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HEALTH INTERACTIVE WITH DR AMINU MAGASHI
Buhari, 2007 and achieving the MDGs
Last minute decision made me to attend the interaction between General Muhammadu Buhari ( GMB ) and Nigerians in Diaspora that took place on Saturday 20th January 2007 at Imperial College , London . I was reluctant that most of the issues that would be raised , I was familiar with them being following the debate about his candidature and his activities over the last Four years . But when a lot of friends called and expressed their desire for me to be there , I availed my self the opportunity to have a first hand information about GMB planned policies towards ridding Nigeria of Poverty , Diseases and Ignorance .
I was impressed to note that larger portion of the discussion centred around achieving the Millennium Development Goals ( MDGs ) not on trivial matters . MDGs generally attempt to help countries get rid of Poverty, Diseases and Ignorance . Poverty in Nigeria has many manifestations and dimensions such as : joblessness , economic dependence at adult age , lack of freedom and inability to provide the basis needs of life for self and family ,dying of preventable diseases and living in dirty environment .
Some of the major reasons that hinder success of government’s efforts to reduce the level of poverty are : lack of comprehensive policy frame work , undue political interference in programme implementation , ineffective targeting of poor, leading to high level leakage of benefits to unintended beneficiaries , too many projects and less funding , overlapping of functions which lead to rivalry among implementers , lack of sustainable mechanism and finally lack of involvement of beneficiaries in project design, implementation, monitoring and evaluation .
A lot of problems such as in the Niger Delta , which was one of the issues discussed will improved if Poverty is addressed among the restive youths of that region and also many children will be in school and be properly educated . From that , Nigeria will have a rapid growth and development . One of the participants brought to the attention of GMB that the country accounts for 10 % of the global estimate of Maternal Death , even though its population only accounts for 2 % of the world population. While many developed nations are working tirelessly to reduce their Maternal Mortality Ratio of a range between 7 to 20 per 100,000 live births. In Nigeria, we are still dangling around 1000 per 100, 000 live birth of Maternal Mortality Ratio (MMR ) . This to me is an embarrassment, because we have all what it takes to curtail the menace .
Not only we need adequate funding to health sector , we must have Good Governance in the system at all levels to improve the unfortunate situation . Our Under Five Mortality Rate of about 201 deaths of children out of every 1000 live birth is not also encouraging , children are dying of preventable illnesses , more or less because our Primary Health Centres are almost in a comatose stage . When I talked to the press in Kano on Thursday , 28th December 2006 where I presented a memo to Kano Gubernatorial candidates , I made mentioned that many of our Primary Health Centres are far away from where people live and work and are decorated with expired drugs , dilapidated structures , corrugated roofs and cob webs and have become in many places the inhabitants of domestic animals . The response I got from many readers across the country indicated almost similar if not exact experience as that of Kano. These are the MDGs expected of any government to address. Others are achieving Environmental Sustainability, Ensuring Gender Equality , Halting spread of HIV/AIDS and other Diseases and Global Partnership for Development. I am happy to note that GMB responded to some of these challenges positively, such as his desire to invest in Bamako Initiative, a concept of Drug Revolving Scheme that ensures hospitals and communities have available and quality drugs at all times . Also ensures Free Education and jacking up the budget of Education and Health. To cap it all, he promised to invest in security , without such the MDGs we are talking about will not be achieved and of course to restructure Nigeria by creating federating units that can become economically viable.
While the debate continues about Buharis’ candidature , his supporters and opponents need to understand that as long as he wants to lead Nigeria come April 2007 , then every citizen is a stakeholder and should feel free to comment in order to enrich the debate . The interaction should be issues based not expression of sentiments , blind hatred and blind loyalty . We should be able to move above those tendencies and look at the Nigeria’s system holistically and through which means can all of us make Nigeria great with Buhari or no Buhari .
With respect to restructuring Nigeria , GMB should tread carefully on that , it is a very delicate issue with a lot of repercussion . While some will hail him , others if properly understood what it means would fight it to the fullest . Restructuring Nigeria may mean changing the revenue allocation formula , changing the way governance is been done or how people get elected in to offices . In doing that he needs the majority support of the Legislatures and other equally well meaning Nigerians . A lot of people clapping for him on that policy are ignorant of the repercussion of such implementation and what it might cause to their states’ or LGA’s .
I want to suggest that restructuring Nigeria is not only about those issues mentioned above . It is also time , we reform our payment system . The system in the government all over the country is a Retrospective Payment System be it Federal , State and LGAs . That way , it has lead to laziness , incompetence and non charlant attitude to work in the civil service . In the sense that whether one comes to work or stay at home for the whole month , his/her salary is rest assured . To me a combination across the three tiers of government of Payment by Result ( Performance Based ) , Fee for Services , Prospective and also Retrospective Payment Systems will strengthen the civil service to achieve maximum turn over , rapid growth and development .
Another issue that I want the GMB to look at critically is his intention to provide Nigerians with Free Education and to some extent Free Health Care . He highlighted in that London interaction that during the First Republic , Both Late Chief Obafemi Awoloho and Late Sir Ahmadu Bello ( Sardauna ) , both of blessed memory had put substantial budget in Health and Education and also making the latter free . In doing that now , we need to fathom the extent of Naira Devaluation and its Purchasing Power Parity compared to our experience in the past . The economic and development indices of those years as compared with the current situation . Providing Free Education and Health will hardly be sustained, if it is achievable at the federal level , I don’t see it happening at the States and LGAs level . What I will propose is a Subsidized Education and Health Programmes and even at that , they have to be rationalised according to needs , socio-economic status of individuals , funding mechanism and the country’s revenue at the moment .
In conclusion, I will like to say that while GMB’s loyal supporters are of the opinion that he is the best candidate Nigeria needs at the moment due to his impeccable Honesty , Prudence and Accountability and his die hard opponents are with the opinion that because of his military mentality and past records of draconian rules he is not fit to lead us . While I cannot take away those good qualities from him , I cannot also completely exonerate him from such criticisms. I have to note that Honesty , Prudence and Accountability are very good elements of Leadership as long as they are translated to Good Governance and Development . A typical example where Honesty , Prudence and Accountability have not translate to rapid growth and development is the case of Kano State . While the Executive Governor , Mallam Ibrahim Shekarau has all those good qualities , but nevertheless he is surrounded by majority bad cronies and he found it difficult to sanction erred subordinates which culminated into sluggish growth and development in the state towards achieving the MDGs .
For any Nigeria’s President taken the mantle of leadership in May 2007 , he/she must convert Honesty , Prudence and Accountability by working harmoniously with legislatures , respecting the constitution and creating a cabinet made up of competent , educationally qualified , dedicated , honest , accountable and passionate Nigerians irrespective of Religion , Tribe or Ethnic group . And to also extend hands of comradeship to State Governors and Local Government Chairmen towards having a reformed agenda for creating a New Nigeria. It is only through these measures that Honesty , Prudence and Accountability will make sense .
Dr Magashi is a Masters Student ( Public Health ) at London School of Hygiene and Tropical Medicine and also a director with Community Health and Research Initiative, Kano, Nigeria, he can be reached at gamagashi@gmail.com or healthinteractive@hotmail.com
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