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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