Delivered At the Centenary Celebration of The Association for General & Private Medical Practitioners Of Nigeria (AGPMN), On Thursday The 12th Of August 2021.
Delivered At the Centenary Celebration of The Association for General & Private Medical Practitioners Of Nigeria (AGPMN), On Thursday The 12th Of August 2021.
Protocol
It is with great pleasure that I deliver this goodwill remark on this important landmark, the Centenary Celebration of The Association for General & Private Medical Practitioners of Nigeria. I will like to start by congratulating the association for this great milestone; it is indeed celebration-worthy.
The role of the Association as providers of health care delivery is such a critical one, given that 60% of health service delivery is offered in the private sector. It is therefore important to ensure that we work together, to ensure we can deliver on the goal of Universal Health Coverage.
The challenges in the Nigerian Health Sector are known to us all, so I wouldn’t dwell on them at this meeting. Instead, I would rather speak about our road to recovery, especially in light of the prevailing realities caused by the COVID-19 pandemic.
It has been a year and five months since COVID-19 changed the world – from seemingly simple behaviours such as regular handwashing to the other extreme such as lockdowns and travel restrictions. This small virus has made the world and indeed Nigeria realise that we are just one disease outbreak away from global destabilisation.
Before the pandemic began, we had set several milestones for ourselves including towards Universal Health Coverage by 2030. Yet, we are faced with the sad reality that COVID-19 has disrupted health systems and economies. In less than two years, the pandemic has caused a setback in development gains achieved over the past 25 years.
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Across the world, we have seen the impact of this pandemic on the livelihoods of people. As a country, we are experiencing our worst recession in the past 40 years. The limited fiscal room at the Federal level of government has affected the States and we have had to adjust our spending and priorities to stay afloat. These prevailing fiscal realities have of course affected the poorest households.
But while we mitigate the immediate consequences of the pandemic, we must also focus on building back our economy and health system for tomorrow — an economy and health system which is resilient to global health crises and economic shocks. By prioritising recovery plans that tackle multiple challenges, Nigeria can recover in a way that is more inclusive, sustainable and resilient.
I have used the COVID-19 pandemic as an example to show us how diseases and weak health systems can destabilise lives and economies.
Now to the solutions; what do we need to do as a government and as citizens? I would speak on three critical areas.
- Increase investment in health security
Neither individual governments nor the global development community can entirely prevent the emergence of diseases. However, we can be better prepared by strengthening our health system through investment in health security and Universal Health Coverage. Investing in health security through financing epidemic preparedness is a smart and cost-effective way to protect lives and safeguard the economy with a significant return on investment. In addition, the resources and infrastructure required for pandemic preparedness also facilitate efforts to fight endemic diseases.
Investing in health security not only saves lives but is also a vital investment in the wider economy. In Ekiti State for instance, we have taken advantage of the COVID-19 pandemic to strengthen our public health security. We have decentralised testing to 145 testing centres, the highest in the country, and improved our disease surveillance capacity to pick up early signals of possible outbreaks.
- Invest in the capacity of health workers
There is a need to address challenges in human resources for health. Challenges in training, and continuous professional development among others should be prioritised and addressed. The quality of our health workers reflects on the quality of our health system. It is therefore pivotal to invest in continuous capacity improvement for health workers. Providing the needed equipment in healthcare facilities is extremely important as health workers cannot function optimally with limited tools.
In my State for example, we have focused on redistribution, capacity building and reward of our health workforce. At the Primary care level, where this time last year, 50% of our nurses and midwives were spread across only 5 of the 16 LGAs, we have redistributed our nurses and midwives within senatorial zones to ensure a more equitable access to skilled hands. We have also trained about 20% of our existing primary health care workforce, with more to be trained this year. We now also recognise stand out performances and celebrate birthdays of staff workers monthly. These non-financial incentives have been proving to be powerful motivators in the workplace environment.
Mindful that more needed to be done, we have recruited more than 20 doctors in last 1 year to support service delivery at the primary and secondary care facilities. We complemented these efforts by establishing a NYSC medical fellowship in which NYSC Corper doctors are actively encouraged to work in rural settings in Ekiti State. The fellowship was borne out of the realisation that in the past, more than 50% of corper doctors posted to the State relocated immediately after camp. Today, as I speak with you, we have managed to retain 99% of all doctors posted to the State since the advent of the medical fellowship.
Similarly, we have developed a program to utilise services of doctors at our teaching hospitals to complement the existing staff at our General Hospitals. This program aligns our goal of increasing utilisation in these facilities with incentive payments to the doctors by ensuring that doctors on the program get renumerated based on a composite number of patients seen.
Our investment in infrastructure has moved away from building new hospitals to modernising existing hospitals and providing the relevant equipment to work with. In addition, we have just developed a bill to set up our drug management agency. The agency, which will be capitalised with the sum of N80m at the outset will shift focus away from fragmented purchase of commodities and consumables to a more structured system that aligns with global good practice across the different supply chain functions.
With our investments in human and physical resources, data measurement and use become even more important. Consequently, we signed a partnership with Helium Health last week, to enable us collect, collate and synthesize health records electronically and in real time. The partnership also offers us the opportunity to digitise payment collection. This demonstrates our commitment to transparency and accountability.
- Health Financing for a resilient and sustainable health performance
To set the State on the right path, and enable us match our ambition with our vision, we tripled our capital budget from N1bn to N3.2bn in 2021. In addition, we have deepened our public financial management processes by consolidating donor resources into our budget.
We have earmarked resources to fund a defined and explicit set of high impact services/interventions to be provided across the State. Working with global partners in the health financing space, staff at our Health Insurance Agency, recently undertook an executive course on health financing.
Our deliberate approach to utilising multiple levers across the health system functions in achieving our health goals have begun to yield some fruit. We have in the last 1 year increased confidence in the system. Anecdotally, there’s an increased interest in the use of health services by households in the State and latest data indicates that we have increased our immunisation coverage rates to 86%.
The journey to achieving our goals requires a thousand steps, but we have taken necessary actions, mindful that, like Johnnie Walker said, we must “keep walking” in the right direction.
Before I round off my address, I would like to touch briefly on the ongoing strike by the NARD. Whilst the issues raised are relevant, the effectiveness of strikes as a tool for negotiation are up for debate. As doctors, our approach to labour and other work related issues must focus on compelling and irrefutable arguments that provides opportunities to gain friends/sympathies across several industries.
As a bonus point, I would like to mention that there is a strong economic rationale for investing in health. Good health boosts individual and household income, as well as a country’s income in different ways. Healthier adults are more productive and healthier, well-nourished children are more likely to go to and remain in school, which in turn is linked to higher earnings in adulthood.
Investing in health, brings measurable benefits to a nation, lifting many out of poverty and ensuring Universal Health Coverage. Ladies and gentlemen, strategic investment in health is the road to recovery.
Finally, I would like to thank the association for the honour and for considering me worthy of this award.
Once again, I want to congratulate the Association for General & Private Medical Practitioners of Nigeria on this landmark celebration. It is my hope that all the lessons shared at this event will be carried forward and implemented towards a healthy and resilient Nigeria.
God bless you All!
Dr. Kayode Fayemi, CONGovernor of Ekiti State
