#Awo30YearsOn: Adewole, Osibogun, Dosumu, Ogunlesi others advocate decentralised healthcare funding

Professionals and policy makers in the nation’s health sector have emphasised the need for a decentralised healthcare funding mechanism to address the weak health system epitomised by uncontrolled and repetitive outbreaks of Lassa fever and cerebrospinal meningitis in the country, in recent years.

The various speakers at the 30th memorial symposium of Chief Obafemi Awolowo held at Awolowo residence, Ikenne, Ogun State, on Tuesday, held that poor financing of health by federal and state government at an average per capita expenditure of $85 continued to be responsible for the nation’s poor health indices.

In examining the theme: “Improving the Rural Healthcare Experience in Nigeria”, the various discussants advanced the need for collaboration between the federal, state and local government towards improved investment in primary health care, integrated health care service and enhanced community participation in the delivery of quality health care.

Personalities at the symposium were, Executive Director, Obafemi Awolowo Foundation, Dr Olatokunbo Dosumu; Governor Ibikunle Amosun of Ogun state represented by his deputy, Mrs Yetunde Onanuga; Minister of Health, Professor Isaac Adewole, represented by Chief Medical Director, University College Hospital, Ibadan, Professor Temitope Alonge; Commissioner for Health in Ogun State, Dr Babatunde Ipaye and his Oyo state counterpart, Dr Azeez Adeduntan.

Other discussants were, Head, Department of Community Health and Primary Care, University of Lagos, Professor Olayinka Abosede; Professor of Community Medicine and Public Health, University of Benin, Mrs Obehie Okojie; Professor of Public Health, University of Ilorin, Mrs Tanimola Akande; Chairman, Association of Public Health Physicians of Nigeria, Lagos Chapter, Dr Doyin Odubanjo and Emeritus Professor Theophilus Ogunlesi.

Professor of Community Health, College of Medicine, University of Lagos, Akin Osibogun, who was keynote speaker at the symposium organised under the auspices of Dideolu Specialist Hospital, Ikenne, said responsible leadership was central to ending policy inconsistencies and promoting strategies that ensure accountability and stewardship in health service delivery.

He called for a change of the reward system to not only motivate but also stem the emigration of trained medical practitioners.

Osibogun who noted that the growing population of Nigerians was not commensurate with available infrastructure, called for funding and equipment of existing teaching hospitals and primary health care centers rather than building more for political purposes.

He lamented a situation where about 80 percent of health budget across levels of government was devoted to paying staff salaries therefore little is left for infrastructure.

Especially, Osibogun beckoned on state governments to allow the local government focus on delivering primary health care in rural communities.

“Health indeed deserves every attention because without it, development is almost impossible and totally meaningless. We have sufficient evidence to show that the way we organise and run our health care system will also have significant impact on health status and health outcomes. Nigeria spends $85 per capita on health while Ghana spends $83 per capita. Infant mortality rate for Nigeria is 78/1000 compared to Ghana 52/1000.”

“The choice of strategies adopted and how the process is driven from selection through implementation and evaluation. A properly prepared and responsible leadership is able to drive the process to success.”

“Although we performed excellently well in controlling the Ebola outbreak in 2014, the uncontrolled repetitive outbreaks of Lassa fever and cerebrospinal meningitis in the country are confirmatory indices of the weakness of our health system. Financing health care services in Nigeria has been a major challenge with a per capita expenditure of $85 compared with a European average per capita health expenditure of about $4,000 and a United States per capita expenditure of $8,500.”

“There is the need for a health care financing mechanism that can ensure Nigerians get prompt access to quality health care. There has been a rapid expansion of the distribution of health facilities in the country over the past 20 years.  We need to operationalise the system and that is the challenge of development. Members of the community who are beneficiaries of health services deserve to have a voice in how services are organised and managed. Health centres must have defined geographic and population responsibilities,” Osibogun said.

In his remarks, Minister of Health, Professor Isaac Adewole, decried that owing to mismanagement of the free health care delivery stand of Chief Obafemi Awolowo resulting in the collapse of primary health care delivery by state governments.

Adewole who was represented by Chief Medical Officer, University College Hospital, Ibadan, Professor Temitope Alonge, therefore advocated the adoption of at least 10 primary health care centers by each teaching hospital in the country.

He also decried that the country continued to devote huge sums of money to vaccine procurement rather than production.

Adewole called on Nigerians to make endowments and donations towards the provision and equipment of primary health care centers that can be adopted by tertiary teaching hospitals.

He also called for focus on geriatrics to ensure that the elderly get requisite medical attention in the country.

Dosumu, who also is Vice Chairman, Dideolu Specialist Hospital, noted the imperativeness for policy makers and other stakeholders to accord attention to how well rural dwellers access quality healthcare.

She prayed for special focus on geriatrics owing to the preponderance of the elderly in rural populations and occupational health considering the exposure of rural dwellers to health risks related to their usage or inhalation of toxic chemicals.

Contributing, former Commissioner in the old Western region,  Dr Omololu Odukunle pointed that employers should be concerned about their employees who suffer from work-related ailments.

Professor Theophilus Ogunlesi averred that local government areas should have specific medical officers focus on advancing primary health care at ward level.

He also harped on preventive health care and planned parenthood.

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