Way forward on Nigeria’s healthcare delivery

Carl Umegboro

In a civilized climate, this wouldn’t stir interest but in Nigeria where public officeholders largely manifest adversely in contrast to the public interest, it should. Recently, the Vice President, Yemi Osinbajo underwent leg surgery in a hospital in his home country. It was a departure from the flawed status quo. Over the years, at any slight ailment, people in authority fly abroad with public funds which chiefly accounts for why healthcare centres are left in decay. Osinbajo literally displayed leadership acumen.

The message is simple – a prudent leader can’t live foreign, abandoning the led to their fate in-home facilities. The action is a template that must be sustained for a turnaround. Government is about the people. This accounts for why Section 14 (2) of the 1999 Constitution of the Federal Republic of Nigeria as amended, explicitly provides; “It is hereby, accordingly declared that (b) … the security and welfare of the people shall be the primary purpose of government”.

The nation’s leader, Muhammadu Buhari is more or less a foreigner as far as healthcare is concerned. In fact, the bills on his medical trips to London, crews alongside the aircraft aggregately should fix a world-class clinic at the State House for government officials and critical issues.

At a point, the first lady, Aisha Buhari on 9th October 2017, by mission or omission raised an alarm over the deplorable condition of the State House Clinic. But after that, what changed? To shuttle a foreign land for healthcare, from inauguration to the end, and presently on the countdown to handover after an aggregate of eight years in office is an anomaly. Also, by writing-off preceding administrations, it was justifiable, to begin with, for overseas healthcare after the inauguration, but unacceptable to sustain it to the end. Nonetheless, for severe cases, foreign healthcare is expedient.

The health sector critically suffers the same neglect as the education sector; most public officeholders abandon home institutions. Even jamborees overseas too. Recently, the Rivers State governor, Nyesom Wike cheerily posted snapshots while on vacation with his Abia state counterpart, Okezie Ikpeazu in Turkey, France amid sundry crises including the ASUU strike which grounded all universities in the country leaving students wondering.

Wike also posed at his son’s overseas convocation when students are helplessly at home. Obviously, public officeholders are largely, grossly insensitive, and manifestly do not grasp the term ‘leadership’, else, their healthcare, education, and jollity overseas alongside family members will be rare.

Back to healthcare, the government must pay compelling attention to the healthcare sector for a strong and healthy nation which contributes to the gross domestic product (GDP). For emphasis, healthcare includes breastfeeding on account of its sundry and compelling health benefits. Thus, to promote compulsory breastfeeding, the World Health Organization (WHO) declared 1-7 August annually as World Breastfeeding Week (WBW) for awareness and advocacy.

During a field trip to Lagos state recently, a report by Mrs Olubunmi Braheem, State Nutrition Officer, Ministry of Health suggests the 2022 – WBW in the state was impactful. From the intensive advocacy for exclusive breastfeeding (EBF) practices, the state reportedly launched breastfeeding toolkits for the creation of breastfeeding spaces in workplaces, outlined activities to support nursing mothers, and advanced it with a symposium – focusing on healthcare actors and community actors.

At the Health Centre in Egbe-Idimu LCDA, the claims were arguably buoyed. Ditto at three other Health centres shuttled. However, outside those health centres, the grassroots obviously need vigorous sensitization. So, beyond the WBW activities, the challenge is the sustainability of the promotion alongside plan implementation to meet the target.

It is therefore expected that there should be success stories during the coming year’s WBW for evaluation. Patently, the state ‘talks the talk’ in a joint statement by UNICEF Executive Director, Catherine Russell and WHO Director-General, Tedros Ghebreyesus on the occasion of World Breastfeeding Week – 2022 but remains to be seen if it ‘walks the walk’. Thus, time will tell. The joint statement emphasized;

“As global crises continue to threaten the health and nutrition of millions of babies and children, the vital importance of breastfeeding as the best possible start in life is more critical than ever. This World Breastfeeding Week, under its theme – Step up for breastfeeding: Educate and Support, UNICEF and WHO are calling on governments to allocate increased resources to protect, promote and support breastfeeding policies and programmes, especially for the most vulnerable families living in emergency settings.

“During emergencies, breastfeeding guarantees a safe, nutritious and accessible food source for babies and young children. It offers a powerful line of defence against disease and all forms of child malnutrition, including waste. Breastfeeding also acts as a baby’s first vaccine, protecting them from common childhood illnesses. And protecting, promoting and supporting breastfeeding is more important than ever, not just for protecting our planet as the ultimate natural, sustainable, first food system, but also for the survival, growth and development of millions of infants”.

It laments that fewer than half of all newborn babies are breastfed in the first hour of life, leaving them more vulnerable to disease and death. And only 44% of infants are exclusively breastfed in the first 6 months of life, short of the World Health Assembly target of 50% by 2025, and to equip health and nutrition workers in facilities and communities with the skills they need to provide quality counselling and practical support to mothers to successfully breastfeed.

Added to these the two global health bodies are protecting caregivers and healthcare workers from the unethical marketing influence of the formula industry by fully adopting and implementing the International Code of Marketing of Breast-Milk Substitutes, including in humanitarian settings; and implementing family-friendly policies that provide mothers with the time, space and support they need to breastfeed are likewise requisite.

These horrid trends alongside needed interventions necessitated the duo (UNICEF and WHO) crying out, demanding governments, donors, civil society and the private sector to step up efforts to prioritize investing in breastfeeding support policies and programmes, especially in fragile and food insecure contexts. This outcry is noble and deserves attention. Thus, synergy had better gather momentum in public interests as the proper development of infants is essential.

Umegboro, a public affairs analyst and social advocate writes via umegborocarl@citizendiaryng