Source: Leadership Newspapers
Nigeria, accounting for 47% of the population of West Africa, according to experts at a 5-day workshop organised by Africa Leadership Forum (ALF), has a moral responsibility to lead the continent towards achieving the Millennium Development Goals (MDGs). Yet its health system is ranked 187th of 191 WHO member states. Writes PEMBI STEPHEN-DAVID
Lending credence to this ranking are health indices such as an infant mortality rate of 101 per 1000; maternal mortality rates ranging from 500 per 100,000 in the South West to 800 per 100,000 in the North East (Partnership for Maternal, Newborn and Child Health, 2006), prenatal mortality rate of 48 per 1000 and child mortality rate of 205 per 1000 (UNICEF State of the World’s children, 2006).
Speaking on ‘Maternal Health in Nigeria’, Professor Friday Okonofua said the goal 5 of the MDGs, ‘‘anticipates a reduction in the maternal mortality ratio by 75% between 1990 and 2015. A near-term evaluation has shown that it is possible to reduce maternal mortality by three-quarters within 25 years in some countries. By contrast, due to inadequate demographic, economic, political and socio-cultural circumstances, it is unlikely that Nigeria would achieve the goal in 2015. However, we must not lose faith – we must remain focused on the MDG target, while thinking beyond 2015 and keeping an eye on the broad picture.’’
He argued that, ‘‘high level political will and a strategy that encourages the alignment of our maternal health strategy with the overall development plans of the country are vitally needed. The vision 20:20:20 for example, must not only target the overall economic growth of the country, it must also focus on ensuring the overall improvement of the living conditions of Nigerians.’’
Okonofua suggested that, ‘’ a significant and sustained reduction in maternal and neonatal morbidity and mortality will provide the best evidence that this has taken place. Concerted effort is required at all levels, from international to in-country efforts and among community stakeholders, health professionals and academicians. A strong political leadership that understands the multi-dimensional nature of the problem and that has an eye for social justice, equity and protection of the rights of its people is needed to drive the mission for the sustained reduction in maternal and neonatal morbidity and mortality in Nigeria.’’
Commenting on ‘legislative Agenda and Programmes for Health Delivery System in Nigeria’, Hon Dr Wale Okediran, former member, Federal House of Representatives, said that, ‘‘Although the National Health Policy advocated a minimum of 10% of the overall budget to be devoted to Health, many state governments as well as the country itself hardly allocate up to 5% of the budget to Health. Even when this allocation is done, average percentage of release is around 50%. With this poor funding, health care delivery suffers a lot in the country.’’
Okediran advised that, ‘‘it is essential to entrench an evidence-based approach to decision-making at all levels of the health system by application of health information systems. This could be addressed as the Federal Ministry of Health improves its capacity to generate and share necessary health data thus funding may have to be increased and appreciation for research promoted.’’
Delivering a paper titled ‘Achieving the Health Related MDGS’, Dr. Jerome Mafeni, Nigeria Country Director Global Health Group, said, ‘‘Nigeria is making progress towards the attainment of the MDGs though the results are mixed. Adequate, reliable and timely data is a requisite for accurately measuring and tracking progress so National Bureau of Statistics and MDAs need to be strengthened. Low performing states will always affect the attainment of national targets. Conditional Grants Scheme is an effective mechanism for delivering funds to the local levels as it encourages governance reforms.
Targeted interventions matched with adequate funding and political commitment works. ’’
While welcoming participants on the opening day of the workshop, the Executive Director of ALF, Mr Ayodele Aderinwale, MFR, said the organisation lunched the Parliamentary Support Institute for Nigeria in 2005 to deliver capacity building programmes for state and national parliaments. He said ‘‘the free training programme was conceived to equip participants with requisite technical skills required to improve the performance of parliamentarians in their oversight and legislative functions.’’
Aderinwale revealed that, ‘‘ The Africa Leadership Forum decided to focus on training parliamentary support staff instead of legislators due to the advantage of sustainability as support staff remain with the assemblies even after legislators are voted out of office.’’ He encouraged participants to utilise the knowledge and experience shared by resource persons. ‘‘The resource persons are well schooled in the areas of discourse, you are at liberty to ask them questions that relate to the sessions they handle.’’
With support from the Norwegian Ministry of Foreign Affairs through the Royal Norwegian Embassy in Nigeria, Mr Atom Lim, ALF’s Publications Manager explained that ALF is expected to deliver a total of 12 workshops between 2010 and 2012. Each of the workshops has been dedicated to a specific theme and a network of Parliamentary Support Staff expected to be formed at the end of each workshop as an advocacy and resource base in their respective assemblies. ‘‘It is expected that an estimated 360 technical competent and professionally committed parliamentary support staff of various Nigerian parliament would have been trained at the end of the project in 2012,’’ he said.