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At NOA conference, optometrist makes case for right to sight for Nigerians by year 2020

By Nike Sotade
26 July 2012   |   8:23 pm
A presentation paper at the ongoing Nigerian Optometric Association (NOA) annual conference has shown that successful health systems have a positive effect on the economies of nations. The presentation at the 36th annual conference of the NOA by Dr. Chukwunonso Nwanze, titled: ‘A Case of Two Visions: The State of the Nigerian Health System and…

A blind man, victim of onchocercosis, more commonly known as river blindness, walks on the street. (Photo by Google)

A presentation paper at the ongoing Nigerian Optometric Association (NOA) annual conference has shown that successful health systems have a positive effect on the economies of nations.

The presentation at the 36th annual conference of the NOA by Dr. Chukwunonso Nwanze, titled: ‘A Case of Two Visions: The State of the Nigerian Health System and its Impact on Visual Health,’ discussed the health system of Nigeria and the impact and relationship it shares with the economy.

While the globally known Vision 2020: The Right to Sight is a global initiative by the World Health Organization (WHO) and the International Agency for the Prevention of Blindness (IAPB) that seeks the elimination of avoidable blindness, Nigeria’s Vision 2020 seeks to make Africa’s most populous nation one of the top-20 economies in the world by the year 2020.

The overall aim of Vision 2020: The Right to Sight is to eliminate the main causes of avoidable blindness and to prevent the projected doubling of avoidable vision impairment by 2020.

During her presentation, Ms. Nwanze mentioned that Nigeria’s poor health system has dire implications for both Vision 2020: The Right to Sight and Nigeria’s Vision 2020, now famously called Vision 20:2020 and added that the integration of the WHO and IAPB’s Vision 2020 with Nigeria’s national health system is crucial for the success of public health.

Nigeria’s President, Umaru Musa Yar’adua, during the launch of the country’s Vision 2020 initiative, confidently stated that “by 2020 Nigeria will be one of the 20 largest economies in the world, able to consolidate its leadership role in Africa and establish itself as a significant player in the global economic and political arena.”

But with just eight years to go before the year 2020, Ms. Nwanze stated that “without infrastructure, our eyes tell us Nigeria’s Vision 2020 cannot be.”

It was a statement that was roundly applauded by those in attendance.

Continuing, she added, “The Vision 2020 Right to Sight initiative is intended to strengthen national healthcare systems and facilitate national capacity-building.

“However, the keyword is integration; we cannot eliminate avoidable blindness in Nigeria if we cannot integrate an equitable, sustainable, comprehensive eye-care system into our national health system.”

Citing South Korea and Chinese Taipei, also known as Taiwan, as examples, Ms. Nwanze said the Far East nations’ National Health Insurance Systems had a positive impact on their respective economies, while the reverse is the case for Nigeria. She also stated that improving Nigeria’s vision healthcare should be a coordinated public health approach, inculcated into the National Health Insurance Scheme (NHIS).

The Nigerian government created the NHIS in May 1999. The scheme encompasses government employees, the organized private sector, and the informal sector. By law, the scheme also covers children under the age of five, permanently disabled people, and prison inmates.

By 2004, the immediate past administration of former president Olusegun Obasanjo further gave more legislative powers to the scheme with positive amendments to the original 1999 legislative act.

While admitting that her presentation was limited due to insufficient literature on the impact of blindness on the Nigerian economy, Ms. Nwanze nevertheless recommended that eye healthcare practitioners take more interest in the Nigerian health system in its entirety and get involved in shaping policies that impact the goals of the health system and eliminate some of the challenges that impact the goals of the Nigerian health system.

Some of these challenges, according to Ms. Nwanze, who holds an MSc and DIC in International Health Management from Imperial College London and a Doctor of Optometry from the University of Benin, are spatial inequality and the emigration of some of the country’s best medical practitioners to better climes.

“Healthcare in Nigeria is influenced by different local and regional factors that impact the quality or quantity present in one location,” she said, while explaining what she meant by spatial inequality. “Due to this, the healthcare system has shown spatial variation in terms of availability and quality of facilities in relation to need.

“The Ministry of Health usually spends about 70 percent of its budget in urban areas where 30 percent of the population resides. There is an assumption that the healthcare service is inversely related to the needs of patients.

She said of the brain drain affecting the healthcare profession, “Migration of healthcare personnel to other countries is a taxing and relevant issue in the health care system of the country. This is due to a supply push factor. However, because a large number of nurses and doctors migrating abroad benefited from government funds for education, it poses a challenge to the patriotic identity of citizens and also the rate of return of federal funding of healthcare education.

“The state of healthcare in Nigeria has been worsened by a physician shortage as a consequence of severe brain drain,” added Ms. Nwanze, who provided data that showed that in 2005, 2,392 Nigerian doctors were practicing in the United States and another 1,529 in the United Kingdom.

They are figures she fears only have an upwards trajectory for a country where no national data on the prevalence and causes of blindness exists.

“Most data used for planning eye care services is generated either from urban areas where the large eye hospitals are situated or from small, focal surveys,” she said. “These small studies indicate that blindness is likely to be a public health problem, but such data cannot be extrapolated to the entire country as the population is culturally, ethnically, and geographically diverse.”

Dr Nwanze’s presentation didn’t entirely paint a gloomy picture, as she mentioned some of the good work being done by the Kaduna State Eye Care Programme (KSECP).

“The KSECP is the oldest sight-saving intervention, and a recent evaluation shows that the delivery of services is significantly improved and generally of good quality. One important key to this success is that health workers from the community have been trained and deployed at various levels, and essential medical products and technologies have been provided,” she said.

“However, evaluation intimates that there is a need to improve linkages between tertiary, secondary, and primary levels of the health system, the onchocerciasis control programme team and the zonal eye care team.

“Based on the success of the KSECP, community ownership of all eye care programmes should be enhanced through supporting community participation and the inclusion of local government and primary health care workers in programme planning,” she said.

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