Health

By Jamila Yunusa Sulieman

They say ignorance is bliss, but only to the ignorant. Over the years, I have read articles on Sickle Cell Disease and witnessed some close associates deal with the unending crisis. Little did I know it would be a first-hand experience for me.

I got married without a genotype investigation, though my spouse was very sincere with his as I carelessly assumed I was of the AA genotype because my siblings all had the AA genotype except for my immediate elder brother. Careless, right? My genotype Status dawned on me during the routine medical test for antenatal. Naturally, I broke down, and full of disappointment, I prayed and cried. I had my first child and two more, which were all declared healthy and free of Sickle Cell Disease. 

It was bliss; family members would congratulate me and help me praise Allah; the feeling was more like hitting the jackpot. Four years passed by after the birth of my third child, and just then, pain and fear decided to take a seat in the kingdom of bliss. I had taken myself for an ultrasound in one of the prestigious Ultrasound service providers, where I was declared eight weeks gone. I took one of the fastest routes to my place. I walked slowly but could feel my heart beating faster; I didn’t have the excitement of pregnancy because all I felt were premonitions.

I would cry myself to sleep, and some nights, I would think deep into the night. I sparked out of melancholy. I started my antenatal clinics at 12 weeks of gestation. I became even more prayerful even though I knew I had very slim chances of having a child who wouldn’t have the SS genotype as scientifically proven. Time passed so fast, and it was 40 weeks already. I welcomed my bundle of joy with much happiness and prayers but with so much fear and guilt. 

The tension in me grew as the days passed by. He was one sickly child with a huge appetite. It was about six months when I finally summoned the courage to take him for genotype testing; after samples had been taken, I waited patiently for the test results; the wait seemed like forever. After waiting three hours, I had to enter the lab and demand the results. The microbiologist would give excuses, and so I knew something was up. 

A few minutes later, the most senior microbiologist in the lab walked up to me. Before he could complete what he was saying, I asked, “It’s SS, right?”. The affirmation on his face broke me. I walked home crying with my baby strapped to my back, and I kept repeating to myself, “I am a bad mother. I have failed my child. What have I done? How can I subject my own child to this?” I wept, I became sobber, I didn’t feel happiness or joy around me. It affected my work, my family life and my social life. 

Although I was down, I immediately registered him for the SCD clinics, I took precautions, I improved his diet, I began researching Sickle Cell Disease, I connected with mothers with Sickle Cell Disease, and we shared observations and suggestions. The nurses and doctors were always welcoming and readily available. Unfortunately, we come across people who do not understand our situation and make us feel we are just blowing things out of proportion. If only they knew the weight we carry in our hearts and the hopelessness we sometimes feel.

Sometimes, I forget his medical condition, but whenever he breaks down, it feels like the end of happiness; the whole feeling of guilt and carelessness becomes a rebirth in my life. Those days and nights of sleeplessness, the pain of watching him go through the pain and all I can do is pray and give him the best care I can. My heart gets shattered into bits and pieces. This I have brought upon my child. 

I question myself whether he would grow up to have a normal childhood like every child. What will be my answer when he begins to question his medical state in future? Would he forgive me? Would he see me as a good mother? Will there come a time when I will stop biting myself so hard?

Indeed, ignorance is not bliss but a silent time bomb waiting to explode. Love and attraction should not be the only basis for marriage; genotype plays a key role. It is time we stopped only reading about Sickle Cell Disease and began to give genotype investigation its due.

Jamila Yunusa Sulieman is an Abuja-based mother of 4 and a graduate of Ahmadu Bello University. She has a passion for enlightening others and imparting knowledge. She can be reached via suleimanjamila21@gmail.com.

By Abdullahi D. Hassan

Nigeria is described as the most populous black nation in the world, with over 200 million inhabitants, Africa’s biggest economy, and endowed with variant mineral deposits to improve the living standards of its citizens. Yet, the country is bedevilled by gross corruption. Poor governance, ethnic tension, and abject poverty threaten integrity and sovereignty.

Even though, in the past, Nigeria witnessed serial military rulers, The nation transitioned to democracy in 1999. Since then, Nigeria’s leadership has emerged; leaders have been elected from different platforms and regions. Thus, the problems lingered; most elections were marred by irregularities, political interference, and power tussles from one inch to the next.

The political parties adopt the concept of rotating power between the north and south to accommodate the plural ethno-religious groups in the country. After the two tenures of Muhammadu Buhari. Bola Tinubu was nominated by the All Progressive Congress (APC). Amidst serials of allegations labelled against him by the opposition to hinder his andidacy, The bulk of Nigerians were enthusiastic about the level of experiences and transformation built in Lagos from 1999 to 2032.

On May 29, a new Nigeria’s president, Bola, was sworn in. In his inauguration speech, he made a striking remark on Nigeria, mentioning, ‘Subsidy has gone, the controversial fuel subsidy scheme. Four decades of financial assistance were institutionalised in the 1970s by the government to minimise the excessive cost of fuel (Premium Motor Spirit) to consumers and affordability to average citizens. Within a week’s time, the prices of basic household items, transport fares, and electricity began to rise at a high pace. Thus, fuel subsidy is the direct government intervention for the common man that benefits directly, without an odd process. Subsequently, the price increment affects the pharmaceutical industry acutely.

In recent months, patients from economically deprived backgrounds with terminal illnesses and diseases have been on recommended drugs and life-support medications. They are exposed to the brunt of fuel subsidy removal principles. Patients with asthma, diabetes, cancer, hypertension, and sickle cell diseases find it hard to afford medications at exorbitant prices. Due to financial hardship, inflation, and 1000 per cent hikes in drug prices.

GlaxoSmithKline (GSK), a British pharmaceutical and biotechnological company, withdraws from Nigeria. After 51 years of operation, The pharmaceutical firm is known for producing effective drugs, anti-biotics, anti-asthma, anti-malaria, allergy relief, painkillers, pain cream, and nasal decongestion. According to the report by the International Centre for Investigative Reporting (ICIR), GlaxoSmithKline Consumer Nigeria faced a setback in sales of N7.75 billion ($9.83 million) from N14.8 billion last year. GlaxoSmithKline’s existence leads to a drug hike, patients being unable to have medication and an increase in fake drugs. Similarly, GSK faces challenges from the high cost of importation of active pharmaceutical ingredients (APIs), a lack of steady power supply, and the depreciation of the naira against the US dollar.

According to the National Bureau of Statistics (NBS), the value of pharmaceutical products imported into Nigeria rose by 68 per cent to N81.8 billion ($99.1 million) between July and September 2023. The reports revealed that most of the drugs were imported from China, India, the United States, France, and Germany.

From the price survey across the country, the drugs were selling: asthma inhalers from N4,000 ($4.86) to N12,000 ($14.57), hypertension drugs from N10,000 ($12.14) to N20,000 ($24.28), augmentin tablets from N6, 000 ($7.28) to N24, 000 ($29.14), and Glucophage from N3, 800 ($4.61) to N6, 200 ($7.53). The prices vary between cities and regions.

David Uja, 63, a retired army officer frail from prostate cancer, undergoes chemotherapy for two sessions. Each cost him $100. She said, “For almost two months. All the prescribed drugs I used have already expired. The little pension received from the government is not enough to buy medicines at a high price. The economy is bad for us; people battle deadly sickness.”

“After I complained to my doctor, who relocated to the UK, Thanks to him, he sent me an Orgovyx tablet via courier, an expensive drug over $400, said Mr David.

Dataphyte reports that in 2021, only three per cent of the Nigerian population will have health insurance. Despite the guidelines of the National Health Insurance Scheme (NHIS), it is mandatory for Nigeria to benefit from the insurance. Public servants have smooth access to it. An employer will contribute 10% of the monthly basic salary, while the employee contributes 5%. The insurance covers the contributor, spouse, and four biological children less than 18 years old. The current monthly minimum wage is $44.45. Technical non-government workers are denied access to health facilities and medication.

In October, the Central Bank of Nigeria lifted the ban on 43 items after 8 years to allow access to foreign exchange and import-listed goods in the country. Never, pharmaceuticals and medical essentials are excluded from the list.

Interestingly, oil is the mainstay of Nigeria’s economy. Even so, the country has remained poor, with its citizens living below the poverty line of $1 per day. Nigeria has been nearly six months without a fuel subsidy. The majority of Nigerians are unable to afford standard health service delivery. These led to fast and quick deaths among the vulnerable. Others reside in rural areas that lack the means to buy drugs at a high rate. Alternative to traditional medicines.

Therefore, deciding on traditional medicine, given its low cost of purchase, Such medicine lacks a scientific approach, and most traditional doctors determine the nature of an ailment by mere observation. Outwardly of any examination and sometimes depend on spiritual healings in order to detect the course of sickness. These have made life more difficult in a nation with a life expectancy of 53.87 years.

Abdullahi D. Hassan is a freelance journalist and writer from Abuja, Nigeria. His journalistic and literary pieces were published in Daily Trust, The Guardian, Triumph, Politics Today, The Daily Reality, and Kalahari Review.     

By Nusaiba Ibrahim Na’abba

We continue to lose a part of us – our brothers, sisters, friends and colleagues – to drug abuse. It keeps getting scarier, forcing all of us to have bleak thoughts about the future. For us to win this war against drug abuse, we need to do the following and, perhaps, more.

Communality: Our common fight against the pervasiveness of these substances was long lost here. Achieving common goals is now a bizarre thing of the past. When problems happen at family or community levels, we begin playing blame games. And to those who think their wards are ‘righteous’, they’ve done an impeccable parenting job. They describe people who are facing the heartbreak of child-related drug abuse as being incapable, too strict or too loving to their kids to let that happen. They then hop on the trend of gentle parenting as the key to having upright children. But reality shows that some parents who battle these problems possess proper parenting skills.

Now, in the case of the neighbourhood or larger community engagements, menial signs of danger are being neglected. Often, these drug dealings and businesses flourish where there is community negligence. The drug lords are purposeful enough to select urban areas where families live low-key lives. There, they conduct their sales without much or any attention from the communities, using selected morning hours for their exchanges. Quickly, a business of millions will happen in front of your house, and you will forever not know.

We must work together to be more vigilant. I am confident that the power of our communal efforts supersedes a few bad eggs that vow to torment the lives of our beloved youths with harmful substances. This battle is beyond a one-man thing. I’m also not generalising the drug dealings to happen in all urban areas in Kano, but there are several allegations about that.

Sustainable Income Options: About four years ago, the BBC Africa Eye gave staggering statistics of codeine consumption in Kano and Jigawa States in their investigative report titled Sweet Sweet Codeine. Well, the situation has only gotten worse with shisha parlours and other unthinkable substances aimed at destroying us in total. The mere imagination of how much is invested in this business is inconceivable. Unlike food, illicit substance addiction does not embrace sorry as an answer. Even in the eyes of the storm, addicts must get their day’s share. And this is why its market keeps expanding and thriving. Before you start arguing, they never fail in their businesses because they always have a market.

Unless a robust, sustainable income generation mechanism is found and proliferated in the minds of young adults into this business, we will continue to lose hope. It is extremely difficult to convince a young adult who has discovered the ropes of this illegal business to start a legal business with a low income. Their state of growth is one, and the reality you cannot overlook is difficult. Adding to the complexity of the already bad situation, you would find it difficult to neglect how politicians spend money lavishly, which is widely spread on social media.

This is one of the most difficult tools that must be deployed in this fight.

Women Groups: I’m 100% supporting creating women groups who can keenly monitor community levels. Women possess an indispensable role in upbringing, and they receive the largest share of agony when they lose their child to drug abuse. When they are part of decision-making, they can contribute immensely to the patterns they notice in their wards, and finally, they own the collective action.

Nonetheless, they must be trained rigorously on the processes they can use to fact-check drug abuse in their kids. It has been an issue that women do not understand the change in eating, sleeping, or engagement habits of their kids, which is drug-related. With the training, the problem can be tackled early before it escalates.

I can vividly recall when a mature lady entered our house some years ago. She came in with deep red eyes, along with a young girl who was 7 to 8 years old. It was in the evening, around 5 p.m., when we were seated in our compound, chatting. The woman, whose age I cannot ascertain, said she needed help with some money to buy foodstuff. By Allah, her appearance and language did not show she needed help. In fact, she appeared to be more of a well-to-do individual. But you could tell she was desperate for something, and the little girl kept giving her looks of disbelief with every sentence she made.

My mother said she had no money to help her. After a moment, she gathered momentum and said goodbye, leaving with the kid. It was only months after the encounter that my mother explained that she was sure that the woman was high on a substance and that she desperately needed money to keep going.

This world is a scary place.

Language and Codes: People who are associated with illicit substance abuse or business create codes for interaction so that they cannot be easily identified. It is usually only the people in their circle who can understand them.

There must be a way of breaking down their language and codes to identify them quickly. It creates a massive gap in understanding the context of discussions; hence, meeting points and business dealings can be set up effortlessly without anybody noticing. In community kiosks where these exchanges happen, they are facilitated by a unique language and code.

We need to break that language barrier to dissect the problem better so we can address it appropriately.

Nusaiba Ibrahim Na’abba wrote from Kano. She can be reached via nusaibaibrahim66@gmail.com.

By Salihi Adamu Takai

The case of culpable homicide has become a daily report case in Kano State. The crime is a rampant nuisance that disturbs the whole country today. This is horrible in a state like Kano, which is the most populous state in Nigeria.

The rampancy of the crime is not only confusing but also the human, physical, and emotional proximity of the parties that are involved in the commission of the crime. The case of the rampancy of the commission of the crime is abnormal considering how it has been in records in police stations and contained in many cases of laws.

Most of the reported culpable homicides in Kano show the relationship and social proximity of the parties involved in it. The accused persons of the reported cases had proximity to the dead persons. This started – (as I have noticed it) – from the Hanifa’s case. Hanifa was kidnapped and killed by her teacher. There was a human proximity between the dead person and the accused person.

The Chinese man who killed his girlfriend had human proximity to the dead person engaged in courtship, and he eventually killed her. The recent case of Hafsa is also a case that confuses lots of people in Kano. The accused person had proximity to the dead person, and she killed him. Yesterday, it was reported that a person raped and killed his sister in Kano.

Therefore, this rampant nuisance in the report of the cases of culpable homicide in Kano is not a mere thing of crime inconsistent with the Penal Code; it’s beyond human perspectives and avoidable. What a relationship that puts people into a dilemma! Son kills his mother, and mother kills her son!!

It’s a collective responsibility of the Kano State community to engage in the proper investigation of the causes of these crimes. Islamic scholars shall always deliver sermons to admonish people on such offences, and the life of the Prophet (SAW) shall be part of the sermon so Muslims can always remain in touch with it.

By Umar Sani Adamu

Poverty has far-reaching consequences on various aspects of society, including health, education, and social structure. Understanding these repercussions is crucial for addressing the root causes and developing effective strategies to alleviate poverty and its associated issues.

1. Health

Poverty significantly impacts health outcomes. Limited access to nutritious food, clean water, and adequate healthcare services contributes to a higher prevalence of malnutrition, infectious diseases, and chronic conditions among the impoverished. Lack of resources often results in substandard living conditions, exposing individuals to environmental hazards. Additionally, stressors associated with financial insecurity can lead to mental health issues, further exacerbating the overall health burden.

2. Education

Poverty creates barriers to educational attainment. Families struggling with economic hardships may prioritise immediate needs over investing in education. Children from impoverished backgrounds often face challenges such as inadequate access to quality schools, resources, and educational support. Limited access to books, technology, and extracurricular activities hinders their development. As a result, the cycle of poverty continues, as these individuals may find it challenging to break free from their circumstances through education.

3. Social Structure

The social fabric of a community is intricately linked to economic well-being. Poverty can contribute to the fragmentation of social ties as individuals grapple with the stress and uncertainty of their circumstances. Communities with high poverty rates may experience increased social inequality and a lack of social cohesion. This can manifest as reduced community engagement, weakened support networks, and a diminished sense of belonging.

4. Crime

Poverty is often identified as a significant factor contributing to crime. Several mechanisms explain this relationship. Firstly, individuals in poverty may resort to criminal activities as a means of economic survival. Limited opportunities for legitimate employment can lead some to engage in illegal activities to meet basic needs. Additionally, impoverished communities may experience higher rates of substance abuse, which can further contribute to criminal behaviour.

Furthermore, the lack of access to quality education and limited social support in impoverished areas can result in a higher prevalence of delinquency. The frustration and hopelessness stemming from persistent poverty may lead individuals, particularly young people, towards criminal behaviour as an alternative to breaking free from their challenging circumstances.

Addressing the Link Between Poverty and Crime

A multi-faceted approach is necessary to mitigate poverty’s impact on crime. Policies to reduce poverty through economic empowerment, education, and healthcare access are crucial. Investments in education, vocational training, and job creation can provide individuals with opportunities to escape the cycle of poverty and reduce the likelihood of resorting to criminal activities.

Social support programs that strengthen community bonds, mental health services, and addiction rehabilitation can address some of the root causes of criminal behaviour associated with poverty. Additionally, targeted efforts to improve law enforcement-community relations and reduce systemic inequalities can contribute to crime prevention.

In conclusion, poverty has profound consequences on health, education, and social structure, with a direct link to increased crime rates. Breaking this cycle requires comprehensive strategies that address the systemic issues contributing to poverty and simultaneously provide individuals and communities with the tools and resources needed for positive transformation.

Umar Sani Adamu (Kawun Baba) wrote via umarhashidu1994@gmail.com.

By Uzair Adam Imam 

Dr. Tosan Erhabor, the Registrar of the Medical Laboratory Science Council of Nigeria (MLSCN), disclosed that a staggering 10,697 medical laboratory scientists have left the country, with 4,504 departing in 2023 alone. 

The brain drain, attributed to various factors, has prompted the Federal Ministry of Health to devise a policy aimed at regulating the migration of Nigerian health workers. 

Dr. Tosan Erhabor expressed his concern about the exodus of medical laboratory scientists during an interview with the News Agency of Nigeria (NAN).  

He highlighted the urgent need for a comprehensive policy to address the root causes of migration and establish regulatory measures. 

“The total number of medical laboratory scientists that have migrated is 10,697,” Dr. Erhabor stated.  

He further revealed that the Federal Ministry of Health is actively working on a policy framework that would govern the migration of health professionals and potentially curb the alarming trend. 

To alleviate some of the challenges faced by health professionals, Dr. Erhabor shared that the government has initiated a review of the hazard allowance for health workers.  

Additionally, considerations are being made to review the minimum wage and other allowances specific to health professionals. Dr. Erhabor underscored the importance of creating a safe and conducive work environment as a crucial factor in stemming the tide of brain drain within the medical laboratory science field. 

The reasons behind the migration, as outlined by Dr. Erhabor, are multifaceted. He cited poor remuneration, uncertainties in career progression within teaching hospitals, the pursuit of education abroad, the desire to acquire new skills, and enhanced professional status as contributing factors. 

Moreover, the security situation in the country, inadequate infrastructure, and a lack of modern equipment have prompted many professionals to seek opportunities abroad. 

The rising cost of living emerged as a critical factor, with Dr. Erhabor noting that it has become practically impossible for the average medical laboratory scientist to provide basic care and quality education for their children. 

The preferred destinations for these migrating scientists are reportedly the United Kingdom, the United States, and Canada, reflecting the global appeal of these nations for professionals seeking opportunities and a conducive working environment. 

As the healthcare sector grapples with this significant challenge, the MLSCN and relevant authorities are urgently working towards implementing effective policies to retain and incentivize medical laboratory scientists within Nigeria. 

The alarming departure of over 10,000 medical laboratory scientists from Nigeria in 2023 has prompted the MLSCN to call for swift policy interventions.  

With a multitude of factors contributing to the brain drain, the urgency to address remuneration, career uncertainties, and infrastructural challenges is crucial to retaining and attracting skilled health professionals within the country.

By Aliyu Nuhu

I saw a post by a friend advising people not to check their symptoms on internet and should go to hospitals for all their complaints. He was partially correct, but wrong in underestimating the power and importance of internet-based knowledge.

Medicine recognizes home treatment for non emergency medical conditions. But there is a caveat that you should consult a doctor if symptoms persist or get worse.

Always remember that doctors themselves know a lot about their speciality, but they also know little in a vast ocean of knowledge in other fields of medicine. You can know better than them if you choose to read.

My son was given about fifteen medications to take after heart surgery. But because I have knowledge of the disease and drug options,I was able to engage the doctor and at the end the drugs were reduced to four. Take note that I did not reduce the medication on my own. I only used my knowledge of pharmacy to engage the doctor and get him to reduce them himself. Some of the drugs were to be taken for few weeks and to be discontinued. Some were doing the same job and one of them has to go. Some were to alleviate symptoms, and if the child didn’t have the symptoms what was the need for them? Some were for pains from surgery and if the wound was healed there was no need for them. I once educated a doctor for asking a child to take calcium for bone strength, but he obviously didn’t know that the body would need vitamin D to successfully process calcium. Medicine is so vast that doctors must also read the internet to keep abreast.

There are treat-at-home symptoms you can learn from internet. I successfully treated myself for common illnesses through internet and over the counter medications. Why should I for instance go to hospital to treat nail fungus? You are your own best doctor. Arm yourself with knowledge before approaching your doctor.

There are symptoms that you know you need professional help. You know the red flags for potentially life threatening symptoms. When you can’t breathe you don’t need anyone to tell you to rush to get medical help at the hospital. When you have severe headache and other symptoms you never had before you should know that you need an immediate medical emergency.

I know when to see a doctor. The important thing for you is to also know when to see your own doctor. Even when meeting with my doctor, my vast knowledge of medicine prepares me for drug options and procedural choices. Internet makes you even choose the right doctor. If you have blood in your urine check for the possible causes. The regular GP may not detect if your condition is postate cancer. Oncologist knows what other tests to do and confirm if you have the condition. If you have shortness of breath, painful arm, etc, the cardiologist is the person that will know that you need angiogram to know if there is blockage in the circulatory system.

We have good doctors no doubt but always know that we have imposters, some that did not even read medicine in the university. Our hospitals are populated with half-baked professionals that only knowledge could save you from their deadly mistakes.

A whole teaching hospital treated a relative of mine for cerebral malaria when she actually had tuberculosis of the spine. My son was diagnosed with truncus ateriosis when in actual fact he had tetralogy of fallot. Without internet I would have been lost. However, a careful check gave me better understanding of the symptoms and led me to the right laboratory that identified the right disease. Internet led me to the right doctors abroad.

It will be suicidal just to rely on doctors without having elementary knowledge of your symptoms and treatment options. Drugs have side effects and also, interaction issues with other drugs or foods. If you don’t read you won’t know. Your doctor is human and has many patients and will not have time to educate you. Educate yourself. Knowledge is not only power, but in medicine it can be a life-saver.

Aliyu Nuhu writes from Abuja, Nigeria.

By Alhaji Musa Muhammad 

The more you have been infected with kidney failure, the more you will come to the mind of the people: “You are finished”. Others take you as a corpse just walking before its last breath.

Hadejia, the area with a number of such cases, is still facing the problem without knowing its root causes. However, there was a time when one of the presenters (name withheld), during a campaign awareness, warned vegetable/fish farmers to avoid using pesticides and herbicides on direct fruits, for example, eggplants.

He said there was a time when he saw a  farmer spraying his eggplant farm and asked him why he was pouring it. The farmer replied yes, I’m spreading it for every fruit to rip simultaneously. The Dr said are you not afraid the chemical will affect the consumers? The farmer replied, ‘I’m not the one who consumed it”.

Efforts have been made by some politicians, especially former senator Ibrahim Hassan, to take urgent action to tackle the spread of the disease. Unfortunately, there is no remarkable feedback about the different gatherings held on the kidney problem in the area.

Community-based organisations have done a lot in organising sensitisation meetings in collaboration with health practitioners, but the community members are still witnessing the increase in the problem.

One thing to be done regarding the kidney problem is the need for the government to take urgent action and mobilise the environment on the causes of the disease.

I must commend the effort and struggle of Dr Isah Billami during his tenure as chairman of Hadejia Ina Mafita to organise a town meeting to learn the solution to the problem. However, there was no positive feedback on the issue.

Our politicians range from the council chairman, members representing Hadejia at the state House of Assembly, senators representing Jigawa Northeast and the Governor at large; your response is highly needed now.

Allah ya kawo mana dauki , Ameem .

Alhaji Musa Muhammad wrote from Hadejia, Jigawa State.

By Lawal Dahiru Mamman

It is not uncommon to see destitute in motor parks, religious centres, T-junctions and other places that pull crowds clutching a doctor’s prescription, soliciting public support to purchase drugs.

Others plead not to be offered money but instead be accompanied by any good samaritan to the nearest pharmaceutical outlet to purchase the medication on their behalf. This is to free them from the accusation of preying on public emotion to beg for money without any justifiable reason.

These are indications that a number of Nigerians cannot afford drugs to treat themselves owing to the fact that healthcare is predominantly financed by households, without government support. According to pundits, this, among other factors, has been instrumental in pushing many citizens into poverty.

In 2021, the World Health Organization (WHO) said, “Up to 90 per cent of all households incurring impoverishing out-of-pocket health spending are already at or below the poverty line – underscoring the need to exempt poor people from out-of-pocket health spending, backing such measures with health financing policies that enable good intentions to be realised in practice.

“Besides the prioritising of services for poor and vulnerable populations, supported through targeted public spending and policies that protect individuals from financial hardship, it will also be crucial to improve the collection, timeliness and disaggregation of data on access, service coverage, out-of-pocket health spending and total expenditure.

“Only when countries have an accurate picture of the way that their health system is performing can they effectively target action to improve the way it meets the needs of all people.”

WHO revealed during the 6th Annual Conference of the Association of Nigeria Health Journalists (ANHEJ) last year in Akwanga, Nasarawa State, that “With healthcare out-of-pocket expenditure at 70.5 per cent of the Current Health Expenditure (CHE) in 2019, general government health expenditure as a percentage of the GDP was 0.6 per cent while government expenditure per capita was $14.6 compared with WHO’s $86 benchmark for universal health coverage (UHC).”

Nigeria currently bears the highest burden of tuberculosis and paediatric HIV while accounting for 50 per cent of neglected tropical diseases (NTD) in Africa, contributing 27 per cent of global malaria cases and 24 per cent of global deaths with Non-communicable Diseases (NCDs) accounting for 29 per cent of all deaths in Nigeria with premature mortality from the four main NCDs (Hypertension, Diabetes, Cancers, Malnutrition) accounting for 22 per cent of all deaths.

On account of the high disease burden, high out-of-pocket health expenditure and low enrollment into the NHIS, now National Health Insurance Authority (NHIA), the Federal Ministry of Health and Social Welfare has unveiled operational guidelines for the NHIA to ensure financial access to quality healthcare in line with Sustainable Development Goals, (SDGs), consequently putting the country on track of attaining Universal Health Coverage (UHC).

The Ministry said, “High out-of-pocket payment for health care services is not good enough, and it is not sustainable. Only 9 per cent of Nigerians have insurance coverage, and 90 per cent don’t.

“Ill health is pushing many Nigerians into poverty. We must, therefore, change the trajectory of healthcare delivery in Nigeria.

“Many people have wondered why the President added social welfare to the Ministry of Health. The answer is health insurance. Health insurance is the key to the Renewed Hope Agenda, and it is the reason the President added social welfare to the Ministry. This is because the President is aware that we need social protection for our people.”

The guideline, which harmonised crucial provisions of the old operational guidelines with the new Act, provided a legal basis for mandatory participation by all Nigerians, the Vulnerable Group Fund (VGF) for citizens who are able to service their insurance after keying-in and empowered the NHIA to promote, regulate and integrate health insurance schemes in the country among other provisions of the Act so as to contribute to poverty reduction as well as socioeconomic development.

The review expanded the operational guidelines from four to five. The first section, Governance and Stewardship, provides, which was not part of the previous guideline, a broad overview of the roles and responsibilities of the NHIA and stakeholders within the insurance ecosystem.

The second section, schemes and programs, identified contributory, non-contributory and supplementary/complementary schemes to ensure the capturing of public and private sector employees, a vulnerable group including those not captured in the National Social Register (NSR) by pooling resources from government, private sector, philanthropist and even international organisations.

Standards and accreditation, which is the third section, will focus on bringing health workers, health facilities and equipment, and patients under one roof for the meticulous running of the NHIA.

The fourth section of the operational guidelines, data management, allows the NHIA to provide and maintain information for the integration of data health schemes in Nigeria. Such data will allow collaboration data sharing between facilities, medical audits, and research and aid seamless decision-making for the authority.

Offences, penalties and legal proceedings, which is the last of the guidelines, ensures stakeholders’ compliance with the provision of the NHIA and provide a legal instrument for the investigation of grievances and disputes between stakeholder in accordance with protocols of the NHIA.

Implementation of this effort by the Health Ministry will make Nigerians worry less about the financial consequences of seeking medical care, providing avenues for early detection and treatment of diseases, which in turn will guarantee a healthy citizenry and increase population health outcomes for national growth and sustainable development.

Lawal Dahiru Mamman writes from Abuja and can be reached via dahirulawal90@gmail.com.

By Abdullahi Adamu

THE rot in federal and state institutions is taking a toll on the hostels and most especially in the national ivory towers.

Besides being overcrowded, many of the hostels lack basic amenities. Investigation in some public high
institution across the country revealed that many of the hostels were filthy as the taps in the toilets and
bathrooms were dry. Most of the taps are only there as decorations, and some of them have never worked for once. They never dropped a single drop of water since their installation.

As an undergraduate, back then, taking one’s bath in the bathroom or even easing oneself in the toilet
was usually a hurdle because of the sanitary conditions of the facilities. Even though there were porters
who came daily (apart from Sundays) to clean, the high number of persons using the facilities coupled
with the water situation was a major challenge. Also, some of the few staff, who sometimes do their best, leave the place at the hands of the killer viruses and bacteria around.

“Due to the limited number of students which the available hostel spaces could cater for, we found ourselves in a situation where a room that is originally meant for four students was being shared by eight students – that is to say, each of the legal and bonafide occupants had a “squatter”. This is in addition to students living off campus who also had to share the same facilities as there were none (toilets) around the lecture theatres – a number that is far beyond the projection at the inception – effectively making it almost impossible for the toilets to be neat.” in many tertiary institutions across the country. The nasty situation in hostels in many tertiary institutions leaves a sour taste in the mouth.

A student in IMO state University said the situation has worsened to the extent that some students take
their bath outside the bathrooms due to long queues and the ugly scene inside.

Another factor which leads to this unhygienic and ugly conditions of the toilet facilities in our public high institutions is the crude and improper usage by the students. Most of the students in Nigeria campuses throw away their internal dirt and defecate like uncivilized people.

For the girls’ hostel, it is also another nightmare. Most girls defecate and urinate in plastic or rubber containers, then empty it into the toilet to avoid contracting infections. Even at that, the toilets are not a place to even visit for any reason, unless when it is the last and only option.

It is more comfortable for me to defecate inside the bush along the post-graduate school to avoid
contracting any disease or foul smell of the school’s toilets.”, one postgraduate student said. Despite fee increasing and enormous internally generated revenues (IGR), including subventions from the
federal and state government amounting to billions of Naira, sanitary conditions of toilets across hostels
in Nigeria universities is appalling. May be this is why almost all our toilets across the country look so bad and unkempt. This is place where knowledge and morals are expected to be, but even the basics of a healthy and decent life are completely absent. No wonder!

Abdullahi Adamu can be reached via; nasabooyoyo@gmail.com