UK-based Clinical Pharmacist, Adaku Efuribe warns that the health of Nigerians may be at risk due to poor chronic disease management, lack of education on healthy lifestyle, poor self-care, among others
According to the World Health Organisation, “Health promotion is the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions’
The table above shows that Nigeria’s population in 2015 was over 182 million, it is now a well-known fact that the population keeps growing while the available healthcare facilities keep dwindling.
Health promotion strategies will go a long way to ensure healthy lives and wellbeing of the citizens. In order to achieve this, education and public health campaign strategies must be adopted to foster healthy living lifestyles, exercise, cutting down on alcohol consumption, quitting smoking, banning smoking in public places as passive smoking is equally dangerous.
A lot of Nigerians are known to ignore the early warning signs of ill health, a great percentage of the populace do not seek medical intervention in good time and always wait for the last minute. This may be due to ignorance, nonchalant attitude towards healthcare and religious influences.
Evidence has shown that lifestyle advice (practicing healthy living tips) and self-care will go a long way in managing certain disease conditions. For instance, long-term conditions such as heart failure, stroke, diabetes, high blood pressure, asthma, etc.
Cancer awareness is another area most people need more information on. Evidence has shown that the risk of having some cancers can be prevented by adopting a healthy living lifestyle, also some cancers can be better managed if symptoms are reported at the early stages for instance prostate cancer which affects men.
According to prostate cancer experts, the men who are most likely to be diagnosed with prostate cancer are older men, black men and men with a family history of the disease.
The question is this, are people aware of those early symptoms or alarm symptoms to report immediately to the doctor in good time, as early intervention will help save lives?
In some developed countries which have organised healthcare systems like the United Kingdom, citizens are invited by way of letters being sent out to their home address at routine intervals or yearly for people to attend their GP Surgeries(medical centre) for routine tests and check-ups, for instance there is the over 60’s health check.
Also when men attain the age of 40 they are invited for prostate screening and other appropriate tests.
Women are encouraged to attend routine cervical smears, to help nip cervical cancer in the bud, just to mention a few.
According to the World Health Organisation, ‘’An overall working definition of integrated service delivery is the management and delivery of health services so that clients receive a continuum of preventive and curative services, according to their needs over time and across different levels of the health system.”
For health, care and support to be ‘integrated’, it must be person-centred, coordinated, and tailored to the needs and preferences of the individual, their carer and family. It means moving away from episodic care to a more holistic approach to health, care and support needs that puts the needs and experience of people at the centre of how services are organised and delivered.
The United Nations recognises number of pharmacists as important for wellbeing.
The density of pharmacists will now be taken into account in measuring the achievement of the United Nation’s Sustainable Development Goal 3, “Ensure healthy lives and promote well-being for all at all ages”. One of the targets under this goal is to “substantially increase health financing and the recruitment, development, training and retention of the health workforce in developing countries, especially in least developed countries and Small Island developing states.”
There is need for more Integrated healthcare in Nigeria where every member of the healthcare team Re- Doctors, Pharmacists, Nurses, physiotherapists, Dieticians, community healthcare workers and other healthcare professionals work together to contribute their own quota to excellent health promotion and healthcare delivery.
For instance in the UK, pharmacists undertake medicines optimisation/ medicines use reviews especially for patients taking medication for long term to help with chronic disease management, aim is to optimise therapy, reduce disease burden and improve the quality of life for those patients.
Medicines use review is an essential tool used to optimise therapy, identify possible adverse drug reactions, contraindications and make recommendations for start/stop treatment especially for elderly patients with long term conditions.
Evidence has shown that there is greater medicines adherence and concordance if patient’s gain full understanding of the indication/rationale for their medicines and they understand the dosage regimen.
It seems the expertise of pharmacists are not fully utilised in Nigeria for modern healthcare delivery strategies. The status quo must change if we have to move forward and develop our healthcare system as attainable in other countries.
We do not have enough doctors in Nigeria to serve our ever growing population; the need for integrated healthcare cannot be over emphasised. Healthcare professionals should engage in CPD-continuous professional development to attain the much needed clinical skills to function effectively in their chosen area of competence.
The elite class in Nigeria seems to have access to good healthcare by way of private treatment, but what happens to the masses and those who cannot afford a square meal a day let alone afford private care.
As our public hospitals are not equipped fully, there is a surge in medical tourism where Nigerians have to pay for exuberant health treatments abroad in places like UK, India, and Spain to mention a few.
This is just a minute part of the populace who can raise enough funds to foot these medical bills, also popular people aka ‘celebrities’ seem to have access to raising funds for their treatment abroad, there is a rising case of kidney disease where people seek treatment abroad and pay millions of naira.
This is a call for the Nigerian Government to promote integrated healthcare, invest more on public health campaigns, health promotion strategies, disease preventative measures, awareness creation on healthy lifestyle and self-care to help tackle the health issues bothering the citizens in other to achieve the United Nations Sustainable Development Goal.
• Efuribe, a Clinical Pharmacist/Independent Prescriber, writes from the United Kingdom