HEALTH INTERACTIVE WITH DR AMINU MAGASHI

 

Health and Development: Memo to all Kano Gubernatorial Candidates

healthinteractive@hotmail.com

 

Being a Text of Presentation at a Press Conference convened by Dr Aminu Magashi, Executive Director, Community Health and Research Initiative (CHR).

 

Venue : Press Centre , Kano , Nigeria

Date :Thursday, 28th December 2006

 

Gentle Men of the press

 

This season, is the season of election and a lot of politicking and campaigns by all registered parties across the country and most importantly our dear state, Kano. Although those activities are the responsibility of politicians , never the less it is also a season whereby all concerned must be engaged to appreciate the enormous task ahead towards governing our nation in a manner that will lead to rapid growth and development and finding succour to the teaming vulnerable people all over the country .

 

For Kano State to have a rapid growth and development , we must ensure Good Governance , Transparency , Accountability , Good policies and Implementation from our leaders and that should translate to improving poverty , reduction of maternal and child deaths as well as reduce the burden of diseases . The debate about improving Health Care Delivery System should not  be surrendered  to only politicians and their cronies , whether we like it or not what they do or not do affect the ordinary man in the street , we in the NGOs , Media , Private Sector and  every one in the state and  of course our  children yet unborn .

 

Health is a fundamental human right not a privilege or commodity and it is not a social but protective service. Development which is about improving people’s life could be measured by assessing Maternal Mortality Ratio, under five Mortality Rate and Life Expectancy at Birth. Nigeria’s Maternal Mortality Ratio is about 948/100,000 live birth with a range between 300 and 1,700/100,000 live births ( 2004 Health Sector Reform Document). Nigeria is accounting for 10 % of the global estimate of Maternal deaths, even though its population only accounts for 2 % of the world population.

 

According to K-SEED Document (Kano State Economic Empowerment Development Strategy) The Kano State Maternal Mortality Ratio is put at 1700 per 100, 000 live birth. It simply means out of every 100,000 live birth in the state, 1700 women die as a result of pregnancy and  related problems.

 

Some of the common problems of Pregnancy leading to high maternal death in the state are

         Eclampsia and Pregnancy Induced Hypertension ( fitting and convulsion before , within labour or after delivery )

         Prolonged/Obstructed Labour

         Haemorrhage ( Bleeding before or after delivery )

         Infections during Pregnancy (Malaria, HIV/AIDS)

 

In a research conducted recently at Murtala Mohammad Specialist Hospital, Eclampsia cases are seen every day while some survived, majority of them died due to late reporting.

 

With respect to under five mortality rate which is about 201 / 1000 live birth, it also simply means out of 1000 live birth,  201 children will not reach their fifth birth day. The commonest causes of Under Five Mortality Rate are

 

  • Malaria

  • Immunisable Child hood illnesses such as Measles , Tetanus , Whooping cough e/t/c

  • Acute Respiratory Tract  Infections

  • Diarrhoeal  Diseases

  • Malnutrition.

 

According to the same K-SEED Document, Kano State targets  to reduce Maternal Mortality Ratio and Under five Mortality Rate by 50 % and 20 % respectively by 2007. While these targets seem unrealistic, there is no baseline date to measure progress. At this juncture, I have to urge our leaders to desist from signing documents they are not too clear about.

 

Free Maternity and Child Health Services is the approach embarks upon by the state to curtail Maternal and Child death. It was first initiated by the immediate past administration of Eng Rabiu Musa Kwankwaso and has continued with the coming up of the current administration under Mallam Ibrahim Shekarau . We must commend them for doing that.

 

The irony of that initiative is the simple fact that it does not overall lead to reduction of Maternal and under five Mortality Rates in the state.  However , we need to fathom why, to enable proffering policy recommendation and solution.

 

Some of the problems are:

  1. Out of stock Syndrome

  2. Lack of enough Personnel

  3. Services not available all the time and not every hospital 

  4. Unnecessary interference by politicians

 

Other important problem is the fact that Free Services is only been provided at the Secondary Health Centres without the involvement of Primary Health Centres been managed by Local Government Authorities . Looking at the risks factors of Maternal and Child Deaths, majority are linked to the Three Delay SyndromeDelay in deciding to seek for care which is related to poverty, ignorance and other cultural norms and values. Delay in Transportation which poses stumbling block due to distance from the affected community to the secondary health centre providing such services.  The last delay is the delay at the centres to institute management on time to avoid more morbidity and untimely death.

 

Gentle men of the press, the failure of the Primary Health Centres managed by Local Government Authorities  will continue to hamper on the need to address health needs of the populace.  Majority of these centres are devoid of skilled midwives and nurses, medical doctors and facilities to respond to emergencies that will resuscitate patients for referral to  secondary health centres.

 

In my work through an NGO , I  have traversed  all the 44 LGAs of Kano and have first hand information about the sorry state of those centres. It is a very pathetic situation capable of shedding  tears. Many are far away from where people live and work . They are decorated with expired drugs , dilapidated structures , corrugated roofs and cob webs and have become in many places  the inhabitants of domestic animals .

 

I mentioned such with all sense of objectivity, sincerity and honesty and one can confidently say that ,  the Primary Health Centres are almost in Total Collapse. It is a typical example of mismanagement of resources and squandering of a mandate of leading the electorate out of the doldrums they found themselves and of course towards achieving Millennium Development Goals .

 

Below are my Policy Recommendations

 

  1. Establishment of Primary Health Care  Development Agency through an executive bill that will be charged with the responsibility of pursuing  vigorous activities in the state through effective collaboration with Local Governments , NGOs and International Development Partners .

 

  1. Creation of a Health Policy Advisory Office under the office of the Governor that will be saddled with the responsibility of providing thoughts and policy direction to the government

 

  1. Sustained and effective collaboration between Ministry of Health and that of Local Government’s Affairs  towards strengthening referrals and achieving common goals.

 

  1. Active involvement of Private Sector through Organised Private Sector Initiatives and Public/Private Sector Partnership . 

 

  1. Improving the welfare package of Health Workers working in rural areas

 

  1. Increasing budgetary allocation to Health Sector from about 5 % of what it is currently to nothing less than 15 % and to ensure wisely distribution of such resources to priority areas.

 

Gentle men of the press , by April 2007 , who ever gets the mandate to lead our great state , this memo will be articulated and submitted  to him as a Proposed Policy Guideline and it is with that , we shall continuously be advocating , monitoring  and  assessing the level of commitment of the administration  to the populace .

 

We all have a responsibility to put our leaders on check and I call on the Media and other Civil Societies to be vigilant in doing such. To wrap it all , I must say that for  any nation to succeed in all its endeavours , its citizens must be healthy  and fit , as the saying goes ‘ Health is not a commodity , but a right , so demand for it’ .

 

Thank you very much for listening

 

Long Live Kano State

Long Live the Federal  Republic  of Nigeria

 

 

Dr Magashi is a Masters Degree Student ( Public Health ) at London School of Hygiene and Tropical Medicine. He is also  the Executive Director of Community Health and Research Initiative , Kano , Nigeria . He can be reached at healthinteractive@hotmail.com or gamagashi@gmail.com .