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Engaging community healthcare workers in addressing primary healthcare crises in Nigeria

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We are currently facing a primary healthcare crisis in Nigeria and speedy intervention is needed to salvage and enhance access to health care for our ever growing population.

Community health workers have the potential to enhance primary care access and quality, but remain underutilised in Nigeria.

A WHO report by Uta Lehmann and David Sanders from the School of Public Health University of the Western Cape, says;

‘The use of community health workers has been identified as one strategy to address the growing shortage of health workers, particularly in low-income countries. Using community members to render certain basic health services to the communities they come from is a concept that has been around for at least 50 years. There have been innumerable experiences throughout the world with programmes ranging from largescale, national programmes to small-scale, community-based initiatives’ (Evidence and Information for Policy, Department of Human Resources for Health Geneva, January 2007)

It is common knowledge that  we do not have trained physician associates or assistants in primary care facilities to support medical doctors in providing primary care services; rather what we have in some  communities are quacks, people parading themselves as medical doctors with no medical qualification what so ever.

But I don’t see any reason why we should not welcome the idea of training physician associates or assistants to fill in the gap for medical staff shortage, when other developing and developed countries that have better healthcare systems do have them.

In Nigeria we do not have enough doctors per population or geographical area, This is the time to train up more community health care workers as this would help in the much needed awareness creation and community based interventions for  managing long term conditions, reducing childhood illnesses due to lack of immunisation. Trained birth attendants will also help reduce maternal mortality and community nursing care will reduce infant mortality.

In a typical medical centre in the UK for instance, healthcare assistants, advanced nurse practitioners, health trainers, clinical pharmacists or prescribers, work alongside doctors to provide patient centered care. This helps to reduce the work load on the doctors as these other clinicians and allied health workers have enough training and experience to manage long term conditions and participate in triage system.

In the UK, a lot of research has been done and there are calls to increase the health work force in the National Health Service (NHS) through the utilisation of community-based lay workers.

Below is an extract from a research published in the journal of Royal society of medicine curated by Dawn O’Shea:

‘’Introducing a workforce of community-based lay health workers in the NHS could address current general practitioners (GP) workload demands, while improving clinical outcomes, according to research published in the Journal of the Royal Society of Medicine.

In the 1960s, programmes in the US funded members of the community provide a bridge between patients and health care providers. By facilitating appointment-keeping and increasing medication compliance, community health workers improved access to and quality of health care, while reducing costs.

In Brazil, community health workers receive basic training in disease identification and monitoring, immunisation, screening and health promotion. They support patients with medication adherence and chronic disease monitoring and liaise proactively with GPs and practice nurses…..

The authors conclude that systematic integration of community health workers at scale in the NHS could be an effective and a rapidly implementable approach to the current primary care workload crisis’’.

(Hayhoe B & al.  | J R Soc Med | 4 Oct 2018     from Dawn O’Shea | UK Medical News | 8 Oct 2018)

Another important area where the community healthcare workforce could be utilised effectively is emergency care or first aid. In most public and private places in Nigeria, there are no ambulance or paramedic services; having well trained community first aid responders would go a long way to save lives in times of emergency for example; cardiac arrest, collapse, and respiratory distress. Having a health unit manned by well-trained first aid responders in all public places like markets, motor parks etc is highly essential.

Healthcare provision anywhere in the world is capital intensive but we can start from the basics; we can reduce the burden or costs in secondary healthcare provision especially in our public hospitals if we lay more emphasis on patient health education and encourage people to engage in healthy living and self-care. Integrated healthcare practice at all levels is an efficient way of providing patient centered care where every member of the healthcare team contributes their quota.

Community healthcare workers are well placed to offer advice on healthy living and self-care in the language people of a specific demographic area would understand.

Hypertension, Chronic Kidney Disease, Type 2 diabetes mellitus, malaria, HIV/AIDs are among the diseases that could be prevented or well managed through patient education and lifestyle advise.

The role of health education cannot be overemphasized. For instance, there is still some form of stigma around epilepsy in some areas in the country; where people who are epileptic are believed to be possessed by some sort of evil spirits, in an unfortunate event of epileptic fits in public places, patients are not well cared for and objects like spoon etc. are inserted into their mouths in the believe that it keeps the airways open, this could be a choking hazard and has made recovery time worse for some patient. Community healthcare workers could perfectly fill that gap of providing basic health education and public health enlightenment.

In conclusion, addressing the primary healthcare crises in Nigeria is no mean feat, but we need to look at the issue holistically, it involves a multifaceted, public and private partnership, but the Government has to lead on this through the inaction of relevant laws and provision of training programmes, monitoring and evaluation etc.

Without health, life is not life; it is only a state of languor and suffering.     

Francois Rabelais

 

Author:

Adaku Efuribe

Clinical Pharmacist/UN SDG Advocate

 

Health

Amref Health Africa Kenya Partners with Sisu Global Health and Surgipharm to improve access to blood

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Nairobi, Kenya, 17 September 2019 – Amref Health Africa in Kenya, Sisu Global Health and Surgipharm have today unveiled a partnership to improve access to blood and safer surgical outcomes during medical missions and emergencies in Kenya.

The partnership is aimed at increasing blood access in all hospitals to reduce internal bleeding-related deaths through the adoption of HemafuseTM, an innovative medical device that allows clinicians to reuse a patient’s own blood gathered from internal bleeding.

This initiative comes in the wake of the recent move by the US President’s Emergency Plan for AIDS Relief (PEPFAR) to stop its annual funding of KShs2 billion for blood collection and testing services in Kenya. This development comes at a time when the country is facing a chronic shortage of blood as the collection of blood has been plagued by the lack of funds for screening tools and human resources to collect and store blood.

“Blood access is critical to safe surgery. Standard surgical practices require two units of blood on-hand before surgery commences, but there is a severe shortage of blood in the country. Surgeries may be delayed or not performed due to a lack of blood, resulting in increased illness and death. This partnership will make use of an innovative solution that will ensure that patients with internal bleeding have a chance of survival,” said Amref Health Africa in Kenya’s Country Director, Dr Meshack Ndirangu.

HemafuseTM, a product by Sisu Global Health, can filter and pump blood from an internal haemorrhage into a blood bag, allowing it to be re-transfused to the same patient. The device can also be reused up to 25 times. This provides an alternative to donor blood.

“It is inspiring to see Hemafuse used to save lives. With this partnership with Kenya, we look forward to enabling thousands of more clinicians to save more lives across the country. The work we are doing is incredibly important and we are proud to have such a strong partnership with Amref to provide access to blood across Kenya,” said Sajju Jain, Chief Operating Officer at Sisu Global Health.

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Speaking at the event, Mr Rakesh Vinayak, Director-Sales & Marketing at Surgipharm, said that the pharmaceutical industry has a critical role to play in finding effective and sustainable solutions to providing access to today’s most pressing health concerns. “Surgipharm has a highly specialised and experienced management team and our relationships with different players in Kenya’s health sector complements and strengthens our existing skill set in logistics across the country. We are excited about the prospects that this partnership brings.”

Amref Health Africa

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Memfys Hospital and GE Healthcare Collaborate to Improve Disease Diagnosis for Nigeria’s South-East Regions

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Memfys is the first hospital in South-East Nigeria to install GE Healthcare’s SIGNA™ Explorer 1.5Tesla MRI system

LAGOS, Nigeria, August 29, 2019 – The collaboration will help provide innovative technology to enable early diagnosis and detection of diseases; Memfys is the first hospital in South-East Nigeria to install GE Healthcare’s SIGNA™ Explorer 1.5Tesla MRI system.

GE Healthcare has partnered with Memfys Hospital to provide the SIGNA™ Explorer 1.5Tesla MRI system services and training to advance early diagnosis of diseases. By providing clinicians with detailed information about diseases such as cancer, neurological disorders and heart diseases, the new equipment will help the hospital to deliver high quality medical services and better care to more patients across the region.

As the only dedicated Neurosurgery hospital in South-East Nigeria, Memfys Hospital is serving a population of over 60 Million People. Investing in the latest technologies such as the SIGNA™ Explorer 1.5Tesla MRI system will help improve the hospital’s diagnostic capabilities for early detection of diseases and at the same time keep up with global best practices to provide the very best for the country and West Africa region at large.

“As a leader in the neurosurgical space, we are committed to continue providing high quality patient care using modern, high tech and reliable equipment that meets the recommendation by the World Federation of Neurosurgical Societies (WFNS). Acquisition of the SIGNA™ Explorer is a huge milestone towards this commitment,” said Professor Samuel C. Ohaegbulam, CEO Global Memfys & Co Ltd.

To ensure sustainability of such investments, Memfys hospital is providing training for both young and experienced doctors embarking on a career in Neurosurgery and Spinal surgery. The hospital is accredited by the West African College of Surgeons (WACS) for full training in neurosurgery making it the only private health institution to enjoy this status in all of Africa. To date, Memfys has trained 20 neurosurgeons and about 10 senior residents.

“We are committed to continue collaborating with both private and public partners to co-create solutions that help tackle pressing healthcare challenges for our region such as Noncommunicable diseases (NCDs), as we strive towards Universal Health Coverage. With the SIGNA™ Explorer 1.5Tesla MRI system, the people of South-East Nigeria will not need to leave the region for such specialized services as it has been the practice in the past,” said Eyong Ebai, General Manager for West & Central and French Sub-Sahara Africa Region.

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According to WHO’s 2018 report, NCDS including stroke, cardiovascular diseases, cancers, chronic respiratory diseases  and diabetes are estimated to account for 71% of the 57 million global deaths, while in Nigeria NCDs are estimated to account for 29% of all deaths (2.1M). Early diagnosis of diseases such as cancer improves outcomes by providing care at the earliest possible stage.

– GE.

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Egypt denies postponing official launch of health insurance system

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Hala Zayed, Minister of Health Pic: Egypt Today

CAIRO – 29 August 2019: Egypt denied delaying the official launch of the comprehensive health insurance system in Port Said, which is scheduled for the first half of coming Septwmbwe, due to failure of teh pilot phase, according to the cabinet’s media center.

Ministry of Health confirmed that the effective implementation of the system will start in the first half of September, especially after the success of the pilot, the center added in a statement.

Earlier in August, President Abdel Fatah al-Sisi called for implementing the health insurance system, taking into consideration the technical, human and medical sides to ensure the good quality of medical services.

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In July, the pilot operation of the comprehensive health insurance system in Port Said governorate started in July.

Prime Minister Mostafa Madbouly said earlier in a press conference that the governorate will be the first to benefit from the new system through 11 general and specialized hospitals and 32 healthcare units.

– Egypt Today 

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