By Hassan Zayamu
Professor Oladapo Ladipo is a globally renowned Obstetrician and Gynecologist with many decades of experience in the health sector. He has also invested many years in consulting and initiating public health program interventions.
Prof Ladipo is the Lead/Co-founder, President and Chief Executive Officer of the Association for Reproductive & Family Health (ARFH ). He is also the Grand Patron of National Advocates for Health (NA4H) in Nigeria.
In this interview with our guest reporter, Hassan Zayamu, Prof. Ladipo spoke on a wide range of health issues including Universal Health Coverage (UHC), health insurance, health literacy, the relevance of Traditional Birth Attendants (TBAs) among others. Excerpt.
The theme for this year’s World Health Day is ‘Building a fairer and healthier world.’ How can we achieve this in Nigeria considering the level of inequity in our healthcare system?
The best approach to have access to quality health services is for the government to ensure that they implement Universal Health Coverage (UHC) and that the citizens have insurance cover to enable access healthcare services, be it at the Primary Health Care (PHC) level, the secondary healthcare level or the tertiary level.
Government policy is very instructive and if the policy is implemented satisfactorily, by provision of adequate funding and oversight on the judicious use of the funds, there is no doubt that all citizens of Nigeria will have access to good quality healthcare service.
We don’t have that luxury at the moment, but we are putting structures to ensure that Nigerians have access to healthcare services that they need.
Do you see making health insurance mandatory in Nigeria a possibility, due to the fact that most times, Nigerians are good are resisting government policies?
Universal health insurance programme for the citizens will guarantee that majority of our people have access to quality healthcare services. But as you know, poverty is endemic in this country and majority does not have a regular source of income. If they cannot pay for their premium, then they will be denied health access.
This is why the National Health Insurance Scheme (NHIS) community scheme should be able to accommodate those who do not have access to high income engagements. There is no doubt that at the end of the day, what the government aims is that the citizens have access to healthcare services.
The Basic Health Care Provision Fund (BHCPF) if well implemented will guarantee that. This is the federal government working in partnership with the states to make sure that the health care systems in place are functional.
Do you see Nigeria attaining UHC in the very near future bearing in mind the myriad of challenges in our healthcare system?
It is not impossible. It is doable if you have a committed government and committed institutions to implement the policies. I can see in the future that we have universal health coverage. It has been done in other countries; there is no reason why we cannot do it here. It is the political will to do so that is important. That political will can be generated even from the community expressing their desires to their legislatures. It is doable if every political party takes health as a priority and make sure that they fund it adequately and also make sure that the facilities available are well equipped and well-staffed.
For example, areas where there are shortages of personnel, we have the people who have retired from active service before the age of 60, they can be reengaged and post them to rural areas which many of them do not mind going to. This could be attractive if they give them enhanced salary to make them comfortable in rural areas.
I think also that the issue of tribalism should not be there. There is no reason why a Yoruba man cannot go to the north to work or Hausa goes to the East to work. There are just some cultural issues rather than religious issues that are preventing such policy to be implemented.
What do you think the government can do differently to improve health literacy in the country?
The best ally is the media. For example, if I want to be the president or the governor and I don’t have the media on my side, I will fail woefully. The media should be able to tell people on a daily basis what type of foods are good. The media should be able to tell parents not to feed their children with food stuff that are bad and harmful to their health. Especially fast foods like hamburgers and even noodles. We call them noodle babies- they are fat and plumb. It is a disaster in the future. They have the risk of becoming diabetic, hypertensive which can kill them prematurely. The media should be able to tell them what age-specific balanced diet is.
The media should be able to tell pregnant women that it is important to go to the health facility. Pregnancy is not just a simple encounter, physiologically, the whole body is affected. Hardly can some people deliver alone. It is risky. It must get to a point where people know that they must be delivered by a skilled birth attendant. This is what we mean by health literacy. Once you know what to do when you have certain symptoms and signs, then as an individual, you live a healthier life.
Do you support the idea for government incorporating Traditional Birth Attendants (TBA) in the health care system in the whole country?
To me personally, the Traditional Birth Attendants (TBAs) have a role to play in the healthcare system in the country. They live in their communities, two; they are respected by their communities, three; they can help to educate their neighbours about health issues. They can help to monitor pregnant mothers in their communities. They can help take pregnant mothers to the hospital anytime they have problem. They can ensure that pregnant mothers understand the rationale of sleeping under the insecticide treated mosquito nets. They can also make them understand the rationale of taking ion and folic acid, the need to go for antenatal care and the need to go to the hospital if the water licks out. They can also help the mothers understand that after delivery, they must breastfeed their babies. That is exclusive breastfeeding for at least, six months.
The TBAs can also help make women know the danger of having multiple births- too many pregnancies and too many births because of the risk of dying in the process of having too many pregnancies. The TBA can provide all these services. They don’t have to take delivery. So, they are still very relevant.
Like I said, even in Lagos state, they government recognized the TBAs and trained them.