 Well, we're back with the breakfast and at this point we'll be looking at health I mean it's been reported and believed that health is wealth Well health experts and officials in recent health dialogue session That was held in the FCT server to make the primary health care work the federal government must ensure adequate welfare and a room Renumeration of service providers at the grass road as Nigerians plan to elect a new set of leaders in 2023 they are urged To make issues of health security and financing key subjects of conversations in their interactions with candidates The complex and fragmented institutional arrangement between the local state and federal government Constraint the delivery of public health services in Nigeria. There's also constrained for the primary health care delivery As well as other sectors stakeholders also noted that there are no adequate resources to sustain the available Doctors and health care providers and this is in this needs to be addressed That's why you have a lot of people who are moving away in a term that we call the jack-by-syndrome In another quits also in other quits month power is also concerned for the health sector according to the Nigerian Medical Association the NMA there 110,000 registered doctors in previous years but as of April 2022 the number of doctors had reduced to 55,000 and Joining us to discuss for that is dr. Neso Chi okirike or KK Ibukwe who is a health expat She joins us this morning from the US. It's good to have you join us Neso Chi. Good morning Good morning Well, I'd like you to talk about this We it's very important that and very commendable that we have health experts in Nigeria sharing concerns about the primary health care But if you look at the primary health care now one of the issues in financing is that the system and the structure is fragmented so Local government is a thought here of government But the local government is not really independent of the state government And so the local government has been left underdeveloped now up until recent time you still have Lawmakers in the different parts of the state Who have rejected the autonomy and financial administration for local government? So how can we? achieve health care security with all of this The infrastructure when it comes to health care in Nigeria as stated is extremely extremely fragmented we need to focus on Certain aspects that need to be strengthened there's usually this tuning triad of three problems when it comes to health care in Nigeria that encompasses the following access to health affordable health care and quality health care But what we need at this point is to have a leadership that is accountable for not only improving health policy but improving funding when it comes to these aspects of Fortifying the health care sector One point that needs to really be focused on as you mentioned is what we call primary Healthcare preventive health care the World Health Organization actually had a call to action to Nigeria recently to focus on these on this specific element of Healthcare to fortify the health care system in the country now What does primary health care or preventive health care actually look like when we're talking about preventive health care? We are talking about every Nigerian Having the possibility to have annual health checkups Which means that you are seeing a qualified doctor on an annual basis to test and screen for age-specific health issues and concerns so screening would include screening for blood pressure Screen for issues with diet for diabetes screen for issues having to deal with cholesterol. We're also doing Cancer screening as well Based on age age appropriate cancer screenings that might encompass breast cancer screening cervical cancer screening Fallen cancer screening and what research has showed on in the various Countries when there is this focus on preventive care this ultimately translates into improved health outcomes for the nation and also becomes cost-effective because if you are preventing Disease before it spirals out of control. There's less money that has to be placed into Treatment so the overall goal is ensuring that we have these practices in place in Nigeria So that there so there is access to improved care for all Nigerians So, um, I like to put this back to you You know the way it's been structured in Nigeria is that you have government as a third tier So you have the federal government you have the state government and then you have the local government now the local government should be responsible for You know the Healthcare primary health care. That's that's what it should be. Okay, the secondary You know should be that consent of the state government and then of course a tertiary should be the concern Well, however, the local government would need the support of the state and the federal but my concern is now that The autonomy for and financial administration of local government has been rejected in the constitutional review process How then can you know the people push for the security of the health care in Nigeria? So, how can the people push for security of healthcare in Nigeria? Guess what? There's an election coming up. You have the opportunity to vote for leadership That will actually be accountable for and listen to the needs of the people You have to take a look and see which leader you believe is going to actually adequately address these issues Four years ago in the 2019 election prior to that. I wrote this article a vote for your health actually Illuminating some of these items that need to be brought to light to our and Guess what to date some of these action items have not occurred So health policy needs to really be reviewed and really needs to be strengthened But we need leadership that is actually going to take action a lot of the problems that you are Bringing to light really is going to be transformed when you have those that focus on Health care as a major issue in this country, of course, we have many issues in Nigeria Yes, there's fuel scarcity. There's Naira scarcity There's overall insecurity, but guess what the issue with this weekend Fractured health care system is one that has been ongoing for years What we do not want to happen is four years from now. We're still talking about the same problems and issues So again, this all comes down to leadership and it all comes down to everyone Really making that effort to Focus on voting for those leaders for that leader I should say that will bring about this form of change in this in the health care center Well, I also like you to speak to the fact that if the people Have to probably vote for I mean you say we're saying that if vote for You know health is very important in the common elections and It's still very dicey. I mean I doubt that we can probably achieve that, you know now because If you say we're going to get to another Constitutional period a process where laws are being made to enable the people Get what they should get now we have actually passed that process just few days before the elections One is just wondering what we can achieve But I like you to also speak to our budget allocation as well over the years We we seem not to have a located enough, you know to meet up the needs in the health care sector and Also, if we're still talking about the elections We still have a lot of persons who will be on their way out or already on their way out the number of doctors Those who should attend to Patients in Nigeria every other day. You have a doctor or medical practitioner leave in the country So how can we also address all of this within this period of the elections? So there are multiple issues that you have brought to light one of them being Funding that is going into the health care sector. I'm ultimately more funding does have to be Placed on health care in the country, but Another important issue is what you alluded to the Nigeria brain train. We have a lot of Nigerian doctors that leave to go abroad to practice on in the US and the UK Elsewhere for various reasons. Why is that? I speak to my colleagues in Nigeria all the time and they bring to light some of the actual issues that occur with the practice of medicine in the country One of them being Having the adequate resources actually do what a doctor has to do to take care of Their patients. We have this lot of resources That does not enable a doctor to really do the best that they can do for patients there's a scarcity of these resources that just Translates into or how outcomes? Um, I want you to think about maybe somebody in your life all of you or somebody in your life that has suffered an issue with their health in Nigeria and it could have been Prevented it could have been prevented. Maybe if we had adequate resources Maybe if we had more doctors on board to take care of the patient to provide Quality care all these things need to be really taken a look closely at One issue I have to also mention that some of my colleagues that so practice in Nigeria tell me about Is even getting the salary that they're supposed to be guaranteed There's some doctors out there that they will practice take care of patients They don't have the resources that they require to do that good job of taking care of patients But at the end of the day Salaries that are promised are not to them so It lends for one to think You know, what are they still doing in Nigeria if they don't even have the salary that they are Required if they don't even have the resources that should be available to every doctor But there also needs to be a focus on retaining quality Qualified doctors in the country that do want to continue to practice here if they are afforded Opportunity that doctors everywhere else in the world Obtained, so that's another issue to consider as well So let's talk about the role of the private sector. We understand that in developed climes Just like where you are you have the private sector involvement You know in health care delivery and of course primary health care, what of you? What exactly can the private sector do and how can they key into developing, you know, the health sector in Nigeria? So private sector there's a lot that can done there needs to be kind of a mutual workforce with private and public sector to collaborate to Allow for certain health initiatives to occur and not just in regards to preventive health But certain areas that affect both private and public Sector when it comes to things like disease Outbreak one of the major issues that the typically see irrespective of preventive health is Disease outbreak we know especially here in Nigeria that there is always going to be Some disease outbreak of some sort. We've had disease outbreaks with lots of fever Of course, we are still in a global pandemic with COVID-19 and when you think about that we need to make sure that we actually have both private sector and public sector unifying in order to strengthen the efforts to ensure that we have adequate epidemiological Surveillance that we have their resources when it comes to certain vaccinations and that we promote education Amongst the people to understand what some of these outbreaks really mean It's never a matter of if there is going to be another Outbreak of some of the disease. It's a matter of when So considering that we know that there is always a potential for disease outbreak in the future It comes down to the collaboration Okay, so yes on the 25th of I mean, I know you've spoken to this but on the 25th of February hopefully and on the 11th of March Nigerians would actually Be going out to the polls to cast your vote for who Becomes the next president precisely on the 25th and of course the 11th governors and state House of Assembly Representative, I'd like you to speak to that now we are grappling with a lot of issue of vote buying It's very easy. I mean, it's a major issue in the sense that people would always want to you know Take money or whatever it is just to cast your vote for whoever is going to be it for it and How can that be you know, how can we get rid of that? Especially when we're thinking about improving the health sector. So I'd like you to speak to that in in a few seconds I mean, unfortunately, there is always that element of potential corruption when it comes to Elections and I understand and I hear what you're saying about Buying of certain individuals, but I think Every voter really needs to look at the big picture You know look deep into your heart and think about what you want the future of Nigeria to look like What you want the legacy of this country to be are you going to be on? Nigerian that is basically ingrained in these kinds of actions of vote buying and potential corrupt activity just to get an immediate gain of some sort or Are you going to look towards the future of your life of your family of the health of yourself and all the individuals in the nation to Hopefully hopefully Transform the landscape of things in Nigeria so that future generations come Will ultimately note that at this time this point in time of the election of 2023 that Steps and strides were made To have a better health sector in this country to have better health care for every single Nigerian health care essentially is a human right and no one should really Impede that ability for every Nigerian to be taken care of when it comes to their health All right, dr. Nesou chi ok k e bookway. We'll have to go now Thank you so much for making our time to be with us We do appreciate your thoughts this morning on the breakfast and of course we look forward to sharing more of your thoughts as we proceed in 2023 Thank you for having all right then do have a great day We have been speaking with a health expert all the way from the United States of America dr. Nesou chi ok k e bookway And that's the size of it. It's important that you Vote for your health security as you go out to cast your vote Please and please the temptation might be high to sell your vote But please do not because you know come back at you make sure that you cast your vote for those who have your interest in different sectors of the economy and having policies that will protect your interest as well And that's the size of it will join the newsroom at 9 o'clock for the news brief If you missed out on a part of the conversation You can be part of it via social media and Facebook Twitter and Instagram and subscribe to a YouTube channel at plus TV Africa and Plus TV Africa lifestyle. My name is messy a book will do this tomorrow. Have a great morning