BUILDING
PEOPLE-CENTERED HEALTH SYSTEMS AND CREATING HEALTHY ENVIRONMENT FOR GROWTH AND
SUSTAINABLE DEVELOPMENT IN SUB-SAHARAN AFRICA
by Lanre Jacob
Being a paper presented on Health and Environment at the Chrisland University, Abeokuta, Nigeria, on the 25th June, 2019.
Lanre Jacob
Once
again, my name is Lanre Jacob. Ordinarily if I had to stand at all to deliver a
paper concerning any subject in a conference like this, that subject should be
about language and not healthcare – because I am a linguist by training.
So, what
brought me into the healthcare space? It was my 30 year journey with cancer
which began at the age of ten. The several dangerous surgeries on my head and
the unspeakable traumas as a result of the tumors became a spur for me to step
into oncology research and cancer advocacy – helping people with cancer and
cancer survivors and championing sustained cancer awareness in Nigeria through
my Foundation – the Lanre Jacob Sarcoma Cancer Foundation.
The Nigerian
health system produces only 20,000 survivors out of 100,000 that have cancer
annually. Such health system cannot be said to be people centered. Perhaps, I
would not have needed to go through so many surgeries for 30 years. In my
cancer case, the first four tumors that were removed from my head were never
taken to the laboratory. Those doctors simply threw them away. And the tumors
continued to grow. It was at the fifth surgery at the OAUTH Ife in 2001 that my
case was diagnosed to be Dermato-fibro-sarcoma,
a rare skin cancer. Such scenarios still persist in the country even as we
speak.
The
probability that a woman living in present-day Kampala or Harare will develop a
cancer by the age of 65 years is only about 20 percent lower than that of her
peers in Western Europe, yet the facilities for providing treatment for cancer
cases in most of Africa are minimal, as illustrated by the sparse distribution
of radiation therapy services in Africa. In many countries in Africa,
especially in Nigeria, medical and radiation oncologists, including oncology
nurses are not enough. Statistics on disease mortality are particularly sparse.
Only about 0.25 percent of the population of Sub-Saharan Africa is covered by
accurate death registration systems.
While we may not generalize because
some countries on the continent like south Africa, Mauritius and the Seychelles are doing well in building
people-centered health systems, we will all agree that most health system on
the continent are still far behind, especially
in health infrastructure.
No doubt Africa is faced with myriad of
challenges, yet, Health is critical to her sustainable human advancement, both
as an undeniable human right and an indispensible contributor to her economic
growth. Health is a good indicator of the progress of nations in accomplishing
sustainable development.
What is
Sustainability and sustainable development?
Sustainability is an inherent component and explicit goal of people-centered
development. People-centered development calls for the establishment of
self-supporting social and economic systems, which are key elements of a
sustainable development in societies.
Man,
anywhere on earth, cannot hope to achieve a sustainable economic development
without first ensuring a good healthcare system and an ecologically healthy
system.
Nations and
institutions run on systems. Systems are built to achieve purpose. It is time
Africa become more focused and purposeful. Building people centered health and
ecologically healthy systems are no longer negotiable.
Building Health Systems to Deliver People Centered
Health Services
Now, what is a system?
A system is an arrangement of parts and their interconnections that come
together for a purpose.
A health system
consists of all organizations, people and actions whose primary intent is to
promote, restore or maintain health. Like any other system, it is a set of
interconnected parts that have to function together to be effective.
A
health system is composed of many parts. These parts include:
The
Patients, Families, Communities, Ministries of Health, Health providers and
Health financing bodies.
Each of these
components has interconnecting roles and functions. In systems thinking, none
of these components should be looked at in isolation, or else we will miss the
many ways that such component interacts with the other components.
The Six Health System
Building Blocks
The World Health
Organization recommends supporting and strengthening a health system based on
certain framework. This are:
1.
Good service
delivery comprising quality, access, safety and coverage
2.
A well-performing
workforce consists of human resources management, skills and policies
3.
A well performing
information system that ensures the production, analysis, dissemination and use
of timely and reliable information.
4.
Procurement and
supply programs that ensure equitable access, assured quality and
cost-effective use.
5.
A good health
financing system capable of raising adequate funds for health, protects people
from financial catastrophe, allocates resources, and purchases good and
services in ways that improve quality, equity, and efficiency.
6.
Effective
leadership and governance that ensures the existence of strategic policy
frameworks, effective oversight and coalition-building, provision of
appropriate incentives, and attention to system design, and accountability
This framework is also
described by the world health organization as health system building blocks.
They are used to strengthen the components that make up a health system.
No doubt, strengthening
a health system takes a long time. Efforts must be well organized, donors must
be coordinated and everyone involved must be committed to a long term process.
Ladies and gentlemen,
in this presentation, because of time constrain, I have deliberately gone
silent about building healthy ecological systems and laid more emphasis on
building health systems.
Yet, the point is not
missed. Health is critical to
Africa’s sustainable human advancement, both as an undeniable human right and
an indispensible contributor to her economic growth. To achieve good health and
sustainable development on the continent, people centered health and ecological
systems must be put in place.
A people – centered
system takes cognizance of productive employment, infrastructural development
and increased Investments in primary and secondary health care. A
people – centered health system promotes health across all social groups, thereby
reducing health inequities and promoting greater social cohesion and reducing
expenditure on illness care.
A people – centered ecological
system seeks better environmental quality
for the poorest populations, while ensuring that today’s economic development
is achieved in ways that do not impair the economic development, health and the
well-being of the future generations
For Africa
to achieve sustainable development, therefore, building people centered
healthcare systems and healthy environments, once again, is none negotiable.
As a former cancer
prisoner, I am aware that Africa is a terrain where fight against cancer and
many other diseases are largely individualistic. But, when a tree is sick, no
man benefits from its fruits. When a citizen is sick, the whole society misses
his or her contributions – and the general growth is slowed down. Building
people centered healthcare system will help eliminate this anomaly in our
societies. And we all will be better for it. This is why I am here. What you
have heard is a voice to the voiceless.
Thank you
all.
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