By Okunade Adekunle, Lagos
The Community Health Extension Workers (CHEW) and Community Officers (CO), operating under the aegis of Association of Private Community Health Practitioners (APCHP), have canvassed for the review of Lagos State Health Service Reform Law 2016, seeking for legal backing to own and operate private healthcare clinic.
The Health practitioners made the plead at a Health Sector Stakeholders parley held at the Lagos State House of Assembly Complex, Alausa, Ikeja.
According to Mr Wole Jonathan, who is a licensed Community Health Officer in
the private practice, argued that most of their members possess required skills, experience and are certified to operate community based Public Health Care centers as enshrined in the National Health Policy.
Jonathan argued that they should be allowed to use their certificate and license to own and operate private health care facilities in the state, saying that.
He added; “We are here on account of the state health reform law which allows other health care providers in the state, the Nurse, the medical laboratory technician, the pharmacy technician and others, who were trained by state government owned institutions, to work in the government establishments and to use their license if they like to operate in the private sector.
“In the law, we observed that it is only the community health group, community health officer and the community extension health worker athat are not given any opportunity to operate, that was why we petition the house of assembly to look into it.
“So we are here today to plead that the Lagos Health Service law be reviewed to allow us to own and operate private clinic and serve as operation officer because we have vital license to that effect.
“We have cited that even the law that affords for Primary Health Care centre, a law of Lagos state recognized that the community health officer be in charge of the government clinic.
“So if one have the qualification which makes one able to be in charge of PHC, is the same qualification not liable to me operate private clinic effectively?”
The Chairman House committee on Health Services, Hon. Olusola Sokunle, informed the gathering that the stakeholders parley was called for based on a petition the group wrote to the Assembly.
In his contribution, the Permanent Secretary Primary Health Care Board , Dr Lateef Lawal, enlightened the group to go through their regulatory body and pressurised them to effect change at the National Assembly level for their inclusion, saying that such change would give room for a seamless adherence at the state level.
Lawal added: “There are no fears, none the only reason for the agitation is because we have unemployment in the market and that is affecting everybody. If the government is able to absorb all the community health officers
there won’t be any call for this, they have their members who are out and unemployed who have to be catered for, so they have to think out of the box and say how can we actualize this?
“Our position is that we cannot be singing different tunes, we have the national body, the federal government, National Council of health, they need to harmonize all the contending issues and it becomes a national act.
“If you have any opinion at all it is easier to go to that council argue your case, they look at the merits and once it becomes a national law, it becomes easier for people like me to say, this is the standard and then we key into it, or else we would have a snowball effect where they will be agitating repeatedly.”
He suggested increase of funding to the health sector from the national budget as a leeway out of the unemployment problem.
“Nigeria is a signatory to the 1915 declaration, which makes it mandatory that 15 percent of our national budget should be dedicated
for health but as at now the maximum you can probably get is between 5 and 8 percent.
“We say that health is wealth, education is also important, you can’t joke with the two, they may look intangible but they form the bedrock
of any progress in the every society.
“So funding needs be increased to address the brain drain amongst the Doctors, a lot of our colleagues go abroad in search of greener
pasture, but the economy is important, if the remuneration is same like in other clime one won’t leave for better climes.”
According to Mrs Abiola Idowu, Acting Executive Secretary of Health Facilities Monitoring and Accreditation Agency (HEFAMAA), the bone of contention is not the issue of ownership but operation.
Idowu stated that care givers need to operate in accordance with the standard practice because of how important the life saving business is.
“Currently the law recognizes their practice under the standing order under the auspices of a supervising physician that is what gives them
the authority to use that order and their cadre (community health practitioners) is not recognized under the health sector reform law of 2006 which establishes HEFAMAA, to operate centres as one of thosethat can be officers in charge.
“Each cadre is trained for specific purposes, Doctors, Nurses respectively, while the Community Health Practitioners are trained to
act as a linkage between the community and the health facilities, for them now to say they want to operate a facility, I don’t think their
training qualifies them for such.
“We are saying they cannot work alone without supervision. We agree that they can work in private establishment due to dearth of nurses.
Anyone can own a health facility but to run it we have a minimum standard in terms of basic amenities necessary to provide health care
services. It must be able to provide emergency services when a patient walks in and at the same time offer curative and preventive services.
“It is also paramount to know when to retain a patient with minor ailment for treatment and when to refer. Also the personnel as it has
to do with different schedules, you must have adequate number of staff, for example a medical centre must be run by a Doctor and you must have adequate nursing staff.”
However, Sokunle who was seconded by another lawmaker, who is member of Health Services Committee, Hon. Noheem Adams, assured the stakeholders that the House would look in the matter critically and get back to them soon.