Health Minister Gives Progress Report on the First Six Months

Nigeria's Health Minister, Professor C.O. Chukwu came into office just over six months ago, at a time of great political turmoil, and following a rapid turnover at the helm of the health ministry. Prior to his appointment, he was Chief Medical Director at the Ebonyi State University Teaching Hospital, and then Professor of Orthopaedic Surgery and Deputy Provost of the College of Health Sciences, Ebonyi State University at Abakaliki. He had just taken a sabbatical as Visiting Professor of Surgery at the College of Medicine, University of Nigeria but before he could settle in Enugu, he received the fateful call from President Goodluck Jonathan that would thrust the health of Nigeria's 150 million people into his hands.

President Goodluck Jonathan 

So what progress, if any, has been made in Nigeria's health care under President Jonathan and Minister Chukwu? In an exclusive interview given to The ANPA Blog, the Minister made his case directly and rendered a progress report on the activities of the ministry during his first six months in office. We asked: "You have been in office for less than 6 months, so it may be too early to discuss your achievements. However, are there some things you are particularly proud to have accomplished?".

Professor Chukwu opened by touting the "new sense of urgency and responsiveness at the Federal Ministry of Health" and his drive to establish "trust and confidence-building" as his guiding principles. Also, he revealed that President Jonathan has been singularly focused on health policy and has invested enormous political capital to pass the Health Bill that will facilitate the development of a functional health system for the country.

But, what specifically has he achieved, we asked. First he recalled that during his Senate confirmation hearings, the entire healthcare sector was in crisis over the wage dispute between the ministry and several groups of health workers. He had swiftly quelled the crisis, he said, by implementing "payment of the new wage structure for health workers and the arrears thereof". To produce transformational changes in the health system, however, the Minister said that he is focused on passing the National Health Bill and the implementation of the National Strategic Health Development Plan. The Health Bill has passed both chambers of the National assembly and is awaiting harmonization. President Jonathan recently expressed confidence that he will sign the bill before the New Year.

A top priority of his ministry, said Professor Chukwu, is to ensure that Nigeria meets the health-related Millennium Development Goals (MDGs) by 2015. However, he recognized from the outset that little will be achieved without fostering a sense of collegiality among all health workers. Notably, during his Senate confirmation, Professor Chukwu was embroiled in a controversy over whether only doctors should be appointed to the top job. Then, he had forcefully emphasized the important role of all ranks of health workers, saying: "The bottom line is that without team work nobody can do it alone." To this end, he said, he went on to create the "Committee on Harmonious Working Relationship among Health Workers/Professionals" charged with  instilling a sense of common purpose among physician and non-physician health workers. Professor Chukwu said he is working at full speed to fully implement his “Action Push Agenda for Health” plan before a new government is sworn in in May 2011. He reiterated what he had told The Guardian about his plan:

‘The Action Push Agenda’ is a compass for the period from April 2010 to May 2011. During this period, our top priorities will be on governance and stewardship, team work and industrial harmony, keeping on track the realisation of the MDGs especially the Health MDGs, disease prevention, surveillance and control, provision of affordable but world-class healthcare services at our public and private tertiary health institutions, and the establishment of a reliable referral system.”

Regarding dissatisfaction among resident doctors, the Minister said he was determined to address them comprehensively and has therefore established a "Committee to Review the Residency Training Programme". He noted that he has invited a broad coalition of medical experts to serve on this committee, including ANPA, which is represented by the Chair of the Education Committee, Dr Dotun Ogunyemi. The Minister said that ensuring quality training and meeting the MDG goals were part of his push to "inspire international confidence in the Health Sector". He pointed out the vital role that diaspora organizations such as ANPA can play in this regard, noting his full personal engagement during the "Retreat for Health Professionals in the Diaspora" held by the health ministry in July 2010.

Other achievements listed by the Minister include: audit/mapping of skills and facilities in the federal tertiary health institutions; providing support for first ever ATLS course in Nigeria; deployment of 2488 midwives across 652 primary health facilities; update of health data and statistics update; convening an inter-country inter-ministerial meeting with Nigeria’s neighbours to discuss and sign an agreement on cross-border health issues; and hosting of the 2nd International Cancer Week.

Health Minister: Increased Government Funding and Inter-Sectoral Cooperation Vital To Improving Health of Nigerians

Nigeria's Health Minister, Professor Onyebuchi Chukwu

For watchers of healthcare delivery in Nigeria, it did not come as a surprise when the country was ranked among the worst countries with weak national health systems; ranking 197 out of 200 in a recent World Bank survey. This poor ranking was attributed to inequitable distribution of healthcare resources between urban and rural areas; and lack of functional referral system due to poor funding. To refresh our minds, only 39 percent of births are assisted by skilled health professionals, just as only 23 percent of children between12 and 23 months receive full course of immunization against childhood killer diseases.

Against this backdrop, the ANPA Blog sought the audience of the Nigeria’s Minister of Health Prof. C.O.Onyebuchi Chukwu on these and other issues related to healthcare delivery in Nigeria during his visit to the United Nations in New York. It is a fact that most diseases responsible for mortality and morbidity in Nigeria are preventable and tied to areas outside of the ministry of health's purview (water supply, sanitation, environmental pollution). The ANPA Blog posed this to the minister and wanted to know what the ministry of health was doing to educate the leadership of the ministries involved and mobilize them for a common purpose of improving the nation’s health.

The minister agreed with facts as posed by the Blog and said that inter-sectoral cooperation was vital to improving the health and health outcomes for Nigerians. He said: “We have engaged those ministries (particularly Education, Water Resources, Environment, Interior and Finance) in bilateral discussions but intend to establish the inter-ministerial/inter-sectoral committee meeting on health.” He maintained that the better educated the leaders of these sectors are, the better will be the health of Nigerians.

The minister touted the great strides made in polio prevention in Nigeria saying “From January 2010 to October 2010 only 10 cases (2 awaiting confirmation) of Wild Polio Virus transmission has occurred in Nigeria.” and that WHO acknowledges that Nigeria has reduced transmission by 98%. The ANPA Blog congratulated the minister on this achievement but reminded him that successes are directly the result of immunization campaigns that are largely driven by external agencies and that there are still pockets of morbidity to vaccine preventable diseases, for example the 100 cases of polio paralysis reported from Jan to Sept 2009 in Kano alone. The ANPA Blog was concerned about the over-reliance on outside funding agencies and minimal national resources devoted to vaccine preventable diseases. The minister acknowledged that foreign donors are helping in the polio eradication program in Nigeria, but that more domestic funds have been committed to the operational cost (about 80%) of polio eradication effort in Nigeria than from external sources. He said: "External donor funds have been used to bridge funding gaps. This is not peculiar to Nigeria.” With regard to polio vaccine procurement, the minister said that domestic funding accounts for 50% while external funding accounts for the balance of 50%.

It is our hope that the minister will follow up on his promise to forge true inter-sectoral cooperation to improve the health of Nigerians particularly the poor and disadvantaged.

LUTH to boost medical tourism: Lessons from Colleagues Who have Gone Home

Since I left Nigeria after completing medical school, I have been back several times and have been in contact with my school mates both inside and outside Nigeria. I have been involved in both soft and heated discussions on the path forward for health care in Nigeria. In some cases, people have blamed physicians like me who received medical education in Nigeria then left Nigeria. In other cases, people see physicians like me as a potential to help pull Nigeria forward by collaborating with our colleagues in Nigeria.

I have had several opportunities to speak with Nigerian physicians in Diaspora that have gone home “successfully”, others who had to rush out after going home and many others who want to yield to calls from both the Nigerian government and people of Nigeria to return home to help.

Although I believe all physicians do not have to go back to Nigeria to help, I think a critical mass may need to go home to develop a collaborative atmosphere that currently is lacking in many medical schools in Nigeria, and which inhibits the potentials of working across the Atlantic.

Prof. Akin Osibogun, CMD of LUTH 

In a recent report that appeared in The Guardian, the Chief Medical Director (CMD) of the Lagos University Teaching Hospital (LUTH), Prof. Akin Osibogun, announced an initiative to "boost medical tourism" through a "public -private initiative arrangement". After reading this story, I wondered if it would be helpful for physicians who have gone home successfully and those who had to return to share their experiences with ANPA members as there might be a lesson or two they can give those thinking of returning home on the “dos” and “don’ts”.

The Indian government successfully attracted its citizens in diaspora back to their country by working with them to answer the question: what do you need for the government to have in place (policy) for you to come back?

Will Nigeria do the same?

Meet Our Bloggers: Nneoma Nwachuku, MPH

We are pleased to announce a new addition to our blogging team. Ms. Nneoma Nwachuku is a member of our partner organization, the Distinguished Nigerian Physicians of Tomorrow (DNPT).

Ms. Nwachuku is a medical student at the University of Connecticut School of Medicine (class of 2013). She received her undergraduate degree from Yale University where she also subsequently completed a Master in Public Health degree.

A proud Ohuhu native, Ms. Nwachuku calls Umuahia in Abia State home. She co-edits a group blog, NigeriansTalk.org, writes a personal blog and is an avid tweeter. Ms. Nwachuku brings to this blog a valuable perspective from the next generation of Nigerian physicians, on how to address the challenges facing health care in Nigeria.

Meet Our Bloggers: Asishana (Shana) Osho

We are pleased to announce the addition of new bloggers from our sister organization, the Distinguished Nigerian Physicians of Tomorrow (DNPT). The DNPT, which is sponsored by ANPA, is a coalition of Nigerian Medical students all over the world with the mission to help find solutions to Nigeria’s health care problems.

The first of our DNPT bloggers is Mr. Asishana (Shana) Avo Osho, a medical student at the Duke University School of Medicine (class of 2014). Mr. Osho is a native of Edo State and grew up in Lagos. He attended secondary school at Loyola Jesuit College, Abuja and subsequently graduated from Oberlin College, Oberlin, OH where he studied biochemistry and French literature.

Mr. Osho is dedicated to the empowerment of marginalized and deprived groups. He is also interested in the delivery of care and in the implementation of health policy in Nigeria and will reflect these interests in his writings.

ANPA Member, Dr. Charmaine Emelife, Explains Why Hypertension is a Killer Disease

As Chairperson of the ANPA Georgia chapter, Dr. Charmaine Emelife, worries constantly about how to improve health care in her home country, Nigeria. An ANPA Board member  and Chairperson, ANPA National Bylaws Committee, she has volunteered for several ANPA medical missions to help address the problem. However, like most  ANPA members, she expends most of her professional time and expertise taking care of her own patients in  Atlanta, GA, where she is partner at Atlanta South Nephrology.

Dr. Emelife, who is a proud alumnus of the University of Nigeria, and Chairperson, University of Nigeria College of Medicine Alumni Association (UNCOMMA), North America chapter, completed an internal medicine residency at the Cook County Hospital, Chicago and then a fellowship in Nephrology/Hypertension at Loyola Medical Center, Maywood, IL. In this video, Dr. Emelife explains why hypertension, or high blood pressure, can cause serious heart and kidney disease and why you should not take it for granted.