‎Nigeria doctors commence ‘total and indefinite’ strike, Tuesday – NMA President

The Nigerian Medical Association, NMA, on Monday announced plan to embark on an indefinite strike, starting from Tuesday, July 1.

The NMA President, Kayode Obembe, who made the announcement at a news conference in Abuja, said the decision followed the expiration of a two-week ultimatum it gave the Federal Governmentto meet its 24-point demand.Mr. Obembe, said the association opted for a “total and indefinite strike” at an emergency delegates meeting held on June 28, after negotiations with the federal government failed to yield relevant results.

“The NMA is taking this painful route because our silence and gentle approach to these contending issues have been taken for granted,” he said.


“We have to take this action in order to save the health care delivery system from anarchy that is palpably imminent.”

He appealed for understanding, and called on Nigerians to prevail on the government to meet the demands.

The NMA president read out an open letter addressed to the Secretary to the Government of the Federation in which the association listed the 24 ssues it wanted the government to address.

The letter, entitled, “Minimum End Point for Restoration of Sustainable Sanity in Patient Care in Nigerian Hospitals’’, was jointly signed by Mr. Obembe, NMA Secretary-General, Adewumi Alayaki,and all heads of its affiliate bodies.

Some of the major issues include reserving the position of chief medical director to only medical doctors, appointment of Surgeon General of the Federation, passage of National Health Bill and providing security for doctors.


The NMA also wants “increase in duty, hazard and specialist allowances, as well as budget for residency training programme”.

It called for the reintegration of its members into the IPPIS platform, and reserving the title of consultants to only medical doctors, among others.(NAN)

Source: Premium Times

FG Moves to Address Shortage of Health Workers

Concerned by the shortage in human resource for health and in an effort to correct the imbalance in quantity and mix of health workers in Nigeria, the Federal Government has inaugurated two committees.

Minister of Health, Christian Onyebuchi Chukwu, inaugurated the committees in Abuja, on Friday.

They included committees on Nigerian Public Health Training Initiative and the National Steering Committee on the Nigerian Health Workforce Registry.

While inaugurating the two committees, Chukwu said that Human Resources for Health are the cornerstone of the health system and that no intervention can be successful in the sector without an effective workforce.

He argued that, "providing the best equipment in our health facilities without health workers with the right skills in the right quantity and mix will not produce the desired improvement inour health indices."

Chukwu lamented: "Human Resources for Health is faced with myriad of challenges globally, regionally and nationally which includes inappropriate and inadequate training with curricular that are not needs-based, poor access toinformation and knowledge resources, inadequate numbers of skilled health workers, mal-distribution at different levels of service delivery to mention but a few."



The Health Workforce Registry, according to him, would serve as check and balance system; monitor progress towards production of required health personnel; provide real-time data on the availability of required health personnel at each level of the healthcare service delivery system as well as retention of skilled healthcare workers at all levels inan equitable manner.



Speaking, the World Health Organisation(WHO), Country Representative in Nigeria, Ruiz Gama Vaz, said that inadequacies in number, mix and quality of human resources for health posed greatest challenges to the health system's capacity to deliver effective and equitable health services.He stressed that addressing health workforce shortages, competencies and productivity are critical intervention to undertake.

Source: Independent.

India moves to establish hospitals across Nigeria

“As the new India High Commissioner to Nigeria, I feel it is too expensive for Nigerians to continue to go to India for medical attention.

“We have discovered that the costs being paid by a Nigerian patient going to India for treatment is even more than the treatment itself.

“What we have, therefore, decided is to have many Indian hospitals come to establish themselves in Nigeria’s six geopolitical zones.

“We strongly believe that with the spread of Indian hospitals in this country, Nigerians may not have to travel to India for any treatment,”

“Gradually, we want Nigeria to stand on her own strength and be the beacon of medical strength for the rest of West Africa,’’Rangaiah Indian High Commissioner to Nigeria.

Delegates Reject Creation Of Surgeon-General’s Office

Delegates at the ongoing National Conference have rejected a proposal by the Standing Committee on Social Sector headed by Iyom Josephine Anenih that an office for the Surgeon-General of the Federation be created.

Earlier before the resolution at plenary yesterday, a group of delegates had rejected the proposal for the establishment of the office ascontained in the report of the committee, which was presented and debated at plenary.

The delegates, in a motion paper distributed to delegates and the conference leadership titled “Motion Submitted To The National Conference Against The Establishment Of The Office Of The Surgeon-General Of The Federation,” also urged other delegates at plenary to reject the proposal as well.

The 37 movers of the motion led by Dr. Uno Uwuga, added that the office in question is alien to most health systems worldwide and will amount to further bureaucratisation of the structures of the health system without additional value.

“The conference should advise the Federal Government against unnecessary duplication of offices orcreation of new bureaucracies in the health system that does not add any value to the primary task of providing quality health services to Nigeria.The conference should not entertain the proposition for the establishment of the office of the Surgeon-General of the Federation,” they said.

The motion was however overtaken by events as conference already rejected the proposal ahead of entertaining the motion.

Meanwhile, delegates at plenary resolved that free-healthcare including free maternal services and free school health programmes be established for children aged 0-5 years; senior citizens from the age of 65 years; persons living with disability or the physically challenged persons.

In the same vein, delegates also unanimously decided that a social security policy be put in place to cater for the wellbeing of the elderlyin addition to the pension policy.

Source: Leadership Newspaper

HIV battle: Uganda tests out rubber band circumcision

The simple device two plastic rings and an elastic band -- cuts off blood supply to the foreskin, which then shrivels and is removed with the band after a week.

"I felt nothing, not even a little discomfort," Igalla said after a procedure taking just minutes, noting there was no blood -- unlike traditional circumcision where the foreskin is sliced off by knife --thus reducing the risk of infection.

Igalla, a father of two, said he opted to have his foreskin taken off for "health reasons".

Scientists have found that male circumcision can significantly reduce the chances of HIV infection because the foreskin has a higher concentration of HIV-receptors than the rest of the penis and is prone to tears during intercourse, providing HIV an entry point.


As well as Uganda, the device is being used in Botswana, Kenya, Mozambique, South Africa, Zambia, Zimbabwe and other sub-Saharan countries.

All have been identified by the World Health Organization (WHO) as "priority" states where the risk of acquiring HIV is high and male circumcision, and access to conventional surgical procedures, is low.

Uganda hopes the device, called PrePex, will convince adult men to be circumcised as part of the battle against AIDS, now resurgent in the East African nation after years of decline, with as many as 80,000 people dying of the disease every year.

From a peak of 18% infected in 1992, Uganda's "ABC" strategy --Abstinence, Be faithful, Condom -- helped slash rates to 6.4 percent in 2005.But rates have crept back up, to 7.2% in 2012.

As many as 1.8 million people in the country now live with HIV, and a million children have been orphaned after their parents died of AIDS.

The makers of PrePex boast that a man"can resume work and almost all daily activities shortly after the procedure," with the device "designed to be placed, worn, and removed with minimal disruption", although they should abstain from sex for six weeks afterwards.

Doctor Barbara Nanteza, male circumcision project manager at Uganda's AIDS Control Programme, said that trials had shown that circumcision reduced risk of transmission from a woman to a man byas much as 60%.

Although some contest the validity of thesestudies, WHO and the United Nations AIDS programme push circumcision as an additional prevention measure in high-prevalence countries where HIV transmission is predominantly heterosexual.

The WHO says there is "compelling evidence" circumcision reduces risk of heterosexually acquired HIV infection in men. The organisation has "prequalified" PrePex, meaning the device has been assessed and meets international standards for efficacy and safety.And with health budgets already overstretched, the device offers a cheaper way to tackle the problem, Nanteza said.

"If circumcision can help reduce the cost, that could very good for the country," she told AFP.

Uganda, long praised for its efforts in the fight against AIDS, launched a general circumcision programme in 2010, when some 9,000 had the conventional treatment.Since then 1.2 million men have been circumcised -- or 13% of men over 15, including 800,000 last year alone, the health ministry said .

The introduction of the PrePex device is expected to boost numbers even further but it's still not enough, according to Nanteza.

Though the device greatly reduces the pain of traditional circumcision, she conceded the issue remained an awkward one for married men.

"It is difficult for them to explain to their wife that they want to get a circumcision to prevent HIV infection when they are supposed to be faithful to them," Nanteza said.

Despite massive health awareness campaigns, problems remain.James Brian, a counsellor with the Walter Reid Project, a US-based medical organisation supporting the programme, said it was essential to emphasise that while circumcision reduces the risk of infection, it does not prevent it.

"After circumcision someone should not think that they are immune against HIV," Brian said, who works with patients to highlight the continuing need to practice safe sex.


Source: Times Live

Yayale Committee Sitting.

Summary Of The Yayale Ahmeds Presidential Committee On Inter-Professional Relationship In The Public Sector: Interactive Session With Stakeholders.

Meeting started with silent prayer by all the attendees at exactly 11am. Introduction of all participants and the associations they represent was done.


The Chairman, Alh. Yayale Ahmed welcomed everybody and stated that, he hoped the committee would find a lasting solution to the disharmony among the stakeholders in the health sector. He promised the committee would do a thorough and perfect job and be an unbiased umpire. Not the headship of the organisation that matters but raising a team to deliver the best for our patients in line with the best practices across the globe. He prayed, this would be the last face off and disharmony in the health sector.

He further stated that all memoranda submitted by each association and regulatory bodies were carefully gone through so all we needed to do was for each association to present what should be solutions and the way forward. Each association was given 7mins to makeher presentation and 2mins to conclude.

AMLSN;

Accused ASSOPON of not changing from the old practice, which gives room for anachy in our laboratories.

APN;

Demanded for an Organogram which should have a Pathologist as the undisputed head of the team in accordance with MDCN Act.

Assoc. of Radiographers of Nigeria(ARN);

Accused the Radiologists of not issuing reports on time, which they claimed is largely due to maladministration of the head of the department of radiology.Their prayers are;
1. Radiographers to be allowed to scan the patients as this is now done in the advanced countries.
2. Radiographers should be allowed to report their films.

Committee of Heads of Pharmacy in Nigeria Health Institutions;

They alleged;
1. Repression from Doctors.
2. Their fellowship not backed by any circular, so they want the fellowship to be recognised in the scheme of service and remunerated accordingly.
3. There's stagnation in their carrier progression which should be corrected.

Environmental Health Officers Association;
1. Functions are streamlined in the ministry
2. They want a directorate of environmental officers in the ministry.
3. Recruitment of more environmentalists.
4. From the Ministry of Health, ministry of preventive health should be carved out so as to resolve role conflict that is in existence presently.
5. Adequate and sustainable budgetary allocation.
6. Department of environment should be captured in the 3 tiers of Govt.


Guild of Med. Laboratory Directors;
1. Their colleagues in the public sector are repressed.
2. The infighting among stakeholders should stop.
3. Employment of Auxiliary technologists should be discouraged.
4. Allow independent observers to inspect laboratories both within and outside the hospitals.
5. Respect the rule of law.

Health Information Managers Association of Nigeria:
1. They alleged complete neglect.
2. Not allowed to rise to the peak of their profession.
3. Exclusion from decision making in our hospitals.
4. Hippocracy of the managers of our hospitals.

Prayers;
1. Record officers to be drafted to all departments in the hospital eg NHIS, A&E etc.
2. Records dept to be operated electronically
3. A curriculum should be developed for them within the university system in Nigeria.

JOHESU:
1. NMA is not a registered labour union, it's a professional association operating as a labour union.
2. The extant Labour laws in Nigeria as well as International Labour Organisation laws should be adhered strictly to by the Govt.
3. JOHESU under it has 5 registered unions hence can negotiate with the Govt.
4. Clinical services in our hospitals can be headed by doctors but the head of health care services should be left open for any qualified health managers.
5. They desire equity, fairness and justice in the health sector.

MDCAN;
1. Medicine should be practiced according to international best practices.
2. All areas in the health sector has a doctor consultant in that field so creating a non doctor consultants will bring chaos and anarchy in such department and who will take the ultimate responsibility of patient care?
3. The laws regulating medical practice in Nigeria need to be amended.
4. Surgeon General of the federation or Chief Medical of health office should be resuscitated.

MHWUN:
1. The headship of our institutions should not be the exclusive right of doctors, every other professional in the health sector should be able to apply for the post or in the alternative a professional administrator to manage our health system.
2. Doctors dominate all the directorates in the ministry of health.
3. Salary relativity should be equitable, they want a single salary structure in the health sector.
4. Entry points for all graduates in the health sector to be level 9.
5. Advocated a health summit.

NAGGMDP;
1. Medicine is an act with a team work hence we need a leader in that team who is a doctor.
2. Appropriate regulations from all regulatory bodies should be sought after.
3. Indiscipline and insubordination should be tackled frontally.
4. Each professional should know his/her limits
5. Respect team work and leader.
6. Office of the Chief Medical of Health or Surgeon-general should be resuscitated.
7. Relativity as it is practised world over should be maintained in our health sector.
8. Conflicting laws governing health care delivery in Nigeria should be abrogated.

NANNM;
1. Training, skill acquisition, and service delivery have moved up.
2. Nurses are not seen and recognised as a professionals
3. They want intenship program for graduate nurses.
4. Fellows of postgraduate nursing college should be recognised as consultants.
5. Incursions of doctors into their profession eg. midwives are no longer allowed to take deliveries in teaching hospitals, Nurses no longer do wound dressing on the ward.
6. Doctors as the head of the team that they claim to be must carry everybody along.
7. Other professionals in the health sector must be allowed to head the hospitals.
8. Doctors should see others as colleagues and not look down on them.
9. All laws should be harmonised

Nigeria Dental Therapist Association;
1. Nigerian university should be allowed to train them in other words, they want to start getting BSc degree.
2. It's a branch of Dentistry but they are not allowed to do their job because of hierarchy in the system.
3. Disparity in the call duty allowances between them and the Dentists is too wide. 1.2 to 7.5%.
4. There's no provision for their freshers to do internship which they want government to make provisions for.

NMA:
1. Medical practice is about patient care therefore, adherence to core professionalism, job description and definition in accordance with international best practices should be our focus.
2. Adherence to principles of relativity in line with training, levels of responsibilities etc, should be strictly observed.
3. Appropriate no-skewed job evaluation facing the reality, as against 2008 evaluation report that NMA refused to sign because of the fraud detected in it.
4. Total avoidance of nomenclature and designations alien to medical practice.

Nigerian Optometrists Association;
1. This profession is supposed to be responsible for primary eye care in our society, but they are not allowed to do so by the ophthalmologists.
2. There's rivalry between them and the ophthalmologists
3. Optometrists are relegated to doing refraction alone, they are not allowed to consult at the OPD.

Prayers;
1. Full recognition and participatory roles in the care of the eye.
2. They should be given full opportunity to consult at the OPD.
3. Department of optometry to be created and stand alone in our hospitals.
4. Scheme of service to be created for them.

Nigeria Society of Physiotherapists;
1. There are certified consultants and specialists among them who should be allowed to practice to their full potentials.
2. Support JOHESU's submissions.

Prayers;
1. In full support of relativity but should be paid according to training and skills.
2. Directorate of physiotherapy should be created.
3. Clinical residency program should be started in physiotherapy.
4. There should be carrier progression without repression or suppression

Nigerian Union of Allied Health Professionals;
1. Appointing doctors both as Hon. Minister of Health and Minister of State for health is no longer acceptable to them,henceforth, for peace to reign doctor should occupy 1 while any other health professional occupy the 2nd.
2. Entry point for all degree interns should be level 8 step 1, pharmacist, 8 step 2, and doctors, 9 step 2, thereafter, all allowances should be fixed for all, abolishing salary dichotomy we are experiencing in the health sector.
3. Directorate for all health departments.
4. In the composition of the management team, instead of about 8 doctors representing themselves and other health professionals, the distribution should be spread out.
5. There shouldn't be a perpetual leader in the health management team although in the clinical setting this can be. In each department, other professionals there must be allowed to head, eg. Radiology, pathology etc.
6. Headship of the hospitals should be left open to all.
7. Registered trade unions should be recognised in the hospitals and be represented in committees and especially,in the National Council on Health.
8. We don't need a Surgeon General.
9. No particular section should lay claims to be the head of all.

PSN;
1. A Pharmacist is an indispensable link in the care of patients.
2. The role of pharmacist should be well defined in Nigeria.
3. No single health profession can provide the health needs of a patient.
4. A pharmacist is a 7 man professional viz;a pharmacist, decision maker, leader, teacher, community leader etc.

SSAUTH;
1. There's shortage of staffs in our hospitals.
2.NMA and NARD are not registered trade unions so, they are not qualified to call for strike.
3. Direct employee of the hospital should be the CEO and not doctors as it is obtainable now.
4. Support creation of more directorates for other professionals.
5. The pronouncement made by NMA that some units should be concessioned or outsourced was unethical.
6. They want only one salary structure in the health sector.
7. Justice Gussau committee report of 2008 should be implemented to the letter.


Dental Technologists Registration Board;
1. Discrimination between HND and BSc holders should be looked into.

Dental Therapists Registration Board;
1. They want degree for Dental Therapists so as to earn respect from other professionals.They repeated virtually all what the association presented.

Environmental Health Officers RegistrationCouncil of Nigeria;
1. Pure preventive health should be looked into instead of concentrating on curative medicine.
2. BSc degree for her members so as to enter into the management cadre.

Health Records Officers Registration Board;
1. To abolish the dichotomy between the HND and BSc holders.
2. To make it as a law that, all hospitals in Nigeria be it public or private should employ a record officer.
3. Record keeping in Nigeria must change from analog to computer.

Institute of Health Services Administration of Nigeria;
1. The leadership tussle should be looked into.
2. Proper structure for team work.
3. Reorganise Ministry of Health.

MDCN;
1. Improvement in funding the health sector.
2. The conflict between the MDCN Act and MSN Act must be corrected.
3. Team work and harmony in the health sector should not be disrupted.


MLSCN;
1. Claimed there's no conflicts in the MDCN and MLSCN Acts.
2. Hospitals to be headed by administrators.
3. Signing what you did not perform is tantamount to fraud so asking pathologists to append their signatures on the results of tests performed by medical laboratory scientists is no longer acceptable to them and this should stop.

Medical Rehabilitation Therapists Board;
1. Internship for their fresh graduates should be approved.
2. More higher institutions of learning should be compelled to offer the course.
3. Postgraduate training for them to be embraced.
4. Discrimination against them should be looked into.

Nigerian Institute of Science laboratory Technology;
1. We are all guilty of the mess we put ourselves in the health sector.
2. There's no reason for the infighting.
3. Discrimination cuts across and not limited to one group an claimed by all.
4. Call duty allowance should be extendedto them.

NMCN;
1. The nurses constitute the largest workforce in the health sector.
2. It is the only profession having 24 hrs contact with the patients.
3. The shift allowance for nurses should be improved upon.
4. Government should look into method of salary negotiations.
5. The issue of skipping for nurses must stay.
6. Midwives should be allowed to palpate pregnant women and take deliveries in our tertiary institutions.
7. Internship for their graduates should be allowed.
8. More Nurses should be appointed into the boards of our health institutions just as we have Doctors in all the boards.

Optometrist and Dispensing Opticians Registration Board;
1. Creation of the department of optometry in the public service.
2.members should undergo internship compulsorily with adequate provision made for that purpose.
3. Review scheme of service to cater for their consultants.

PCN;
1. Government should compel all hospitals in Nigeria both public and private to employ the services of a pharmacist.
2. The activities of pharmacy technicians and patent medicine vendors should be looked into and properly regulated.
3. Government should improve on the funding of the council.
4. The council is opposed to the office of Surgeon-general as been requested for by NMA unless if the office is left open for other health professionals eg. Pharmacists, Nurses etc to aspire to occupy the office.

Radiographers Registration Board of Nigeria;
1. Increase in funding and proper monitoring.

Institute of Public Analysts of Nigeria
1. Proper integration into preventive health.

After all the presentations, the Chairman, appreciated all the stakeholders present, he asked, 'do you all believe that if there are no patients there can't be hospitals?' which we all answered in the affirmative. He reassured us that the committee would be unbias and that arrangements have been concluded for members of the committee to visit
countries to look and study their health systems and come out with recommendations in line with international best practices and put an end to recurrent altercations, indiscipline, insubordination and industrial disharmony in health sector.

Meeting was brought to a close at 5.10pm with silent closing prayer from everybody.

Source: Nursing World Nigeria.

NMA PRESS RELEASE.

OPEN LETTER TO THE SECRETARY TO THE GOVERNMENT OF THE FEDERATION

Senator Anyim Pius Anyim
Secretary to the Government of the Federation
Shehu Shagari Complex
Three Arms Zone
Abuja.

Your Excellency,

FACING THE CHALLENGES IN THE HEALTH SECTOR.RESOLUTIONS OF THE NIGERIAN MEDICAL ASSOCIATION (NMA) NATIONAL OFFICERS COMMITTEE (NOC) MEETING HELD ON THE 10TH OF JUNE, 2014 AT THE NATIONAL SECRETARIAT AND SUBMITTED TO THE OFFICE OF THESECRETARY OF THE GOVERNMENT OF THE FEDERATION WEDNESDAY 11TH JUNE 2014.

1.The post of Deputy Chairman Medical Advisory Committee (DCMAC) has been circularized and operational. Rather than abolish it, the NMA hereby demands that four (4) DCMACs for teaching hospitals and three (3) for the Federal Medical Centres beappointed forthwith to assist the CMACs whose statutory responsibilities are too heavy for any single individual to handle. Directors in other government agencies are supported by several Deputy Directors, why not the CMAC who is also a Director? Such a DCMAC must have same qualifications as the CMAC.

2.The NMA is opposed to the appointment of Directors in the Hospitals. This Position distorts thechain of command in the hospital, induces anarchy and exposes the patient to conflicting treatment and management directives with attendant negative consequences.

3.The NMA demands that grade level 12 (CONMESS 2) in the health sector MUST be SKIPPED for medical doctors. Consequently no medical/dental practitioners should be on that grade level anymore.

4.The title CONSULTANT in a hospital setting describes the relationship between the Specialist Medical Doctor and his patient. It will be a source of confusion if the title is applied to any other health worker who statutorily does not own patient. NMA therefore declares with unmitigated emphasis that if non-doctor consultants are appointed, it will lead to chaosand anarchy in the health sector. This should not happen.

5.Relativity in health sector is sacrosanct. The NMA hereby demands for immediate implementation of the January 3rd, 2014 circular. The NMA also demands the immediate payment of the arrears of the corrected relativity for 22 years during whichher members were short changed.Much as we are not against salary increase for any category of workers, either in health or elsewhere, the NMA demands for immediate adjustment of the doctors salary to maintain the relativity as agreed and documented once CONHESS is adjusted.

6.That Government should expedite the passage of the National Health Bill (NHB), and extend Universal Health Coverage to cover 100% of Nigerians and not 30% as currently prescribed byNational Health Insurance Scheme(NHIS).

7.Surgeon General of the Federation MUST be appointed with immediate effect.


8.The entry point of the House Officer should be corrected to CONMESS 1 step 4 as originally contained in MSS/MSSS while the Registrar/Medical Officer is moved to CONMESS 3 step 3.

9.Clinical duty allowance for Honorary Consultants should be increased by 90% of CONMESS

10.Adjust the specialist allowance as contained in the 2009 collective bargaining agreement. Additionally, ALL doctors on CONMESS 3 and above MUST be paid specialist allowance or its equivalent that is not less than 50% higher than what is paid to other health workers.

11.Hazard allowance MUST be at least N100, 000 per month for Medical Doctors.

12.Immediate release of the circular on rural posting, teaching and other allowances which MUST include house officers.

13.Immediate withdrawal of the CBN circular authorizing the Medical Laboratory Science Council of Nigeria (MLSCN) to approve licenses for the importation of In-Vitro Diagnostics (IVDs).

14.Immediate Release of Circular on retirement age for Medical Doctors as agreed with the FederalGovernment (FG)

15.The Federal Government through the Federal Ministry of Health should formalise and implement the report of the interagency committee on residency training as well as release the uniform template on appointment of Resident Doctors in line with earlier agreements. Moreover, a concrete Funding framework for residency training must be established. The Overseas clinical attachment must be fully restored and properly funded in the interest of the nation.

16.That in the interest of harmony in Federal Medical Centre, Owerri the government should pay the salaries of our members in the centre as agreed on 21st October, 2013.


17.Immediate concrete steps must be put in place for the reintegration of our members back into the IPPIS platform.

18.All attempts to coerce house officers not to join NARD must stop.

19.The orchestrated intimidation, harassment and physical assault of our members in departments ofPathology (Laboratory Medicine) by Laboratory Scientists which is being tolerated by the Federal Ministry of Health (FMOH) must stop.

20.The Endless circle of incomplete salary payment to our members in many hospitals in the name of shortfalls in personnel cost must stop.

21.Universal applicability of all establishment circulars on the remuneration and conditions of service for doctors at all levels of Government must be guaranteed.

22.Government should as a matter of urgency set up a health trust fund that will enhance the upgrading of all hospitals in Nigeria.

23.The position of Chief Medical Director/Medical Director must continue to be occupied by a Medical Doctor as contained in the Act establishing the tertiary Hospitals. This position remains sacrosanct and untouchable.

WHY DID THEY NOT ASK THAT THE POST OF VICE CHANCELLOR BE OPEN TO EVERYONE IN THE UNIVERSITY SINCE ASUU AND SANU ARE MADE UP OF GRADUATES

CAN YOU BE A JUDGE OF THE HIGH COURT OR COURT OF APPEAL IF YOU ARE NOT A LAWYER? WHY DO THEY THINK THE HOSPITALS WHERE LIVES ARE SAVED EVERYDAY SHOULD SACRIFICE THE ESTABLISHED LEADERSHIP I.E. CHIEF MEDICAL DIRECTOR?


24.The NMA henceforth shall not accept the continued violation of any of the terms of the 2009 Collective Bargaining Agreement. This is exemplified by the payment of Medical Physicists and Optometrists with OD (who are on CONHESS) call duty allowance using the CONMESS Circular. Similarly, the phrase Ministries, Departments and Agencies (MDA) in the said agreement should replace Federal Ministry of Health and other Federal Health Institutions as contained in the2009 CONMESS Circular.


In the light of the fore-going therefore, the NMA hereby gives government 14 days to meet all her demands as stated above or have her members called out for a resumption of the TOTAL and INDEFINITE withdrawal of service suspended on 5th January 2014.

The NMA is taking this painful route because our silence and gentle approach to these contending issues have been taken for granted.

We have to take this action in order to save the health care delivery system from anarchy that is palpably imminent.We hereby appeal to all Nigerians for their understanding and to press on Government to meet with our demands to avoid the STRIKE which is scheduled to start on the 1st of July 2014 from 00.10 hours GMT.

DR. Kayode OBEMBEDR.

Source: Secret Reporters.

Midwifery: bridging culture and practice.

Midwifery: bridging culture and practice

Thursday, June 5th:

The last day of the 30th ICM (International Confederation of Midwives) Triennial Congress started with a truly interesting session titled ‘promotion of midwifery as a career’. Chaired by Ingela Wiklund (ICM Board Member) and conducted in partnership with the White Ribbon Alliance (WRA), it was an interactive workshop focused on an exploration of what it means to be a midwife around the world today, examining the stereotypes in different countries and identifying strategic ways of challenging them.


Nester Moyo, ICM Senior Midwifery Advisor, started the session by saying that midwifery has been described as an aging profession. Unfortunately, there are not many young people striving for a career in midwifery, due to the negative image portrayed about midwives.


Brigid McConville (WRA) introduced a short film called ‘Mythbusting Midwives – The Downside’. Midwives around the world shared some words that they heard people using to describe them and their work.


A midwife from Malawi shared her experience saying that ‘what I feel is that midwives have a bad reputation’, they are often called ‘bossy, dismissive, unskilled, uneducated, old fashioned, strict, without compassion’. Voices from the audience shared: ‘The bad image presented by the media is due to the fact that midwives support pain and labour, therefore are sometimes perceived as bossy and unkind’.

A male midwife from Malawi shared that the majority of people in his country consider midwifery as the lowest level on a professional scale.

The second part of the movie, called ‘The Upside’, presented the good things people say about midwives and included: ‘caring, helpful, gentle, emphatic, loving, listening, understanding, strong, warm, indispensable, compassionate, humane, supportive, sensitive to unspoken needs, magical, passionate about their work, knowledgeable, calm, extraordinary’.

Many countries face low enrolment in midwifery education programs, for example Tanzania has seen a 90% decrease in student intake compared to a decade ago. Reasons include the status of midwives, negative perception of midwives’ role, poor pay, and working conditions.

Nester Moyo said the issue lays in our society’s perceptions about midwifery, ‘the power gradient that midwives create between them and the women they serve’, said Nester. ‘Society sees midwives as those people who don’t want to work with anyone else, don’t listen and don’t understand’.

Secondly, Nester said that the entry qualifications for midwifery education are not competitive, they are often called ‘academic leftovers’.
The third theme that came through was the education process itself, because of the perception of student midwives. ‘We are not producing confident individuals, we need to change the ways we address, interact, and treat young midwives’, added Nester.

The fourth point Nester made were the conditions of service; ‘the economic level of a country does not necessarily reflect the conditions midwives work in’.

Nester also stated that midwives don’t have a uniform image around the world, therefore people ‘don’t want to join this feeling of vagueness’.

Frances Ganges, ICM Chief Executive, shared her experience in the US and said that on several occasions people asked her ‘are you really a midwife? They still have those?’ She added that midwives in the US only attend 10% of births. When she worked as a nurse, one would be sent to a postpartum unit as a punishment as it was believed that didn’t require skills.

Mary Chuwe, WRA Tanzania, shared the example of a campaign that was carried out to promote midwifery in her country, called ‘Be in Science – Choose Midwifery’. Before the campaign, ‘midwifery was seen as a last resort, not the ‘career of choice’, said Mary. By establishing youth clubs in schools and encouraging students to take science classes, the campaign promoted a very high awareness of midwifery and as a result – more students enrolled in midwifery programs. 


Dr Ngai Fen Cheung, Adviser to Chinese Midwifery Expert Committee, Chinese Maternal and Child Health Association, was the final Congress speaker and gave a presentation on cultural sensitivity and midwifery. ‘Cultural sensitivity is a key concept running through the ICM Essential Competencies for Basic Midwifery Practice’, said Dr Fen.

‘The concept of culture is a set of rules and ideas that guide formation of groups’. Dr Fen added that culture is a way of life with implications for health, thus cultural variations must be considered for midwifery and MNH.
‘Midwifery is an indispensable culture. Midwives have brought not only physical comfort to the birthing woman, but also cultural comfort’.

Cultural sensitivity in midwifery care is meeting the cultural needs of women and families in childbirth; overcoming those cultural practices that harm women and babies; and having a healthy culture of its own to meet these challenges. Midwives need to learn about the cultural aspects that affect maternal health: religion, rituals, nutrition, etc.

‘Midwives often provide cross-cultural care. They need to understand cultures and cultural changes’, stated Dr Fen.

The closing ceremony started with student midwives presenting a scroll with 1000 signatures gathered for Precious Cargo. Frances Day-Stirk thanked the Board Members who finished their second term: Deliwe Nyathikazi, Mirian Solis, Mary Higgins, Maria Papadopoulou, Marian Van Huis, and Debrah Lewis.

She also welcomed the new Board Members: Dr Jemima Dennis-Antwi, Sandra Oyarzo-Torres, Dr Rafat Jan, Myrte De Geus, Dr Rita Borg Xuereb, Serena Debonnet. Frances Day-Stirk also thanked the host association, stewards, Congress Manager – Malcolm MacMillan, professional Congress organizer, translators, ICM staff and ICM Chief Executive.

She also thanked all the midwives who tweeted about the Congress and helped spread the word. In her thank you speech, she said ‘We’re building relationships and expanding collaborations. We can’t do it alone!’.

She added ‘If we don’t change, we don’t grow. If we don’t grow, we aren’t living. I look forward to a future, where there are more midwives in the world, where midwives are the norm – not a novelty. I look forward to the development of many more programs for midwifery education. I look forward to a strong ICM network, strategic partnerships and collaboration’.

A wonderful and heart-warming video was screened, showcasing the highlights of 30th ICM Triennial Congress: messages from participants, fun times, sessions and workshops, singing and dancing, five exciting days wrapped up in little under 10 minutes. A Czech orchestra, Dulcimer Pralinka, had the participants clapping cheerfully and continuously to the musical interlude.

Finally, the Congress baton was passed on to Canada, for another fantastic 31st ICM Triennial Congress in 2017! The Canadian Association of Midwives (CAM) invited everyone to Toronto and performed ‘Amazing Grace’ with lyrics adapted about midwives and midwifery. The spectacular closing ceremony ended with a dance performance.

Source: International Confederation of Midwives.

Communique Issued at the End of a Two Day Meeting of The Joint Health Sector Unions (JOHESU) and Assembly of Healthcare Professional Associations (AHPA) At the Medical and Health Workers Union of Nigeria (MHWUN) Secretariat at No. 12, Aba Close, Garki, Abuja on 5th - 6th June, 2014.


Following the JOHESU/AHPA meeting with his Excellency, the secretary to the government of the federation (SGF), Senator Anyim pius Anyim, GCON, Honourable Ministers of labour and productivity, Health, Chairman, salaries, income and wages commission, Head of the civil service of federation and other top government functionaries on 5th June 2014.

The JOHESU and AHPA held its meeting at MHWUN secretariat on 5th and 6th June, 2014 to extensively review the meeting with the government on the lingering issues between Government and JOHESU and resolved as follows:

1) ISSUANCE OF APPROPRIATE CIRCULAR ON CONSULTANCY FOR OTHER HEALTH PROFESSIONALS

JOHESU/AHPA expressed satisfaction over the circular number MH/PM/138/Vol.111/79 of 16th May, 2014 released by government formally restoring consultancy statues to other health care professionals and approving the payment of specialist allowance to deserving officers.

In furtherance to this, JOHESU/AHPA has therfore directed that all members who are due and satisfy the existing criteria, as upheld by the court judgement for consultancy position should apply for the payment of the allowance with its accrued arrears with effect from 1st January, 2010 in line with the CONHESS circular reference SWC/S/04/S.410/Vol.11/349 dated 8th december 2009.

2) ABOLITION OF THE POST OF DEPUTY CHAIRMAN MEDICAL ADVISORY COMMITTEE (DCMAC):

JOHESU/AHPA is delighted that Govt accepted the unions position that the creation of deputy CMAC is both unlawful and un-established and as such, no further appointment should be made into the post henceforth. Members of JOHESU nationwide are hereby directed to ensure tht this decision is enforced in all institution.

3: LOPSIDEDNESS AND UNLAWFUL CONSTITUTION OF BOARDS OF MANAGEMENT OF VARIOUS TERTIARY HEALTH INSTITUTIONS:

JOHESU/AHPA was vindicated that lopsidedness exists and must therefore be corrected. That a membership on the board of federal medical center, Owo who is not a nominee of JOHESU should be substituted as demanded by JOHESU while all unoccupied or vacant positions across all the boards should be identified for occupation by the nominees of the unions and the professional associations.

4) CIRCULARIZATION OF PROPER PLACEMENT OF INTERN MEDICAL LABORATORY SCIENTISTS ON CONHESS 8:

The eventual circularisation of the proper placement of intern medical laboratory scientists is a welcome development. However, JOHESU/AHPA appealed to government to amend the entry point to CONHESS 8 step 2 as applicable to other health professionals and that the new circular should include a provision that post NYSC officer shall be placed on CONHESS 9 step 2. This was accepted.

5) PROMOTION OF OFFICERS FROM CONHESS 14 TO 15 AS DIRECTORS:

Official circulars have been issued and government further reiterated that promotion from CONHESS 14 TO 15 is mandatory for all eligible officers and must be done procedurally. Deserving officers who are denied promotiions are urged to report any such denial to their respective board and union executives for appropriate action.

The meeting further resolved that federal ministry of health should accelerate the process of compliance by the CMDs and the MDs and where it is not carried out, the process of disciplinary action should commence and the case of non compliance by Jos university teaching hospital and others were mentioned by the unions

6)IMPLEMENTATION OF SKIPPING OF CONHESS 10 AND PAYMENT OF ITS ACCRUED ARREARS:

Government agreed that the affected members of JOHESU/AHPA will be paid the arrears and has equally calculated the cost implication which will be discussed at the meeting to be attended by FMOH, budget office and head of the civil service of the federation and the ministry of finance on 10th june, 2014 to realise this.JOHESU/AHPA therefore called on the concerned agencies of government to expedite action on the process to realise the payment of the accrued arrears without any further delay.

7) ISSUES TO BE HANDLED BY YAYALE AHMED COMMITTEE have been refered:The issues are:

1) Appointment of CMDs/MDs of teaching hospitals in accordance with the extant laws and the need to give consideration to permanent staff of the hospitals rather than the university based personnel

2) Advertorial for appointment of CMDs/MDs should no longer be skewed in favour of one professional group but made open to all competent and qualified health professionals

3) Job Evaluation report of year 2008

4) Abdullahi Bello presidential report on harmony in the health sector.

5) The interpretation of the phrase"medically qualified"

8) ADJUSTMENT OF COLLECTIVE BARGAINING AGREEMENT OF 2009 AS IT WAS DONE FOR NMA IN THE SAME SECTOR IN JANUARY, 2014:

The national salaries, income and wages commision informed the meeting that the financial implication of the adjusted collective bargaining agreement of 2009 has been calculated and that it has been forwarded by the ministry of health.

It is the expectation of JOHESU/AHPA that government shall issue circular on this matter within 30 days unfailingly.

We appeal to our members nationwide to remain calm and go about their normal duties and refuse to be provoked in any form and should remain steadfast and focused.

In conclusion, government should take note of the maturity, patience and understanding of JOHESU because, we would have been on strike over these issues. Therefore, all these outstanding issues must be addressed within the stated time frame of 30 days to avert industrial unrest.

Source: Nursing World Nigeria.

Viagra may increase melanoma risk, study finds

The little blue pill used by men to boost bedroom performance may be detrimental in the great outdoors, according to new research.



The study,published in JAMA Internal Medicine, found sildenafil, commonly known as Viagra, may increase a man's risk for melanoma by as much as 84 percent.


The study involved nearly 26,000 men enrolled in the Health Professionals Follow-Up Study at the Harvard School of Public Health.


In 2000, the researchers interviewed men enrolled in the study about their sexual health, use of Viagra, as well as their history of sun exposure and genetic skin cancer risk, including hair and eye color and history of moles.

Skin cancer or mole? How to tell

They then tracked occurrences of various types of skin cancer melanoma, squamous cell carcinoma and basal cell carcinoma based on self-reported questionnaires over the next 10 years.

The researchers identified 142 incidences of melanoma, 580 of squamous cell carcinoma and 3,030 of basal cell carcinoma. They found men who used Viagra were at nearly twice the risk for developing melanoma.

However, there did not appear to be any link between the drug and risk for other types of skin cancers.
The researchers also did not find any evidence that erectile dysfunction itself increased melanoma risk.

Though the findings raise concerns about the safety of sildenafil, the authors of the study say their findings do not prove the drug causes melanoma, just that there is a correlation.

They say further investigations would need to be conducted to understand cause and effect.

Source: CBS NEWS

Over 300 Primary Healthcare Centres Have No Officials – Al-Makura

Nasarawa State governor, Umaru Tanko Al-makura has lamented the plight of rural communities at accessing primary healthcare services even when the state boasts of over 700 healthcare centres which are largely under lock and key for want of qualified staff.

Al-makura made this known yesterday in Lafia while fielding questions from our reporter on the condition of healthcare delivery system in the state.

“We have over 700 primary health care centres in the state and it will shock you to know that, more than 300 of them are unmanned because the nurses are not there, the midwives are not there because our youths now no longer find the profession of nursing or being a nurse or midwife lucrative,” he lamented.


He noted that some cardinal factors like robust training programmes and institutions for nurses and midwives and attractive welfare packages to attract would-be nurses and midwives have not been thoroughly thought through before building hundreds of primary healthcare centres.


“Nobody is talking about that, and we keep building hospitals, and primary health care centres with nobody to man them. I cannot build hospitals and start importing nurses and midwives. How many staff would 700 primary healthcare centres take and in each of them we have not less than 25 people and you are talking about many thousands of staff?”

“So, we have to produce them locally and that is why I am now intervening in the provision of a school of nursing, school of midwifery and school of health technology because my emphasis is on primary healthcare system. I am not bordered about referral hospitals and all that. What we need to provide for the ordinary man is to ensure that he gets the basic primary preventive care, that he would be able to put at bay some of these infectious diseases and sicknesses. So that is the challenge he said.

Source:

NACA debunks compulsory premarital HIV testing for couples

The National Agency for the Control of HIV/AIDS has debunked reports that the new National HIV/AIDS Prevention Plan compels intending couples to carry out HIV test, as a precondition for marriage.

The agency in a statement on Monday said the statement credited to the Director, Bauchi State Agency for the Control of HIV/AIDS, Tuberculosis, Leprosy and Malaria, Mr. Yakubu Usman- Abubakar, was false.It stated, “We wish to clarify that no part of the newly developed National HIV/AIDS Prevention Plan stipulates or recommends compulsory HIV testing for intending couples or any group or individuals.“


The national HIV-prevention plan is essentially a strategic document designed to provide direction for HIV prevention programming in the country. It focuses on ensuring that the prevention priorities and goals set by the country and the President’s comprehensive response plan are achieved.“

One of those critical goals is to avail 80 million men and women knowledge of their HIV status, and there are set standards and approaches for achieving this. Compulsory testing before marriage is not one of them.”

The agency reiterated that compulsory HIV/AIDs testing was against the policiespassed in the new Anti-Stigma law by the National Assembly.It stated that HIV testing is voluntary andnot compulsory and nobody should be compelled to get tested for HIV. It addedthat voluntary testing is the gateway to HIV prevention, treatment, care and support.

Source: Punch

Malaria: Ogun distributes 2m mosquito nets

In order to reduce prevalence of malaria among its people, the Ogun State Government has distributed two million insecticide nets to all local government areas in the state.

The Commissioner for Health, Dr. Olaokun Soyinka, disclosed this during the ministerial press briefing to mark the third anniversary of the Senator Ibikunle Amosun administration in Abeokuta.

He said the government collaborated with the Society for Family Health to distribute the nets.Soyinka explained that over 57,000 rapid diagnostic test kits were also procured by the government and distributed to primary health facilities to curb the disease.

Source: Punch

Midwives could cut maternal, newborn deaths by two thirds

The authorities at the United Nations Population Fund have said that with the right training and support, midwives could provide 87 per cent of the essential care needed for women and newborns, and could potentially reduce maternal and newborn deaths by two thirds.


This was contained in a report released on Tuesday by UNFPA, together with the International Confederation of Midwives, World Health Organisation and partners.

The report, entitled, “State of the World’sMidwifery 2014: A Universal Pathway —A Woman’s Right to Health,” states that major deficits in the midwifery workforce occur in 73 countries where the services are most desperately needed. It recommends new strategies to address the deficits and save millions of lives of women and newborns.


The Minister of Health, Prof Onyebuchi Chukwu, did not return the call made to his phone, and he did not respond to the short message also sent to him.The report reads, “The 73 African, Asian and Latin American countries represented in the State of the World’s Midwifery 2014 suffer 96 per cent of theglobal burden of maternal deaths, 91 per cent of stillbirths and 93 per cent of newborn deaths, but have only 42 per cent of the world’s midwives, nurses anddoctors.”


It urges countries to invest in midwifery education and training in order to contribute to closing the glaring gaps that exist.

Source: Punch

"Life Starts in the Hands of a Midwife"

Every two minutes, a woman dies in pregnancy or childbirth, according to UN estimates, adding up nearly 290,000 maternal deaths each year. Nearly 3 million newborns die each year as well.


Most of these deaths are entirely preventable: Prenatal care and the presence of a skilled attendant at birth – services provided by midwives – could avert as many as 3.6 million deaths a year.



The International Day of the Midwife, on 5 May, commemorates the work of midwives around the world.

“The world needs midwives now more than ever,”said Dr. Babatunde Osotimehin, the Executive Director of UNFPA, the UN Population Fund.Yet there remains too little support for midwives. Many are working in decrepit health facilities, lacking basic equipment and life-saving resources.

“My challenges, there are so many,” Anthony Kiplagat, a midwife, said from hisclinic in Kenya.“The population is overwhelming… but you are not able to provide for all of them,” he said.

Life-saving care


Every pregnancy is accompanied by risks – some of them deadly. Sepsis, obstructed labour and post-partum haemorrhage are among the major causes of maternal death.

The presence of a skilled birth attendant is one of the most important factors in the survival of a mother and her baby. Yet about a third of all births continue to take place without a midwife or other skilled attendant.


“My interest in midwifery came as a result of seeing my community back at home, in the rural village, suffering – women dying because of pregnancy-related issues,” Mr.Kiplagat said.

In addition to delivering care throughout pregnancy, during childbirth and in the post-delivery period, midwives also provide comprehensive sexual and reproductive health services, such as family planning counselling. All of these services reduce maternal death rates and improve child survival.


Over burdened


But with insufficient investment in health care, and too few healthcare personnel, midwives often find themselves overburdened.“Where I’m working, there are four midwives. And those four midwives, they have to cover maternity – that is their part– [as well as the] paediatric ward, female ward, children’s ward,” said Enis Banda, a midwife in Malawi.


“Those midwives, they are trying their best to work day and night... To them, it is a very difficult situation,” she emphasized.


“The issue is lack of proper working equipment… especially in the [area of] supplies. Sometimes in our facility, we experience shortages of drugs. Yes, we provide good services, but if you don’t provide the drugs, at the end of the day, you have not really helped that woman,” Mr. Kiplagat said.

“We get burnout,” he added.Investment, support needed Midwives do not only need supplies and equipment. They also require extensive training to safely manage childbirth and to be able to recognize life-threatening complications.

UNFPA supports midwives through the provision of clean delivery kits, funding and supplies for healthcare facilities, and training programmes.


Between 2008 and 2013, UNFPA supported the training of over 10,000 midwives.But much more investment and support are needed at every level, from governments, civil society organizations and community leaders.


The second-ever State of the World’s Midwifery report, set to launch in June 2014, will offer further evidence of the steps required to ensure all women and families have access to quality midwifery care.


The report – a joint effort of UNFPA, the International Confederation of Midwives, the World Health Organization and other partners – will offer new data from 73 countries that account for more than 95 per cent of all maternal, newborn and child deaths.Yet even as they struggle to manage overwhelming caseloads, midwives know their work is invaluable.“I am proud of my profession,” Ms. Banda said. “I like to work as a midwife because I know that for those people who are like a president, a doctor or a teacher, life starts in the hands of a midwife.”
Source: ICM

Nursing home staffing standards reduced severe deficiency citations, researchers find

New research supports that nursing home staffing levels correlate with better quality of care. But it points to a phenomenon fewer could have predicted: diminished registered nurse hours spent on direct care.

The research could shed new light on discussions over the relation of caregiver skill mix and outcomes in nursing homes.

“[Mandatory] staffing regulations led to a reduction in severe deficiency citations and improvement in certain health conditions that required intensive nursing care,” but they had the unintended effect of lowering the mix of direct care nursing skill, according to the study published in Health Economics.

In fact, the standards caused many facilities to use fewer registered nurses relative to licensed practical nurses and nursing assistants, and reduce the absolute level of indirect care staff, wrote authors Min M. Chen, Ph.D., of the College of Business, Florida International University, Miami, and David C. Grabowski, Ph.D., of Harvard Medical School, Department of Health Care Policy.

The researchers based their findings on more than 45,000 nursing home-year observations from 1996 to 2006 in California, Ohio and “control states” where there are no minimum standards.

Additional metrics included detailed information on nursing home characteristics, resident census, payment source and quality indicators measuring different dimensions of quality.Chen and Grabowski stressed, however, that facilities that ranked in the bottom quartile for staffing prior to the new regulations were most likely to “increase LPNs and CNAs and substitute away from indirect care staff, and improve in quality.



”While many advocates and researchers maintain that higher caregiver-resident staffing ratios lead to better care, the idea is not universally accepted.

University of Maryland nurse researchers explore effects of turnover on residents’ care

Two studies examining the relationship between turnover of nursing staff and quality problems in nursing homes have found adverse outcomes.

The studies, both published in December, were based on data from the 2004 National Nursing Home Survey, which generated a sample of 1,174 nursing homes representing more than 16,000 nursing homes in the U.S.

The first study, “Are Nursing Home Survey Deficiencies Higher in Facilities with Greater Staff Turnover,” was published in the Journal of the American Medical Directors Association.

In that study, Nancy B. Lerner, RN, DNP, CDONA, an assistant professor at the University of Maryland School of Nursing in Baltimore and colleagues, including University of Maryland professor Alison M. Trinkoff, RN, ScD, MPH, BSN, FAAN, found that turnover for both licensed nurses and certified nursing assistants was associated with quality problems as measured by deficiencies considered to be closely related to nursing care.In the second study, “Turnover Staffing, Skill Mix, and Resident Outcomes in a National Sample of U.S. Nursing Homes,” published in the Journal of Nursing Administration, they found adverse resident outcomes, such as pressure ulcers and pain, are related to high turnover among certified nursing assistants.

The study found that even after controlling for factors including skill mix, bed size and ownership nursing homes with high CNA turnover had significantly higher odds of pressure ulcers, pain and urinary tract infections.“Changes are needed to improve the retention of care providers and reduce staff vacancies in nursing homes to ensure high quality of care for older Americans,” Lerner states.

Further the study by Lerner and colleagues suggests the need for continued research using deficiencies as a measure of quality in addition to the quality indicators used by others.

Source: nurse.com

Residents Doctors’ Warning Strike Commences

Patients at the Lagos University Teaching Hospital, LUTH, are stranded as the doctors there enforced the strike.

In Abeokuta, the Ogun State capital, Resident Doctors of the Federal Medical Centre, Idi Aba joined their colleagues nationwide in the ongoing 3-day warning strike.

A visit to the hospital revealed that although the resident doctors have withdrawn their services as directed by the national body, the action seemed not to be having much impact as nurses and consultants attended to patients.

Attempts to speak with the union leaders and management of the hospital proved abortive as they said they were not willing to speak on this development.

In Abuja, Nigeria’s Federal Capital Territory, the strike was in force also,but the Spokesperson of the National Hospital, Dr Tayo Haastrup,said that the welfare package of resident doctors can be negotiated with the Federal Government without putting the lives of teeming Nigerians at stake.

Resident Doctors at the Federal Medical Centre, in Owo, Ondo State also joined their counterparts across the country.

Channels Television was at the hospital to monitor the situation at the hospital. Though our crew was not allowed into the wards by the security officials at the hospital, there activities to indicate that other health workers in the hospital were at work.

We had an interview with the Chairman, Association of Resident Doctors in the hospital, Raymond Omotayo who highlighted the demands of the association from the federal government, noting that if the demands are not met by July 1, 2015, the Doctors will be forced to embark on an indefinite strike action.

All our efforts to speak with the Chief Medical Director of the hospital, Dr Femi Omotosho proved abortive as he was said to be out of the state and other senior officers in the hospital were not willing to speak to our correspondents.


Resident doctors in Rivers State were not left out in the strike as Channels Television visited the Braithwaithe Memorial Specialist Hospital in Port Harcourt, where patients were seen waiting to see doctors that were not available.

Source: Channels TV

NMA Advocates Health Centre for Lassa Fever Patients

The Federal Government has been called to establish health centres and facilities where Lasa fever patients could be treated and managed.Nigeria Medical Association (NMA) South East zonal caucus made the appeal during its emergency meeting in Owerri where the association discussed what it called issues of urgent National Importance.

Briefing newsmen, the chairman of the South East zone of NMA, Dr. Emeka Obiora, disclosed that there had been an outbreak of Lasa Fever in the zone, especially in Ebonyi State, and decried the non-availability of medical facilities to handle the deadly disease.

Obiora pointed out that victims of Lasa Fever in the zone could only receive best treatment in Erua Edo State or Lagos State, lamenting that in the process of transferring such patients the possibility of contacting the disease becomes very high.

He also lamented that as a result of lack of diagnostic facilities in the zone, medical personnel are put at the risk of contacting the disease easily, explaining that the meeting in Owerri was meant to enlighten the people about the way to handle the situation.

Source: Independent

Society for Family Health Dragged to Court Over Condom Advert

Society for Family Health has been dragged before a Federal High Court in Lagos over a Gold Circle condom advert published in a national newspaper on May 12.

In the suit filed by Sonnie Ekwowusi on behalf of the Project for Human Development (PHD), the applicant is asking the court to declare that the said condom advert, which was published without the Health risk warning clause, is illegal and unconstitutional because it contradicted Articles 2,3 4, 48, 49 and 50 of the Nigerian Code of Advertising Practice, Sales Promotion and Other Rights/Restrictions on Practice (fifth edition) of the laws of the Advertising Practitioners Council of Nigeria (APCON).



Joined in the suit filed pursuant to Order 2 Rules (1)(2)(3) & (4) of the Fundamental Right (Enforcement Procedure) Rules, 2009, of the 1999 Constitution, are The Guadian Newspapers Limited and APCON.PHD also stated that the publication without Warning Clause "the condom is not 100 per cent safe, total abstinence or faithfulness is the best option", is contrary to Sections 17, 37, 38, 39 (3), 45 of the 1999 Constitution and Articles 17, 18, 27 and 29 of the African Charter on Human & Peoples' Rights (Ratification Enforcement) Act, CAP 10.

The applicant is also asking the court to declare that the failure/negligence/refusal of the 1st respondent (Society for Family Health) to insert the aforesaid health risk warning clause on the packets of "Gold Circle" condom which it markets and advertises throughout Nigeria is contarary to article 49 of the APCON laws, sections 17, 37, 38, 39 (3), 45 of the 1999 Constitution and therefore illegal and unconstitutional.

PHD is also seeking a court declaration that the failure/negligence/refusal of the third respondent in ensuring that the first and second respondents insert the aforesaid health risk warning clause in order to comply with APCON laws was a dereliction of its duty as a national regulatory body and watch dog of the society.

The applicant is therefore asking the court to give an order directing the third respondent to henceforth ensure that no"Gold Circle" condom or any condom at all of the first respondent is advertised or published to the Nigerian public without compliance with APCON laws.

It also prayed the court for a perpetual injunction restraining the 1st respondentor their agent from further advertising the "Gold Circle" condom or any condomat all in The Guardian Newspaper or any other media or anywhere in Nigeria without compliance with APCON laws .

Source: ThisDay.

'We Want People to Be Conscious of Their Health'

The Chairman of Gbagada Phase II Residents Association in the Bariga Local.Council Development Area of Lagos State, Mr. Adewale Tijani has stated thatthe group wants residents of the area to be conscious of their health status always.

Speaking against the background of the health screening exercise organised weekend for residents of the area and the general public, Tijani stated that with otherwise healthy people just slumping and never recovering alive, it was important to do periodic medical examination to avoid such emergencies that could lead to death.

With the collaboration of the Muslim Medical Volunteers of Lagos State, the residents' association performed free blood pressure test, urine analysis and general consultation for Mafolukwu and Gbagada Phase II communities where hundreds of people turned up.

Speaking to journalists during the exercise, Tijani reiterated that the reasons for the programme was to avail people the opportunity of knowing their health status, get treated for common diseases such as malaria and above all, counselled on the importance of such periodic checks.He emphasised that the initiative is a corporate social responsibility of the Gbagada Phase II Estate residents association with the aim of strengthening the relationship between both benefitting communities. He said the medical personnel from their partners, the Muslims Medical Volunteers of Lagos State, rendered the free medical screening exercise for bothcommunities and prescribed drugs for some with complaints.

"Over the years, this initiative has encouraged residents to monitor their health status. It is amazing and fulfilling to see the crowd that is part of this programme. This shows that the initiative has helped the residents in both communities. The individuals that were screened that came out with infections based on the tests were given free drugs as well," he said.

A member of the medical personnel explained to THISDAY that urinalysis test is commonly used to diagnose a urinary tract or kidney infection to evaluate causes of kidney failure, to screen for progression of some chronic conditions such as diabetes mellitus and high bloodpressure (hypertension).

He added that it might also be used in combination with other tests to diagnose some other diseases.

"Additional tests and clinical assessment are often required to further investigate findings of urinalysis and ultimately diagnose the causes or specific features of an underlying problem," he explained.



He explained that blood pressure is the force of blood against the walls of arteries.

"Blood pressure is recorded as two numbers-the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats). The measurement is written one above or before the other, with the systolic number on top and the diastolic number on the bottom. For example, a blood pressure measurement of 120/80 mmHg (millimeters of mercury) is expressed verbally as "120 over 80. Normal blood pressure is less than 120 mmHg systolic and less than 80 mmHg diastolic," he said further.He stressed that high blood pressure is dangerous because it makes the heart to work too hard and it also makes the walls of the arteries hard as well.

"High blood pressure increases the risk for heart disease and stroke, the first- and third leading causes of death for Americans. High blood pressure can also cause other problems such as heart failure, kidney disease, and blindness.

"Having your blood pressure checked is quick and easy. Blood pressure is measured in millimetres of mercury (mmHg) and recorded as two numbers systolic pressure 'over' diastolic pressure. For example, the doctor or the. nurse might say '130 over 80' as a bloodpressure reading. Both numbers in a blood pressure reading are important.

As we grow older, systolic blood pressure is especially important," he added.A resident of the community and a beneficiary, Mrs. Ronke Afolabi said that the free health care was a good idea adding that she was glad to be part of the screening exercise.

Afolabi commended the organisers of the programme and singled out the chairman of the resident association for the wonderful opportunity he provided her to know her status.

One of the doctors that participated in the exercise,Dr. Ade Ekemode of Ekemode Memorial Hospital, Surulere, Lagos said the free screening exercise was a good move by the association, citing the fact that medical check-up is not common among Nigerians citizens. He said that the programme was good for the community because it came from good consciences.He added that some of the patients that knew their medical status from the checks could proceed further with treatment of the conditions detected.

Ade also said there were certain predisposing factors that could lead to hypertension such as stress and added that if identified early enough, it could be managed to prevent complication like stroke.

"This programme does not screen for HIV, but from blood pressure checks they can be able to detect those with hypertension and the urine test candetect candidates with diabetes," he added. He said he had participated in the programme since 2010 eventhough he is not a resident of the community.


The Secretary to the Bariga Local Council Development Area, Mr. Johnson stated in an interview that the free medical programme was organised by the Gbagada Phase II Residents' Association to render comprehensive medical service to the people. He commended the initiative of the association for complementing government efforts in the health care delivery project.

The Bale of Mafolukun community, Mr. Badamosi thanked the organisers of the programme on behalf of his community for the opportunity given the residents to enjoy the benefits of the programme.

Source: ThisDay

‘Strengthening Our PHC Can Help Reduce Maternal, Child Deaths’

Nigeria’s maternal and infant mortality rate still remain high despite interventions. In this interview with WINIFRED OGBEBO, Nigeria’s country representative, Bill and Melinda Gates Foundation, Dr Mairo Mandara shares on what is needed to bring the figures down.

What areas is the foundation looking at in your work in Nigeria?

The Bill and Melinda Gates Foundation right from the beginning is built on the principles of the fact that all lives have equal value therefore the work of the foundationis aimed at giving dignity to people who are poor. So the foundation works in various sectors to make sure that every human being have a reasonable health and they help themselves out of poverty. We also work on children because children are the most vulnerable. We work tomake sure that children have good health, we work in the area of immunization, pneumonia, diarrhea and diseases. We work in maternal health to make sure that pregnant women have pregnancy that is safe and they deliver safely. Where they choose to rest in between children, we support them to do that. We also support agriculture. We work very closely with the Federal Ministry of Agriculture to support the agricultural development agenda. We are in particular, trying to support Nigeria to be able to produce its own rice to feed itself. We are working very closely with Alhaji Aliko Dangote in the routine immunization programme. He has also shown a lot of interest in agriculture. So basically what we work in, are areas that a lot of poor people in the community are in need of.

Despite the several interventions, maternal and child mortality rate is still high. What do you think could bedone to bring the figure down?

I am a health expert. I specialize in obstetrics and gynaecology. The key to improving maternal and child health in Nigeria is basically primary health. I can assure you that if we pass the health bill, we have a significant or 0.5 or one per cent of our budget goes to the primary health care; I am not talking of teaching hospitals but primary health care centres. That is where children are taking when they have diarrhea. That’s where women go for antenatal. That’s where women go for delivery, to take their blood pressure and all. That’s where they go where all their basic health issuesare taken care of. So for me, there isneed to strengthen primary health care.Another thing to strengthen primary health care is making sure that we have adequate and quality manpower; our nurses and midwives are properly trained and they train to actually give good service. So if we could do this, I can assure that we’ll improve maternal and child health.


What specific interventions in primary health care do you think can bring positive results ?

I will start with the one thing we shouldn’t do; build clinics. We already have enough primary healthcare centres. We need to furnish and refurbish them so that they can become functional. We need to make sure that every primary healthcare centre has a nurse and a midwife that can do antenatal and deliver women. We need to make sure that our health care providers are retrained to be able to respect and give women dignity because a lot of women don’t like to go to hospital because they are disrespected. We will need the hospital to have some autonomy to be able to get some whatever they need like medicines, and so on and so forth. We are piloting strengthening routine immunization in Kano with Dangote Foundation. The Dangote Foundation, the Bill and Melinda Gates Foundation and the Kano State government are doing something similar to primary health care under one roof, putting all the money together so that even a local government primary health care have an account and therefore they can access what they need. They don’t have to wait for full bureaucracy. So cut on bureaucracies, cut on middlemen; supplies through this, supplies through that and make sure that ourwomen and children have access to basic essentials. Things that kill women and children are things that are shaming; things like malaria, diarrhea and pneumonia and these are things that can easily be eradicated.

In what ways is your organization trying to make an impact in maternal and child health in Nigeria?

We are doing it a number of ways. We believe that one of the reasons our leaders don’t make very critical decisions is because they don’t have data because if you don’t have data you make decisions arbitrarily. So we are supporting the Saving One Million to make sure that across the country, data is well collated and its used for decision making. We are supporting direct maternal and child health intervention in various states.Gombe is one example of a state that we are working on. We are working in diarrhea diseases and pneumonia in Benue, Kebbi and other states depending on what their needs are. If you go to states around the south west, we are heavy on agriculture-cassava. I am sure that you know that the yellow cassava is a programme we are supporting to make sure that cassava becomes an income generating route for the country.

How much is the timeline budget your foundation has for health?

With the existing programmes that are going on, the investment of the foundation in Nigeria is about $700m and our annual cheque is multi years because when you give a grant, the grant runs for a couple of years and the annual cheque that are written varies from year to year between a 140, 200,170. But the complete investment is about $700 million for a period of time between three to five years in various sectors.

Source: Leadership Newspaper