A public health physician and former Chief Medical Director, Lagos University Teaching Hospital (LUTH), Idi-Araba, Lagos, Prof. Akin Osibogun, has advocated integrated health services for Nigerians, which will incorporate tested elements of traditional medicine with orthodox medicine.

Osibogun, of the Department of Community Health and Primary Care College of Medicine University of Lagos (CMUL/LUTH), Idi-Araba, Lagos, in a lecture, titled: ‘Optimising Health Services for Nigerians in the 21st Century’, delivered at the Medical Guild Lagos 2023 Scientific Conference, last week, said: “I have put forward the argument that advancing the health of Nigerians in the 21st Century will require intersectoral c q1ollaboration addressing the social determinants of health in addition to ensuring a resilient and sustainable health system which itself must be designed to make health care available, accessible, of high quality and relevant to the health needs of Nigerians. If we fail to address the issues of availability, accessibility, quality, and relevance, then we will fail in advancing the health of Nigerians. However, we cannot afford to fail if we want history to judge us fairly!

“Distinguished ladies and gentlemen, an integrated health service for Nigerians will incorporate tested elements of traditional medicine with orthodox medicine; it will ensure a firm handshake between all levels of the healthcare system – primary, secondary and tertiary; it will recognize and appreciate the complementary role of both the public and private health sectors. Integration must thus be vertico-horizontal or multi-dimensional.”

Osibogun said the steps Nigeria needs to take to advance the health of Nigerians in the 21st Century and beyond though straightforward in his opinion, require strong political commitment and a clear vision.

“Let us strengthen the private sector through access to single digit loans, tax holidays and similar policy tools; let us improve on our investments on development and retention of human capital for health; let us guarantee effective demand for health through a mandatory health insurance agenda and we will see the cycle turn in favour of improved health for Nigerians. I believe we can do it and we must do it as that is the only responsible choice we have!”

Osibogun said from national experience, government bureaucracy and inefficiencies make quality delivery of services often difficult. He said the future of quality delivery of services is largely in private provision and government regulation of services.

The public health physician said financing availability will require investments in health infrastructure, equipment, pharmaceutics and consumables as well the pre-service and in-service development of human capital, availability addresses the Supply side of the problem.
Osibogun said to address the demand side of the problem and ensure that citizens have access to needed health services, then Nigerians must look for fair financing mechanisms, particularly those that protect citizens against catastrophic expenditure for health. He said catastrophic expenditure for health sends individuals, families, and communities into spiraling poverty.

“If we are ever going to lift our people out of poverty, we must address their health and access to health services. A mechanism that can help in achieving this must be fair in fund pooling and health risk sharing. Either a general tax mechanism or a dedicated tax mechanism in the form of mandatory health insurance can be a fair fund pooling mechanism.

“Whichever of the two pooling mechanisms is adopted, our next concern will be the quality delivery of health services. In my opinion, the best fund disbursement mechanism to promote quality delivery of health services will be a pay-for-performance mechanism in which providers are paid on the basis of both quantity and quality of services provided,” he said.