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Health For All: Achieving Universal Healthcare Coverage in Nigeria | Adaku Efuribe

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Adaku Efuribe

Incurring catastrophic expenses for health care is a global problem. In richer countries in Europe, Latin America and parts of Asia, which have achieved high levels of access to health services, increasing numbers of people are spending at least 10 percent of their household budgets on out-of-pocket health expenses.

UHC means that all people and communities receive the health services they need without suffering financial hardship?

UHC enables everyone to access the services that address the most important causes of disease and death and ensures that the quality of those services is good enough to improve the health of the people who receive them.

UHC is not just about health care and financing the health system of a country. It encompasses all components of the health system: systems and healthcare providers that deliver health services to people, health facilities and communications networks, health technologies, information systems, quality assurance mechanisms and governance and legislation.

Can community health care workers address the Primary healthcare Crises in Nigeria?

‘Community health –care workers know the traditions, cultures and practices of their communities, making them indispensable especially during an outbreak of emergencies’ (WHO)

With the reduction in the number of doctors in Nigeria today, it is high time the health ministry makes use of ad hoc staff to fill in the gap in suitable aspects of primary care provision,

In many developed countries of the world who can boast of a good number of primary health care centers per geographical area/population; they still make use of physician associates, health visitors, advanced nurse practitioners, pharmacist independent prescribers, nurse advisors, and health care assistants etc to fill in the gap.

In Nigeria we do not have enough medical practitioners per population or geographical area. This is the time to train and retrain more community health care workers as this will help in managing long term conditions, reduction in child hood illnesses due to lack of immunization.

Trained birth attendants will also help reduce maternal mortality and community nursing care will reduce infant mortality.

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Studies have been conducted in some developing countries and there is enormous evidence to portray the importance of integrating lay health workers in the primary health care force.

I believe this is a step in the right direction if we must provide universal health coverage in Nigeria.

The systematic integration of community health workers at a large scale could be an effective and a rapidly implementable approach to the current primary care workload crisis we have in Nigeria

I feel there is a sense of urgency for this; and I’m calling on all stakeholders to work together towards achieving UHC in Nigeria.

Reference: [World Health Day, WHO]

Author:

Adaku Efuribe is a Pharmacist with professional experience in medicines management, clinical pharmacy and integrated healthcare.

 Adaku is a strong advocate of Universal health coverage and has an inspiring vision of what this should look like in the future. She is passionate about achieving the United Nations SDG goals and committed to advancing health promotion and integrated Healthcare.

 

Health

Why smoking waterpipe tobacco aka shisha is harmful to your health | Adaku Efuribe

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I wish to draw attention to a public health issue that has become popular in the major cities of Nigeria which is shisha smoking. It is worthy of note that using shisha also poses the same risks as cigarette smoking. I have decided to write this article to create some form of awareness about shisha.

Few days ago, I watched a youtube interview which featured a popular Nigerian artist and throughout the interview the artist engaged in a shisha smoking session which was quite shocking to me.

Following the recent issues emanating with codeine and tramadol abuse among youths in Nigeria,

The federal ministry of health has to up their game in educating the general public on the harmful effects of social substances that are dangerous to health.

There are mixed messages regarding shisha coming from uninformed people that do not understand the ingredients that make up shisha.

The other day I read a comment on social media made by a young Nigerian lady ; advising people that there is nothing wrong with shisha and using it is a way of taking nutritional supplements,

The lady went on to say shisha is mixed with vitamins and minerals and those who engage in smoking it are getting their daily vitamins and minerals.

Her comment had hundreds of likes from people who are as uninformed as her.

The World Health Organisation (WHO) fact sheet on waterpipe tobacco smoking states that -Waterpipe smoke is toxic. Laboratory analyses of waterpipe smoke reveal measurable levels of carcinogens (including tobacco- specific nitrosamines, polycyclic aromatic hydrocarbons [PAH], volatile aldehydes like formaldehyde, and benzene), and toxicants such as nitric oxide and heavy metals. Additionally, the burning charcoal generates high levels of carbon monoxide.

Systematic reviews of existing research point to significant associations between waterpipe smoking and lung cancer, periodontal disease and low birth weight . More recent data suggest probable associations with oral, oesophageal, gastric and urinary bladder cancer, as well as chronic obstructive pulmonary disease, cardiovascular disease, stroke, chronic rhinitis, male infertility, gastro-oesophageal reflux and impaired mental health.

Shisha smoking is becoming popular among artists and some celebrities in Nigeria. This is a worrisome trend as such people could easily influence their fans and followers into smoking it as well.

As a clinician I don’t see anything classy in engaging in risky behaviors that could endanger ones health and probably shorten life span.

I care about the health of Nigerians and any little information as regards to self care and healthy living would help especially in this day and age where our healthcare sector is a reflection of system failure in all quarters.

A lot of people believe that smoking shisha is safer than smoking cigarettes but this is not true unfortunately.

The key facts about shisha show that it is even more risky and harmful to health than cigarette smoking.

The British Heart foundation advises that shisha smoking – also called hookah, narghile, waterpipe, or hubble bubble smoking – is a way of smoking tobacco, sometimes mixed with fruit or molasses sugar, through a bowl and hose or tube. (BHF)

Please see below key facts about shisha from a publication by the British Heart Foundation (BHF) to learn more:

‘What is in a shisha pipe?

Shisha pipes use tobacco sweetened with fruit or molasses sugar, which makes the smoke more aromatic than cigarette smoke. Popular flavourings include apple, plum, coconut, mango, mint, strawberry and cola. Wood, coal, or charcoal is burned in the shisha pipe to heat the tobacco and create the smoke because the fruit syrup or sugar makes the tobacco damp.

When you smoke shisha, you and anyone sitting near you are breathing in smoke which releases toxins including carbon monoxide and heavy metals –reducing your body’s ability to carry oxygen around in your blood.

How harmful is shisha smoking?

Traditionally shisha tobacco contains cigarette, tobacco so like cigarettes it contains nicotine, tar, carbon monoxide and heavy metals, such as arsenic and lead. As a result, shisha smokers are at risk of the same kinds of diseases as cigarette smokers, such as heart disease, cancer, respiratory disease and problems during pregnancy.

It’s difficult to say exactly how much smoke or toxic substances you’re exposed to in a typical shisha session. People smoke shisha for much longer periods of time than they smoke a cigarette, and in one puff of shisha you inhale the same amount of smoke as you’d get from a smoking a whole cigarette.

The average shisha-smoking session lasts an hour and research has shown that in this time you can inhale the same amount of smoke as from more than 100 cigarettes.

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Some people mistakenly think that shisha smoking is not addictive because the water used in the pipe can absorb nicotine. In reality, because only some of the nicotine is absorbed by the water, shisha smokers are still exposed to enough nicotine to cause an addiction.

Is herbal shisha safer?

No it isn’t. Shisha, herbal or otherwise, usually contains tobacco. Fruit or herbal flavours do not mean the product is healthy. Even if you use tobacco-free shisha, you’re still at risk from the carbon monoxide and any toxins in the coal or charcoal used to burn the shisha.

Second hand smoke is also a worry. If you’re smoking with other people or in a public place and the shisha includes cigarette tobacco, it’s likely you’ll breathe in their second hand smoke too’’ (BHF).

Now that you know the key facts about shisha, I expect you to make an informed decision whether to use shisha or not considering the risks and associated diseases.

Healthy living is the greatest gift you can give yourself, why not choose health!

 

Author

Adaku Efuribe is a United Nations Sustainable Development Goal Advocate with expertise in medicines management, health promotion and integrated healthcare

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Health

Telehealth: the game-changer for healthcare in Africa

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The statistics remain grim; nearly half of the world’s population still lacks access to essential health services, and each year at least 100 million people are pushed into poverty in the attempt to pay for access to these services.

Those figures should be an anomaly, but are the stark reality – and the fact remains that many of the people who fail to get much-needed access to care live in Africa. Emerging economies typically bear the brunt of a lack of access because of gaps in the availability of services and citizens battling to afford even the most basic healthcare.

The challenge of having such a high number of the continent’s people unable to access even basic healthcare, which is a fundamental human right is increasingly being offset by the introduction of solutions borne from rapid technological advancement – innovations that are removing traditional barriers to access.

One such innovation is telehealth – or telemedicine – which is the remote diagnosis and treatment of patients through the use of telecommunications and digital technology such as mobile devices and computers.

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Telehealth as a viable solution in the quest for access to care

Telehealth has quickly gained itself a reputation as an effective solution to help achieve the goal of universal health coverage. The industry has grown exponentially and it is predicted that it will be worth approximately $89 million globally by 2023.

This growth can largely be attributed to telehealth’s benefits, which have been widely felt wherever it has been adopted. By enabling healthcare professionals to diagnose and treat patients without needing to see them face-to-face, telehealth effectively helps lower the costs of delivering healthcare services.

Telehealth also has the potential to overcome shortages of healthcare professionals by increasing access to specialists in bigger and more well-equipped medical centres, hospitals and academic institutions. This has far-reaching consequences in places such as Africa, where patients often have to walk long distances or catch multiple forms of transport before they even get the chance to join a long queue to see a medical professional – a reality I have often witnessed myself. I believe telehealth is a big step in the right direction of overcoming this challenge and I am heartened by the encouraging signs of its uptake in Africa.

All telehealth requires is access to a mobile device and internet connection, which has proved to be a massive area of growth in Africa.

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Mobile has helped Africa leapfrog many of the challenges the continent faces – ranging from accessing financial services to education – so it comes as little surprise that subscriber penetration reached 444 million in 2017 and is expected to hit 634 million by 2025.

More than just being mobile, though, African citizens are making the move to smartphones and mobile broadband: from 250 million people with smartphones and 38 percent of all connections being mobile broadband at the end of 2017, this will accelerate to 690 million smartphones and mobile broadband connections sitting at 87 percent by 2025.

These millions with smartphones and mobile broadband connections are able to access life-changing – and life-saving – services, such as telehealth solutions.

Creating opportunities for access to healthcare is at the forefront of my vision and innovations like telehealth excite me. This shift has led to a proliferation of platforms and apps that open up access to care.

There are multiple kinds of apps that allow people to talk to or text doctors, get daily health tips and find out what their symptoms can mean, or which help people living with specific illnesses – such as diabetes – manage their disease. And these apps have widely proven to not only improve access to care, but also to ultimately improve the patient experience.

In fact, our latest Future Health Index (FHI) research has shown that a third of South African healthcare professionals say that their patients’ experience has been positively impacted by telehealth in the past five years. It has also indicated that 38% of South Africans are open to remote consultations for non-urgent care – showing the potential of telehealth as a tool to provide care.

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Targeting poor and underserved communities

There are additional examples of telehealth solutions that have been implemented specifically to improve access and provide healthcare services to the poor and those living in remote, rural areas.

In Kenya, for instance, 450 healthcare providers have partnered with M-TIBA, a mobile service that allows people to send, spend and save money specifically for healthcare, to provide mobile ultrasounds for over 100 000 patients.

Kenya also launched its national telemedicine initiative for the poor and marginalised in rural areas in 2015. The initiative helps patients and healthcare providers in rural areas to use video conferencing to interact with experts at the country’s biggest referral hospital, Kenyatta National Hospital. This not only helps with diagnosis and treatment, but also with training and research.

In South Africa, the Impilo Initiative also helps give access to care in rural areas, but focuses specifically on women and girls and providing pre- and post-natal care. Established in 2018, it equips community health workers with smartphones and tablets to facilitate virtual doctor’s appointments.

Although there are no formal statistics on hand to reflect exactly how many patients these two initiatives have positively impacted, I have seen enough telehealth solutions in action to know that they make a tangible difference in the lives of the people that need it most.

Philips too, for example, has numerous telehealth solutions that we have piloted in Kenya that we can see are making a real difference in underserved communities. The Philips Foundation, for instance, is supporting a number of projects that explore the use of mobile ultrasound technology at primary care level to enhance availability of affordable services in the underserved communities and remote areas of Kenya.

One such project is called “Mimba Yangu”, in collaboration with the Centre of Excellence in Women and Child Health of the Aga Khan University, which is currently looking into the feasibility, impact and costs of quality antenatal care and examining if ultrasounds before 24 weeks of pregnancy, as recommended by the World Health Organisation (WHO), will result in better health outcomes for mothers and babies.

Together with Amref International University, the Philips Foundation is also testing the viability of ultrasound in the business models of midwives. These projects look, in particular, at our Lumify and Philips Mobile Obstetrics Monitoring (MOM) solutions.

The Lumify uses a smartphone-based mobile app and portable ultrasound to help both healthcare professionals and mothers. Medical professionals are able to deliver care wherever it is needed even in the most remote locations, while mothers are able to see clear and high-quality images of their unborn babies. This means that patients can be treated at the point-of-care with a greater chance of success because of faster and more accurate diagnosis and treatment. We pride ourselves on this innovation as we work towards reducing mother and child mortality rates on the continent.

The Philips Mobile Obstetrics Monitoring (MOM) solution, meanwhile, is a scalable telehealth platform that allows midwives to remotely monitor patients from hospitals or home through data collected from physical examinations and then shared to the centralised MOM server. This data can then be used to determine if a pregnancy is high-risk so that immediate care can be provided.

MOM has been used successfully in Indonesia – which, like most African countries, is an emerging market. I personally witnessed its efficacy as the pilot was run during my time as the Head of the Philips consumer business in Indonesia. In this pilot study, detection of very high-risk pregnancies increased threefold and zero maternal deaths were recorded. There was also a 99 percent reduction in anaemia from the first to the third trimester through enhanced patient management. These results are testament to the impactful difference our innovations are making.

It’s clear then that telehealth presents a clear opportunity for Africa, where nearly 700 women die of pregnancy-related causes every day. Research by the WHOhas shown that at least two thirds of mothers and children can be saved with cost-effective interventions and solutions like the Lumify and MOM – making it critical to introduce them to these countries to avoid preventable deaths.

These examples clearly show the immense potential of telehealth to drive widespread access to essential healthcare services – making it critical for healthcare providers to continue to implement these solutions at scale to give citizens across the African continent the healthcare they deserve.

Article by Jasper Westerink, CEO Philips Africa

SOURCE: https://www.linkedin.com/pulse/telehealth-game-changer-healthcare-africa-jasper-westerink-2e

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Cyclists raise sh1.7b for health in Uganda

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The cyclists some in their 60’s and above started the gruelling race in Luweero

Not often in Uganda does a cycling race raise over a billion Shillings in one week. But this is what happened last week as AMREF Health Africa in Uganda in partnership with AMREF Flying Doctors in the Netherlands held their second fundraising event in Uganda.

The event (Africa Classic) that started on June 23 had 58 cyclists from the Netherlands covered 600km through 7 districts of Uganda, ending at the Imperial Resort Beach Hotel in Entebbe on Saturday.

ome of the cyclists ride towards the finish line at akiwogo in ntebbe hoto by ichael subuga
Some of the cyclists ride towards the finish line at Nakiwogo in Entebbe. Photo by Michael Nsubuga

The cyclists some in their 60’s and above started the gruelling race in Luweero, Nakasongola, Masindi, Hoima, Kibaale, Kiboga, Mubende, Mpigi before finishing in Entebbe.

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A cheque amounting to Euros 413,920 (sh1.7b) was presented to AMREF Group CEO Dr Githinji Gitahi who was in the company of country director at Amref Health Africa in Uganda Abenet Leykun Berhanu, at the end of the race.

According to Githinji, the AMREF office in the Netherlands organises the riders after each one of them gets involved in fundraising up to 5000 euros each.

he cyclists going through one of the villages during the frica lassic hoto by ppo arsijns
The cyclists going through one of the villages during the Africa Classic. Photo by Eppo Karsijns

He said the money is used to support different health interventions in Africa through the provision of health care to communities that are not near health centres, especially improving lives of women and children in disadvantaged communities across the country.

“We are focused on improving lives of women and children; some of the money is going to train midwives and we are also going to ensure more children get immunized through more outreach services; we have been doing this but now we are going to increase on those services,” Githinji said.

Berhanu said last year 70 cyclists participated in the first race which raised 503,806 Euros (sh2b)

“We use the same funds to build the capacity of community health workers and public health facilities including hospital and providing other health services,” Berhanu noted.

Article first appeared at: https://www.newvision.co.ug/new_vision/news/1502792/cyclists-raise-sh17b-health-uganda.

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