Permanent Secretary, “reducing malnutrition is an important goal of development, since malnutrition not only slows down development, it directly leads to morbidity and mortality.
A member of the Board of Trustee, CS-SUNN, Dr. Phillipa Momah said the vision of the organization as well as its mission is to mobilize facilities and scale up nutrition across board in the country.
Expressing her gratitude and appreciation to all that made it to the program, Momah said CS-SUNN is looking forward to seeing an improved food security in the country, reduce under nutrition among infants, children and adolescents in the country.
Making his presentation, the Project Manager of CS-SUNN  Mr Sunday Okoronkwo said “every single day, Nigeria loses about 2,300 under five year’s and 145 women of child bearing age. This makes the country the second largest contributor to the under five and maternity mortality rate and the cause is malnutrition.”
Okoronkwo added that those children who survive malnutrition often become stunted. Stunting is the major indicator used to measure childhood malnutrition.   Malnutrition comes in different form.
“Stunting: too short for the age (chronic malnutrition).Wasting: too thin for their age (Acute malnutrition). Obesity: overweight.
 “The trend of nutritional indices from 1990 to 2015. Stunting reduced from 43 percent to 33 percent. Wasting from 9 percent to 7 percent, Underweight from 36 percent to 19 percent. Exclusive Breast Feeding (EBF) increased from 2 percent to 25 percent, which is an improvement but the target is 100 percent. 
“When a child don’t get the required EBF, that child will be malnourished when compared to a child that has 100 percent EBF”, Okoronkwo explained. 
He further said that a child with stunted growth will not be able to achieve potentials, adding that in Lagos State, wasting is now a serious issue and something need to be done stressing that the basic causes of malnutrition include: economic structure, lack of food, inadequate care for children, insufficient health service and unhealthy environment, diseases which can lead to malnutrition.
CS-SUNN’s Project Manager said that some of the causes are interconnected and the fight against malnutrition is a fight for all, hence all need to invest to prevent under nutrition, build human capital, boost shared prosperity and improve health outcomes.
He added that there is need for team work as the team movement recognizes this fact and also individual support are needed.
He stated that, “the policy of malnutrition was launched in 2013 and it is a key challenge in Lagos state. The guiding principle of the State policy for food and nutrition include is reduction of malnutrition through SUN activities with high impact and low cost intervention, recognition of nutrition as a developmental issue and incorporating food and nutrition consideration into development plans at all levels of government amongst others.
“The strategic objective includes reducing micronutrient deficiency disorder in the country.  Our target is to reduce the proportion of people who suffer hunger and malnutrition by 50 percent by 2025.”
The Lagos State Team Lead of Alive and Thrive, Dr Uche Ralph- Opara commended the partnership and support  of all stakeholders, with hope that the team can translate the plans to action in order to achieve a great Nigeria.

Foundation Moves Reduce Scourge Of Fibroids

...Says It’ll Provide Free Surgeries For 1000 Women
To tackle  the growing prevalence of fibroids among women, Benjamin Olowojebutu Foundation (BOF), weekend unveiled its Love story to offer free fibroids surgeries to 1000 women free of charge.
The Executive Director of the Foundation,  Dr. Benjamin Olowojebutu  who  announced this in Lagos described fibroids as a benign mass that grows in the womb even as he regretted that fibroids ranks among one of the conditions affecting women across Africa.
According to him, a lot of these superstitions, myths and fallacies surrounding the condition are the main reasons women are dying from fibroids.
He said, however, the risk of developing fibroid could be reduced if a woman married early and there was a break in their menstrual flow.
He said the major challenge contributing to the reason many people seek for other alternatives was due to the cost of surgery which he said ranges from half a million, adding that the foundation was ready to meet the needs of indigent women who could not afford to pay for surgeries.
Unveiling the Love story of BOF and journey to a 1000 free surgeries this year, Olowojebutu who is also a surgeon disclosed that BOF carried out no fewer than 626 free surgeries last year.
He explained that the BOF was a dream birthed and driven by love and compassion to help indigent people suffering from various diseases such as Fibroids, Lipomas, Breast lumps, Hydrocele and Hernias.
Recalling that the in 2018 Vision36 was born, to treat a minimum of 36 indigent women free of charge in each of the six Geo political zones of Nigeria, he said: the goal of BOF is to in the long run change the health care space with love and compassion.
He said this year, the foundation’s project tagged: ‘Journey to 1000 free surgeries” will be helping 1000 indigent patients suffering from Fibroids, Lipoma Breast Lumps and Hernia.
“We have started already we just concluded the Ikorodu outreach where eight fibroid surgeries took place.  We will be going to Cross River, Imo, Abia Edo and Ondo and Rivers State from the 1st of February, 2019.”
He said that BOF would be having its first out station outreach in Gambia and South Sudan July, 2019.

‘Creating Awareness For Social Health Insurance Programme’

Chioma Umeha

Dr Olusola Akande, Executive Secretary of Oyo State Health Insurance Agency (OYSHIA), has called for increased awareness among Oyo citizens on social health insurance programme in the State to enable them to embrace the scheme.
Akande said adequate sensitisation on the importance and benefits of health insurance are required for the programme to really gain ground sufficiently.
The health insurance agency boss spoke at a media dialogue on improving access and uptake healthcare for marginalised women and children in Oyo State which was organised by Oyo State Ministry of Information in collaboration with OYSHIA and the United Nation Children’s Fund (UNICEF).
According to him, the agency has recorded 100,000 enrollees in the last 18 months of its operations and that it targets was to hit 450,000 to cover five percent of the population of the state before June.
He listed the efforts of the agency aimed at providing quality healthcare services for the people of the state without experiencing catastrophic health expenditure.
He also said, no fewer than 100 pregnant women in the state have delivered through Caesarean Section (CS) done under the health insurance scheme and that thousands of residents of the State have benefited from the scheme.
He was worried that many people are still unaware of the activities of OYSHIA and sought the support of the media to propagate the importance of health insurance to the people so that more people would enroll in the scheme.
Akande said OYSHIA has been rated very high in terms of performance and assured that the agency would not relent in making sure that the people of the state enjoy quality healthcare without expending their entire savings on medical bills.
Contributing, Mr. Rotimi Babalola, Director, Press and Public Relations, Oyo State Ministry of Information, Culture and Tourism,  praised UNICEF for its efforts in ensuring the wellbeing of children and women.
Mrs. Blessing Ejiofor, UNICEF Communication Specialist, in her remarks said access to quality healthcare is a right of every child and charged the media to assist in reporting issues that would prompt the policymakers to take proactive steps and implement policies that would make life better for children, women and other vulnerable groups.
She explained that the objective of the dialogue was to create an opportunity for media advocacy on increasing access and uptake of healthcare services for children and venerable populations through the health insurance scheme using Oyo State Health Insurance Agency (OYSHIA) as a case study.
Ejiofor said the initiative was also designed to provide media partners with the knowledge and material that would assist them to understand the issues, advocate and report health insurance scheme to create more awareness of it and encourage more people to enroll in the scheme.
Similarly, Dr Adebola Hassan, UNICEF Health Specialist and other experts in their various presentations dwelled on the importance and benefits of health insurance and stressed the need to attain Universal Health Coverage (UHC) and ensure good health for the citizens.

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