Why is Health not a priority to Africa's Policy Makers?

I had yet another conversation with a friend and medical colleague this week about another unnecessary death in Nigeria. A 33yr old man developed a clot in the traffic and subsequently had difficulty in breathing.He was rushed to two hospitals;one had no qualified doctors to help and the second could not work the oxygen,he was dead on arrival at the third.

This is one of many,many stories I've heard and I'm almost certain you have heard too.Not only is there hardly any emergency care,there is also quite poor primary care;I have heard of several instances where hypertension,diabetes and other non communicable diseases have gone unnoticed and undiagnosed until there has been a stroke,heart attack,blindness or other complication.

In my roles,I have been in charge of Health budgets and carried out many Health sector reviews.Rather than complain about the approach to Health by our policy makers,I'd like to seek out some champions in the Health sector who are willing to listen to their inner voice and who want to leave a good legacy and ask that they commission urgent reviews of their sector.

Health services should be commissioned based on best available data and according to need.We have a data collection issue, however, there is a strong anecdotal evidence as to prevailing ailments. There are pockets of best practice for example the Rwandan Health system where maternal and child mortality has been halved and life expectancy increased by nearly a decade in an eight year period.

Despite the remarkable change made by Rwanda, life expectancy across Africa is poor apart from a minority of countries including Mauritius,Seychelles and CapeVerde who have a slightly higher number than the rest of Africa.

I strongly believe that Africa's Health offering to its people can be much better than it is although people are becoming weary by the slowness of the progress.Initiative after initiative have been put in by various local,national and global bodies without sustainable change.Our consultancy is focussed on reviewing Health Strategy and strengthening processes that keep a health system sustainable.The hardwork of evaluation,review,providing solutions and re-evaluating must not be bypassed.While this may be seemingly uninteresting,this is the bedrock of excellence.

Most people who know me will say I talk about the Health sector inefficiencies all the time and a friend once told me "forget all this English,what you're trying to deal with is the drop dead syndrome in Africa".While it was funny and seemingly simplistic to me at the time;that is the issue.The lack of a clear Health Strategy and follow through has led to a very weak Primary Care and Emergency care system.Health conditions are not prevented or diagnosed early and when the inevitable fatality occurs,there is certainly no robust emergency care to deal with it.

Talking about progressive initiatives,one that has caught my attention recently is the Community Health insurance scheme at Obio Cottage Hospital.It would be good to reproduce successful schemes at scale and get the support of the Government.

To make changes sustainable and continuously improving,rigorous evaluation must be in place with strong Governance and a focus on Quality.I have practised medicine in Africa and in Europe and I know we can improve our system.This is the very reason I set up the Monica Alabi Healthcare Consultancy based on years of helping review Healthcare Systems,designing Health Strategies and services and monitoring the impact of the changes made.

While we cannot tackle every aspect of the Health system at once,providing first, a sustainable primary care that offers basic health services to most of the population is crucial,I believe in equity and in offering the greatest good to the greatest number of people.Secondly when emergencies occur as they will no doubt will,having an emergency care network and process that save lives should be available.

For the sake of the health and reputation of the continent, I would like an urgent review into Primary and Emergency Health in Nigeria in particular and across Africa in general.If you have a system that works,evidence and share it with the world and if you don't, put in urgent changes.

We all want a Healthcare Sector that is on par with the best in the world,we all know we have the brain power to achieve it and we all know we can do it if we want to.Let us think about Africa and let each of us make a change today.

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