Advocating for ‘The Think Tank in Nigeria’s Health (3T+H)’

Synopsis is a facebook group founded and being coordinated by Engineer Auwal Sani Anwar to brainstorm on issues that boarder on development, good governance, economics, politics and socio-cultural issues. Auwal Sani Anwar a Chemical Engineer is one of the restless Nigerian youths that is always occupied with ideas in chatting a new Nigeria and writes […]

Synopsis is a facebook group founded and being coordinated by Engineer Auwal Sani Anwar to brainstorm on issues that boarder on development, good governance, economics, politics and socio-cultural issues. Auwal Sani Anwar a Chemical Engineer is one of the restless Nigerian youths that is always occupied with ideas in chatting a new Nigeria and writes weekly columns in Leadership and Blueprint Newspapers. It was really an interesting and useful moment as the guest moved professionally and brilliantly from one question to another.
Due to lack of space, I will only highlight few health related questions and some of the responses by Dr Mandara. The 1st question was asked by Dr. Jamilu Tukur, a lecture with the Department of Obstetrics and Gynaecology, Aminu Kano Teaching Hospital, Nigeria; “Nigeria has one of the highest rates of maternal and newborn deaths worldwide. In your opinion, why has our rates continued to be high despite the resources available to Nigeria? How can the rates be drastically reduced so that we can catch up with other countries that are as resource endowed as Nigeria?”
Dr. Mairo Mandara response was detailed as such will only capture it succinctly as follows “ The Maternal Mortality Ratio (MMR) in Nigeria compared to other countries of Africa is unacceptably high, 545 as reported in the last demographic health survey compared to Ghana, or even Ethiopia. This clearly shows that MMR is not a reflection of the wealth of a country. Rather, it is a product of a number of key indicators which Nigeria has not been able to get right to date. The most important indicators from my perspective lie with prevention and management of emergencies when they occur. According to various researches, most maternal deaths occur in young girls between the ages of 15 and 20 years and women over 40 years from various causes ranging from bleeding with attendant Anaemia, Eclampsia, Infections, Abortions etc. If we can successfully manage to make sure that young girls below the age of 20 years stay away from being pregnant in the first place, this will automatically take these cadre off the risk of maternal death and could reduce our MMR by as high as about 20% without any intervention. This could be achieved if there is commitment by government and communities including parents by ensuring all young girls remain in school at least to completion of secondary education. Moreover, completion of secondary education has been found to be strongly associated with women attending antenatal care when pregnant, delivering in health care facility, taking their children for immunization and hospital care………………The second important issue is how we do as a country with health care provision especially good Primary and Secondary Care. Our Primary Health Care (PHC) could easily be described as comatose. The key issues I believe we need to address in this is strengthening PHC especially having well trained mid-level health care providers i.e. Nurses and Midwives who would deal with the crucial primary care that prevents maternal death. At the moment, this sector of our health care is neglected. This responsibility is constitutionally with the state and LG governments. It would therefore be important to focus our advocacy efforts for the improvement of this sector on the state and LGAs. We need to acknowledge that we need to spend a lot of time getting them up to speed in understanding the implication of this sector and how if well addressed would actually save the states money. ”
Another interesting health related question was asked by Dr. Muhammad Saddiq, Doctoral Student at University of Sheffield, UK as follows “Nigeria has spent over US$4 billion from a range of development assistance partners since 2002 for different health programmes. Despite this large investment, the past decade has seen rising inequities in access to healthcare services among Nigerians as well as stagnation or indeed deterioration of important health indicators. Why are international development assistance still being put in the hands of state agencies, since it is clear that these institutions have little role in people’s lives?” . She highlighted that “a lot of international development assistance are not given directly into the hands of government. Most assistance are given through third parties ie NGOs and most of them are International NGOs – except probably for things that come through World Bank, IMF and ADB which are loans in real sense. Technical Assistance generally will be discussed with governments but they are not the direct implementing partners. What happens is that because of these technical assistance, governments then refuse to budget for those things themselves and mainly pay staff salaries and do infrastructure. The second major problem is that Nigeria does not have a very clear and crisp plan of what it wants to achieve over the next few years. This is in contrast to say Ethiopia and Rwanda where government has a very clear National Plan for next couple of years, 10-20, and every partner has to buy into their plan.
In the 2nd part of this article next week  I will dwell on the questions I asked, Dr Mandara’s  response and what I consider a recommendation in moving forward to set up another platform “The Think Tank in Nigeria’s Health Sector (3T+H)” that will dwell  on health advocacy.
All comments to Dr Aminu Magashi at [email protected]