NEED TO PLUG THE GAPS IN NIGERIA’S HEALTHCARE

[:fr]Today, communicable disease like Malaria, HIV/AIDS, Tuberculosis, Poliomyelitis and Cholera, as well as other Neglected Tropical Diseases-NTDs, are ravaging Nigeria and make the biggest dent on the image of and perceptions about the country.

Taking malaria for instance, the National Malaria Elimination Programme says this disease is responsible for 60% outpatient visits to health facilities, 30% childhood deaths, 25% of death in children under one year and 11% maternal death in Nigeria. It also estimates annual financial loss to the country as a result of Malaria in the form of treatment costs, prevention and loss of man-hours at 132 billion Naira.


If any progress is to be achieved in reducing the burden of this disease, government has to urgently implement the pledge by African leaders at the July 2013 Abuja +12 summit, which was re-echoed in the theme of the 2015 World Malaria Day, to increase investments in the malaria elimination programme. In addition to boosting the distribution of Long Lasting Insecticidal Nets, Indoor Residual Spraying and Larval Source Management are two other scientifically-proven methods that must be boosted to control and eliminate the disease.
At the end of 2014, the Nigerian government launched the National Strategic Plan on TB Control 2015-2020, after a survey revealed that with a total of 180,000 cases occurring annually, Nigeria had the highest burden of TB in Africa and ranked 3rd highest TB burden country in the world. The Survey showed that in 2013, only 16% of TB cases were received, which meant that more than 500,000 TB cases in the country were not reported. Approximately one million persons will be co-infected with HIV, while 200,000 are expected to have Multi Drug Resistant TB. Nigeria ranked 13th among countries with MTDR-TB globally.
According to the National Agency for the Control of Aids, Nigeria recorded more than 30% of new infections of HIV in the 21 priority countries of sub-Saharan Africa, with an estimated 60,000 children born HIV positive every year, despite a reduction in overall HIV prevalence. Nigeria also accounts for one third of new HIV infection cases among children in the world. To reverse the trend, Nigeria has launched a National Operational Plan for the Elimination of Mother-to-Child Transmission of HIV in Nigeria (2015-2016), with a goal to reduce by 90% the number of new infections among children and to reduce AIDS-related maternal deaths by 50%.
Another low hanging fruit which must be quickly plugged is the total elimination of the Wild Polio Virus, the disease that cause paralysis in children under the age of 5. Thankfully, there has not been any reported case of the WPV since July 2014 but health experts warn that despite this gain, Nigeria cannot afford NOT to continue its massive and comprehensive immunisation. It must prioritise and step up vaccination of children especially in the North-east of the country, where insurgency has displaced millions, to justify global optimism that Nigeria will be the next country to exit the list of polio-endemic countries.
Closely tied to the success in the eradication of the WPV is the need to improve immunisation coverage of children to sustain the 91% national average, attained  by the National Primary Healthcare Development Agency by the end of 2014. What this means in fact is that 31% of eligible children are being reached by safe vaccines. 31% is however, too low if Nigeria is to reduce under-five mortality, which the Nigeria Demographic Health Survey of 2013  puts at 128 per 1000 live births.
With its resources, Nigeria is still plagued by cholera, a disease that has been eliminated in developed countries because of the availability of treated water, toilets and access to hand washing facilities. UN figures show that half of Nigeria’s 170 million population do not have safe water and a third do not have proper sanitation. The 2013 National Demographic Health Survey shows that only 28.7% of Nigerians have access to basic sanitation facilities, meaning up to 49 million Nigerians defecate in the open. In June and July 2014 alone, Nigeria recorded 22,347 cholera cases in 17 states of the federation and 288 deaths.
 
Among countries with NTDs, Nigeria has been certified free of the Guinea Worm disease but is still grappling with Human African Trypanosomiasis, Buruli Ulcer, Lymphatic filariasis, Onchocerciasis, Schistosomiasis and Leprosy. NTDs are so termed because they are almost exclusive to rural-poor, low-income countries. Though safe and cost effective means of prevention and control are available, the NTDs continue to cause immense suffering and often life-long disabilities for rural poor populations.
 
Realistically, government can only continue to reduce the burden of these communicable diseases, if it implements the April 2001 African Union pledge of at least 15% increase in its annual budget for the health sector. Nigeria’s health sector budget is far from the recommended. Expanding the coverage of the National Health Insurance Scheme from its current 7.5% of the population will also help to improve health outcomes.
President Muhammadu Buhari in his inaugural address on Friday May 29, pledged a commitment to combat the threats of communicable diseases, as well as review and revamp the entire field of medicare throughout Nigeria’s health sector. This is particularly heartwarming given the myriad of equally challenging issues before the new administration. Indeed, hope is rekindled that the Buhari administration fully appreciates and recognises the need to plug the gaps and reverse the negative health indices attributed to Nigeria.
 
H.S

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