It is becoming increasingly obvious that to achieve Sustainable Health Systems (SHS), Business, among others, must take the lead. This applies to both developed and resource-limited communities. Corporate Social Responsibility (CSR) is now birthing Corporate Social Development (CSD). Successful business leaders know that for business to grow, you must have this competitive advantage. It is all about considering the business of health and consequently, the health of business.
The World Business Council for Sustainable Development now has a project that is addressing this issue. Have you read their Executive Brief? Check www.wbcsd.org
Sunday, May 28, 2006
Friday, May 26, 2006
Welcome!
This welcome is belated, but it is better late than never.
I am a Change Agent. I want to see sustainable development especially as regards Health Systems in resource-constrained settings. This is my Creed: my chosen path in life. I seek for people with similar vision-those who are entirely sold out. It is a well known fact that you achieve more when there is a cross-fertilization of ideas; when resources are pooled together.
You cannot as yet acquaint yourself entirely with my person in this single post but I reproduce below an essay I submitted when applying for a Master's Program I have just been admitted into. This will give you a glimpse of me.
Please read.
The Master of Strategic Leadership towards Sustainability Program: My Statement of Interest.
I live in a region of the world termed “developing” . This classification appears to be a misnomer . Everywhere I turn I see stagnation , retrogression and at times , outright decay . There are just a few segments of our daily lives that we have noticed the similitude of progress-slow , painful progress .
I have a background in the health industry. Some of our health indices were better during the pre-independence era than what obtains now. We even have done more harm to ourselves than good during our development, so-called. Consider Nigeria, my country. Nigeria is a populous nation of about 150 million people. This country occupies a landmass of about 923,768 sq km. She is blessed with abundant natural resources but sadly ranks as one of the poorest nations of the world. The average Nigerian lives below the poverty line. Corruption, greed, years of military rule, unstable economic polity, lack of political will and poor planning are some of the reasons why Nigeria remains poor. The health sector is not spared. The health indices are poor. A 2003 estimate puts Nigeria's infant mortality rate at 71 per 1000 live births and life expectancy at 51 years. In 1993, there were 5,208 persons per doctor and for many years, less than 3% of the GDP was spent on health care. Infectious diseases remain a major problem and preventive measures are rudimentary, almost non-existent. Public health institutions are mere spectacles of what they should be: most are under-staffed; the out of stock syndrome is rampant; health workers embark on work to rule campaigns incessantly and many health centers are death traps. There is substantial evidence that things were not this way at the beginning. Our development is not sustained. We grapple with mediocre leadership.
This is the state of many countries in the developing world.
I have been accosted by many, even accused, that I hold a somewhat simplistic, parochial view about the solution to the development issues facing resource-constrained settings. I strongly believe that the solution lies in our hands. We have to allow for responsible leadership that will give Sustainability issues priority of place. Otherwise, we will still continue to reel in the quagmire of under-development. This has been the thrust of my pursuits for a long time.
Ideas of a sustained environment first formed in my mind when I volunteered to join a Self-Help group that embarked on tree planting and beautification of my secondary school. I was in secondary school and we had just had a rain storm that pulled down a good number of the trees in my school. A tutor spearheaded this project and I came to learn from him that an imbalance in the milieu of the things on earth often results in chaos and devastation.
While at the university, I joined a socio-philanthropic organization called Les Ami where we imbibed principles of social responsibility and became advocates of sustainable development especially as regards healthcare delivery. Through this organization, we were able to conduct awareness campaigns about our core values at different levels of the university and the host city. We got some of our funding from the WHO and some public-spirited individuals.
I have an undergraduate degree in Medicine and Surgery from Nigeria’s premier university. I am at the moment involved in postgraduate training in Family Medicine at the Evangel Hospital, Jos, Plateau State, Nigeria. Before commencing residency training, I worked with a number of health outfits. Out of these, the public health outfits provided the most satisfaction as they exposed me again to issues of inequity in health distribution, inefficient, inaccessible and dilapidating health systems. I was able to carry out community mobilization and health advocacy which most of the time focused on establishing small but efficient health systems that work for people living in resource-limited communities. Sustaining larger healthcare networks was a challenge.
The Grace and Harold Sewell Foundation recognized these efforts and issued a scholarship to enable me present two papers at the 133rd Annual Meeting of the American Public Health Association last year. The papers bordered on sustainable healthcare development in developing countries. We have authored several other documents for publication/presentation at other fora. Recently, we started addressing the issue of universal access to antiretroviral drugs which is not possible without sustainable supply. If the supply is constant, then, we can scale up all other aspects of HIV care.
I have always nursed the ambition of pursuing a postgraduate degree in public health. While applying to schools around the world, I stumbled on information about the masters program in Strategic Leadership towards Sustainability which began to shed light on a peculiar principle dubbed The Natural Step Framework. I instantly came to terms with the fact that this degree is what I have been looking for to enable me achieve all that I have set to do for my community. For now, I have put on hold the quest to study this broad categorization called public health and pursue initially (if admitted into the program) principles that will empower me to follow my passion-that of ensuring sustainable development especially as regards healthcare delivery.
As at now, I am filled with burning questions which I hope this masters program will enable me to answer. It is common knowledge that health systems do not exist in a vacuum. Disease results as a complex interplay of several factors. And good health is not just the absence of physical ailments-the person is viewed as whole. Thus, the relationship of health systems to other systems is pivotal. Considering the whole systems approach how does health systems relate to other systems? With the well-known demon of brain drain bedeviling developing countries, how do you train and retain manpower for sustainability? What alternatives are available to build human capacity? What is “community”? How do you mobilize community to take responsibility for sustainability? How do you foster social responsibility by the corporate community?
I want to learn from other would-be course participants about how they were able to carry out advocacy campaigns to convince policymakers to ensure that sustainable development is given priority. How do we manage scarce resources to allow for needed growth? How does widespread poverty impart on development? What methods are available to reduce poverty? I can go on.
The developing world is my constituency. My immediate community is my starting point. If I am admitted into this program, I intend to use whatever I learn to ensure sustainable development especially as it relates to sustainable health systems. I will become a better ambassador for this cause.
Ifeolu Joseph Falegan, MD.
I am a Change Agent. I want to see sustainable development especially as regards Health Systems in resource-constrained settings. This is my Creed: my chosen path in life. I seek for people with similar vision-those who are entirely sold out. It is a well known fact that you achieve more when there is a cross-fertilization of ideas; when resources are pooled together.
You cannot as yet acquaint yourself entirely with my person in this single post but I reproduce below an essay I submitted when applying for a Master's Program I have just been admitted into. This will give you a glimpse of me.
Please read.
The Master of Strategic Leadership towards Sustainability Program: My Statement of Interest.
I live in a region of the world termed “developing” . This classification appears to be a misnomer . Everywhere I turn I see stagnation , retrogression and at times , outright decay . There are just a few segments of our daily lives that we have noticed the similitude of progress-slow , painful progress .
I have a background in the health industry. Some of our health indices were better during the pre-independence era than what obtains now. We even have done more harm to ourselves than good during our development, so-called. Consider Nigeria, my country. Nigeria is a populous nation of about 150 million people. This country occupies a landmass of about 923,768 sq km. She is blessed with abundant natural resources but sadly ranks as one of the poorest nations of the world. The average Nigerian lives below the poverty line. Corruption, greed, years of military rule, unstable economic polity, lack of political will and poor planning are some of the reasons why Nigeria remains poor. The health sector is not spared. The health indices are poor. A 2003 estimate puts Nigeria's infant mortality rate at 71 per 1000 live births and life expectancy at 51 years. In 1993, there were 5,208 persons per doctor and for many years, less than 3% of the GDP was spent on health care. Infectious diseases remain a major problem and preventive measures are rudimentary, almost non-existent. Public health institutions are mere spectacles of what they should be: most are under-staffed; the out of stock syndrome is rampant; health workers embark on work to rule campaigns incessantly and many health centers are death traps. There is substantial evidence that things were not this way at the beginning. Our development is not sustained. We grapple with mediocre leadership.
This is the state of many countries in the developing world.
I have been accosted by many, even accused, that I hold a somewhat simplistic, parochial view about the solution to the development issues facing resource-constrained settings. I strongly believe that the solution lies in our hands. We have to allow for responsible leadership that will give Sustainability issues priority of place. Otherwise, we will still continue to reel in the quagmire of under-development. This has been the thrust of my pursuits for a long time.
Ideas of a sustained environment first formed in my mind when I volunteered to join a Self-Help group that embarked on tree planting and beautification of my secondary school. I was in secondary school and we had just had a rain storm that pulled down a good number of the trees in my school. A tutor spearheaded this project and I came to learn from him that an imbalance in the milieu of the things on earth often results in chaos and devastation.
While at the university, I joined a socio-philanthropic organization called Les Ami where we imbibed principles of social responsibility and became advocates of sustainable development especially as regards healthcare delivery. Through this organization, we were able to conduct awareness campaigns about our core values at different levels of the university and the host city. We got some of our funding from the WHO and some public-spirited individuals.
I have an undergraduate degree in Medicine and Surgery from Nigeria’s premier university. I am at the moment involved in postgraduate training in Family Medicine at the Evangel Hospital, Jos, Plateau State, Nigeria. Before commencing residency training, I worked with a number of health outfits. Out of these, the public health outfits provided the most satisfaction as they exposed me again to issues of inequity in health distribution, inefficient, inaccessible and dilapidating health systems. I was able to carry out community mobilization and health advocacy which most of the time focused on establishing small but efficient health systems that work for people living in resource-limited communities. Sustaining larger healthcare networks was a challenge.
The Grace and Harold Sewell Foundation recognized these efforts and issued a scholarship to enable me present two papers at the 133rd Annual Meeting of the American Public Health Association last year. The papers bordered on sustainable healthcare development in developing countries. We have authored several other documents for publication/presentation at other fora. Recently, we started addressing the issue of universal access to antiretroviral drugs which is not possible without sustainable supply. If the supply is constant, then, we can scale up all other aspects of HIV care.
I have always nursed the ambition of pursuing a postgraduate degree in public health. While applying to schools around the world, I stumbled on information about the masters program in Strategic Leadership towards Sustainability which began to shed light on a peculiar principle dubbed The Natural Step Framework. I instantly came to terms with the fact that this degree is what I have been looking for to enable me achieve all that I have set to do for my community. For now, I have put on hold the quest to study this broad categorization called public health and pursue initially (if admitted into the program) principles that will empower me to follow my passion-that of ensuring sustainable development especially as regards healthcare delivery.
As at now, I am filled with burning questions which I hope this masters program will enable me to answer. It is common knowledge that health systems do not exist in a vacuum. Disease results as a complex interplay of several factors. And good health is not just the absence of physical ailments-the person is viewed as whole. Thus, the relationship of health systems to other systems is pivotal. Considering the whole systems approach how does health systems relate to other systems? With the well-known demon of brain drain bedeviling developing countries, how do you train and retain manpower for sustainability? What alternatives are available to build human capacity? What is “community”? How do you mobilize community to take responsibility for sustainability? How do you foster social responsibility by the corporate community?
I want to learn from other would-be course participants about how they were able to carry out advocacy campaigns to convince policymakers to ensure that sustainable development is given priority. How do we manage scarce resources to allow for needed growth? How does widespread poverty impart on development? What methods are available to reduce poverty? I can go on.
The developing world is my constituency. My immediate community is my starting point. If I am admitted into this program, I intend to use whatever I learn to ensure sustainable development especially as it relates to sustainable health systems. I will become a better ambassador for this cause.
Ifeolu Joseph Falegan, MD.
The 14th ICASA, Abuja, Nigeria.
I (in traditional African attire) accompanied 2 Consultant Family Physicians (shown in picture) to the 14th ICASA (International Conference on AIDs and STIs in Africa) that held in Abuja, Nigeria. It was a gathering of 
world-renowned researchers, AIDs experts, Activists, OVCs (orphan and vulnerable children), PLWHA, donor organizations, pharmaceutical companies, government dignitaries from all over the world and other stakeholders in HIV care.
One message resounded (reverberated?) repeatedly: it is high time we stopped the talk and just took action-simply scale up (in a sane way of course!) all aspects of HIV care. Period!
Here, we brainstormed, after one of the sessions.
Check www.icasa2005.org.ng for other details
world-renowned researchers, AIDs experts, Activists, OVCs (orphan and vulnerable children), PLWHA, donor organizations, pharmaceutical companies, government dignitaries from all over the world and other stakeholders in HIV care.One message resounded (reverberated?) repeatedly: it is high time we stopped the talk and just took action-simply scale up (in a sane way of course!) all aspects of HIV care. Period!
Here, we brainstormed, after one of the sessions.
Check www.icasa2005.org.ng for other details
Thursday, May 25, 2006
Middle level capacity building: Ensuring viable alternatives for under-resourced settings-a case in focus
DR. IFEOLU JOSEPH FALEGAN*; ECWA EVANGEL HOSPITAL, JOS, NIGERIA
Background- The developing world faces the daunting task of training and retaining manpower. There is a dearth of healthcare professionals. For instance, the projected immediate need of surgical specialists in Nigeria is 5756 but only 1256 are at post leaving a shortfall of 4500. The West African College of Surgeons is at the forefront of ensuring middle level surgical manpower development in Africa. There exist at the moment several programs in various African countries that seek to achieve this same objective. We consider one such case: the example of Evangel Hospital, Jos, Nigeria.
Method- We examine this hospital, founded in 1959; the different departments; the nationally acclaimed vigorous residency training program in Family Medicine; the dedicated local and foreign experts who facilitate this training and the impact this hospital has had on developing Nigeria’s middle level manpower.
Lessons Learnt- Evangel Hospital complements the effort of the West African College of Surgeons to develop middle level surgical manpower.
Conclusion- To achieve sustainable healthcare development, we must collaborate to discover evidence-based best practices that will ensure viable alternatives and allow for middle level capacity building.
Keywords- Manpower, Under-resourced settings
*Presenter
Submitted for presentation at the 46th Annual Scientific Conference of the West African College of Surgeons.
Wednesday, May 24, 2006
Nigeria is a populous nation of about 150 million people. This country occupies a landmass of 923,768 sq km. She is blessed with abundant natural resources but sadly ranks as one of the poorest nations of the world. The average Nigerian lives below the poverty line. Corruption, greed, years of military rule, unstable economic polity, lack of political will, poor planning are some of the reasons why Nigeria remains poor.
The health sector is not spared. The health indices are poor. A 2003 estimate puts Nigeria’s infant mortality rate at 71 per 1000 live births and life expectancy at 51 years. In 1993, there were 5,208 persons per doctor and for many years, less than 3% of the GDP was spent on health care. Infectious diseases remain a major problem and preventive measures are rudimentary, almost non-existent. Public health institutions are mere spectacles of what they should be: most are under-staffed; the out of stock syndrome is rampant; health workers embark on work to rule campaigns incessantly and many health centers are death traps.
The need for alternatives, for other viable options to the existing health care framework was borne out of necessity, out of the quest for survival. There was no intention to compete with public health institutions. Faith-based health institutions provided that viable alternative to rescue the masses from the doldrums prevalent in the nation’s healthcare system.
The ECWA (Evangelical Church of West Africa) medical directorate (EMD) has for many years provided quality healthcare to the ordinary Nigerian. It is a beacon of hope to many. It is a well-planned department of ECWA intended to be efficient in healthcare delivery. It adopts a holistic approach to the care of the person. Thus the recruitment process to the leadership of the EMD is a very thorough and competitive one.
The director of the EMD reports to the leadership of ECWA. He has several deputy directors reporting to him. These deputy directors head various health organizations run by the EMD. The EMD anticipated the problems being encountered by the public health institutions and set out to serve as a model that will bring sustainable healthcare development. Several consultations were made. Existing health policies were critically examined. The reasons for successes and or failures of several health programs were debated. A common standpoint was reached. Several departments were set up to meet different needs.
The School of Health Technology was set up to train community health extension workers. 55% of Nigeria’s populace lives in rural areas with significant health needs. Graduates from this school are trained to meet these peculiar needs.
The ECWA Community Health Program is spread through many states of the federation and is made of primary/secondary health centers. This program often traverses very difficult terrain to bring healthcare to the grassroots. It is a ready employer of graduates from the School of Health Technology.
The ECWA Evangel Hospital is a center of excellence for residency training in family medicine. There are several consultants (local and foreign) in different fields of medicine who facilitate this training. This hospital also serves as a referral center for many hospitals (including government teaching hospitals) in northern Nigeria. It is at the moment undergoing transformation to become the Bingham university teaching hospital.
The Vesico-Vagina Fistula (VVF) center is located within the Evangel hospital premises. It is one of its kinds in the country. It was borne out of necessity as many women develop fistulae due to a complex interplay of several factors. According to a retrospective study done on 899 women with obstetric VVFs in this center (check American Journal of Obstetric and Gynecology, 2004, April), the typical VVF patient was small and short; had been married early but was now divorced or separated; was poor, uneducated and from a rural area and had developed her fistula as a primigravida during a labor that lasted at least 2 days and which resulted in a stillborn fetus. This center has significant overseas sponsorship and the latest technology and expertise are employed in the repair of the VVFs of these helpless women.
The Family Health program is sponsored by the Packard foundation. It seeks to provide viable options for the family as a whole. It trains health workers and collaborates with many health institutions especially in northern Nigeria. It aims to reduce maternal morbidity and mortality especially in northern Nigeria. It organizes training workshops for emergency post-abortion care, seminars on family planning, universal precaution, cost-effective ways of managing sexually transmitted infections and so on.
Christoffel Blindenmission (CBM) supports the ECWA Eye hospital, Kano. It is a large eye referral center sited in the second largest city in Nigeria. There are consultant ophthalmologists and others, who help dispense health and train doctors from Nigerian universities undergoing their fellowship training, theater nurses and primary eye care personnel. World-class surgeries are done here. It is a resource center for many eye care projects spread throughout the West African region.
The School of Nursing and Midwifery supplies well-trained and much-needed nurses to the depleted workforce.
The ECWA Hospital, Egbe, also serves as a center of training for family medicine. It has for a long time collaborated with researchers from other Nigerian university to carry out groundbreaking studies. It provides affordable quality healthcare to people in its community.
The EMD has other subsets, which has for a long time been serving the people.
The EMD is involved in several collaborations to achieve its objectives. There is no disconnect with other institutions. It collaborates with the WHO, UNDP, the Packard foundation, EngenderHealth, the Netherlands TB and Leprosy program and so on to bring quality healthcare to Nigerians.
The EMD is not alone in its quest to provide sustainable healthcare development. There are other faith-based initiatives that aim to serve this purpose. This pool of faith-based health organizations provide succor from the turbulence experienced in healthcare delivery in Nigeria.
The lack of space will not allow us the luxury of elucidating the impact the EMD has made on the ordinary Nigerian. The results, however, as overwhelming as they seem, have not made EMD rest on its oars as new opportunities to influence the health polity are continually being sought after.
We present our example. We present this viable option for developing countries.
The health sector is not spared. The health indices are poor. A 2003 estimate puts Nigeria’s infant mortality rate at 71 per 1000 live births and life expectancy at 51 years. In 1993, there were 5,208 persons per doctor and for many years, less than 3% of the GDP was spent on health care. Infectious diseases remain a major problem and preventive measures are rudimentary, almost non-existent. Public health institutions are mere spectacles of what they should be: most are under-staffed; the out of stock syndrome is rampant; health workers embark on work to rule campaigns incessantly and many health centers are death traps.
The need for alternatives, for other viable options to the existing health care framework was borne out of necessity, out of the quest for survival. There was no intention to compete with public health institutions. Faith-based health institutions provided that viable alternative to rescue the masses from the doldrums prevalent in the nation’s healthcare system.
The ECWA (Evangelical Church of West Africa) medical directorate (EMD) has for many years provided quality healthcare to the ordinary Nigerian. It is a beacon of hope to many. It is a well-planned department of ECWA intended to be efficient in healthcare delivery. It adopts a holistic approach to the care of the person. Thus the recruitment process to the leadership of the EMD is a very thorough and competitive one.
The director of the EMD reports to the leadership of ECWA. He has several deputy directors reporting to him. These deputy directors head various health organizations run by the EMD. The EMD anticipated the problems being encountered by the public health institutions and set out to serve as a model that will bring sustainable healthcare development. Several consultations were made. Existing health policies were critically examined. The reasons for successes and or failures of several health programs were debated. A common standpoint was reached. Several departments were set up to meet different needs.
The School of Health Technology was set up to train community health extension workers. 55% of Nigeria’s populace lives in rural areas with significant health needs. Graduates from this school are trained to meet these peculiar needs.
The ECWA Community Health Program is spread through many states of the federation and is made of primary/secondary health centers. This program often traverses very difficult terrain to bring healthcare to the grassroots. It is a ready employer of graduates from the School of Health Technology.
The ECWA Evangel Hospital is a center of excellence for residency training in family medicine. There are several consultants (local and foreign) in different fields of medicine who facilitate this training. This hospital also serves as a referral center for many hospitals (including government teaching hospitals) in northern Nigeria. It is at the moment undergoing transformation to become the Bingham university teaching hospital.
The Vesico-Vagina Fistula (VVF) center is located within the Evangel hospital premises. It is one of its kinds in the country. It was borne out of necessity as many women develop fistulae due to a complex interplay of several factors. According to a retrospective study done on 899 women with obstetric VVFs in this center (check American Journal of Obstetric and Gynecology, 2004, April), the typical VVF patient was small and short; had been married early but was now divorced or separated; was poor, uneducated and from a rural area and had developed her fistula as a primigravida during a labor that lasted at least 2 days and which resulted in a stillborn fetus. This center has significant overseas sponsorship and the latest technology and expertise are employed in the repair of the VVFs of these helpless women.
The Family Health program is sponsored by the Packard foundation. It seeks to provide viable options for the family as a whole. It trains health workers and collaborates with many health institutions especially in northern Nigeria. It aims to reduce maternal morbidity and mortality especially in northern Nigeria. It organizes training workshops for emergency post-abortion care, seminars on family planning, universal precaution, cost-effective ways of managing sexually transmitted infections and so on.
Christoffel Blindenmission (CBM) supports the ECWA Eye hospital, Kano. It is a large eye referral center sited in the second largest city in Nigeria. There are consultant ophthalmologists and others, who help dispense health and train doctors from Nigerian universities undergoing their fellowship training, theater nurses and primary eye care personnel. World-class surgeries are done here. It is a resource center for many eye care projects spread throughout the West African region.
The School of Nursing and Midwifery supplies well-trained and much-needed nurses to the depleted workforce.
The ECWA Hospital, Egbe, also serves as a center of training for family medicine. It has for a long time collaborated with researchers from other Nigerian university to carry out groundbreaking studies. It provides affordable quality healthcare to people in its community.
The EMD has other subsets, which has for a long time been serving the people.
The EMD is involved in several collaborations to achieve its objectives. There is no disconnect with other institutions. It collaborates with the WHO, UNDP, the Packard foundation, EngenderHealth, the Netherlands TB and Leprosy program and so on to bring quality healthcare to Nigerians.
The EMD is not alone in its quest to provide sustainable healthcare development. There are other faith-based initiatives that aim to serve this purpose. This pool of faith-based health organizations provide succor from the turbulence experienced in healthcare delivery in Nigeria.
The lack of space will not allow us the luxury of elucidating the impact the EMD has made on the ordinary Nigerian. The results, however, as overwhelming as they seem, have not made EMD rest on its oars as new opportunities to influence the health polity are continually being sought after.
We present our example. We present this viable option for developing countries.
2-Page Summary for Faith-Based Health Initiatives....
Nigeria is a populous nation of about 150 million people. This country occupies a landmass of 923,768 sq km. She is blessed with abundant natural resources but sadly ranks as one of the poorest nations of the world. The average Nigerian lives below the poverty line. Corruption, greed, years of military rule, unstable economic polity, lack of political will, poor planning are some of the reasons why Nigeria remains poor.
The health sector is not spared. The health indices are poor. A 2003 estimate puts Nigeria’s infant mortality rate at 71 per 1000 live births and life expectancy at 51 years. In 1993, there were 5,208 persons per doctor and for many years, less than 3% of the GDP was spent on health care. Infectious diseases remain a major problem and preventive measures are rudimentary, almost non-existent. Public health institutions are mere spectacles of what they should be: most are under-staffed; the out of stock syndrome is rampant; health workers embark on work to rule campaigns incessantly and many health centers are death traps.
The need for alternatives, for other viable options to the existing health care framework was borne out of necessity, out of the quest for survival. There was no intention to compete with public health institutions. Faith-based health institutions provided that viable alternative to rescue the masses from the doldrums prevalent in the nation’s healthcare system.
The ECWA (Evangelical Church of West Africa) medical directorate (EMD) has for many years provided quality healthcare to the ordinary Nigerian. It is a beacon of hope to many. It is a well-planned department of ECWA intended to be efficient in healthcare delivery. It adopts a holistic approach to the care of the person. Thus the recruitment process to the leadership of the EMD is a very thorough and competitive one.
The director of the EMD reports to the leadership of ECWA. He has several deputy directors reporting to him. These deputy directors head various health organizations run by the EMD. The EMD anticipated the problems being encountered by the public health institutions and set out to serve as a model that will bring sustainable healthcare development. Several consultations were made. Existing health policies were critically examined. The reasons for successes and or failures of several health programs were debated. A common standpoint was reached. Several departments were set up to meet different needs.
The School of Health Technology was set up to train community health extension workers. 55% of Nigeria’s populace lives in rural areas with significant health needs. Graduates from this school are trained to meet these peculiar needs.
The ECWA Community Health Program is spread through many states of the federation and is made of primary/secondary health centers. This program often traverses very difficult terrain to bring healthcare to the grassroots. It is a ready employer of graduates from the School of Health Technology.
The ECWA Evangel Hospital is a center of excellence for residency training in family medicine. There are several consultants (local and foreign) in different fields of medicine who facilitate this training. This hospital also serves as a referral center for many hospitals (including government teaching hospitals) in northern Nigeria. It is at the moment undergoing transformation to become the Bingham university teaching hospital.
The Vesico-Vagina Fistula (VVF) center is located within the Evangel hospital premises. It is one of its kinds in the country. It was borne out of necessity as many women develop fistulae due to a complex interplay of several factors. According to a retrospective study done on 899 women with obstetric VVFs in this center (check American Journal of Obstetric and Gynecology, 2004, April), the typical VVF patient was small and short; had been married early but was now divorced or separated; was poor, uneducated and from a rural area and had developed her fistula as a primigravida during a labor that lasted at least 2 days and which resulted in a stillborn fetus. This center has significant overseas sponsorship and the latest technology and expertise are employed in the repair of the VVFs of these helpless women.
The Family Health program is sponsored by the Packard foundation. It seeks to provide viable options for the family as a whole. It trains health workers and collaborates with many health institutions especially in northern Nigeria. It aims to reduce maternal morbidity and mortality especially in northern Nigeria. It organizes training workshops for emergency post-abortion care, seminars on family planning, universal precaution, cost-effective ways of managing sexually transmitted infections and so on.
Christoffel Blindenmission (CBM) supports the ECWA Eye hospital, Kano. It is a large eye referral center sited in the second largest city in Nigeria. There are consultant ophthalmologists and others, who help dispense health and train doctors from Nigerian universities undergoing their fellowship training, theater nurses and primary eye care personnel. World-class surgeries are done here. It is a resource center for many eye care projects spread throughout the West African region.
The School of Nursing and Midwifery supplies well-trained and much-needed nurses to the depleted workforce.
The ECWA Hospital, Egbe, also serves as a center of training for family medicine. It has for a long time collaborated with researchers from other Nigerian university to carry out groundbreaking studies. It provides affordable quality healthcare to people in its community.
The EMD has other subsets, which has for a long time been serving the people.
The EMD is involved in several collaborations to achieve its objectives. There is no disconnect with other institutions. It collaborates with the WHO, UNDP, the Packard foundation, EngenderHealth, the Netherlands TB and Leprosy program and so on to bring quality healthcare to Nigerians.
The EMD is not alone in its quest to provide sustainable healthcare development. There are other faith-based initiatives that aim to serve this purpose. This pool of faith-based health organizations provide succor from the turbulence experienced in healthcare delivery in Nigeria.
The lack of space will not allow us the luxury of elucidating the impact the EMD has made on the ordinary Nigerian. The results, however, as overwhelming as they seem, have not made EMD rest on its oars as new opportunities to influence the health polity are continually being sought after.
We present our example. We present this viable option for developing countries.
The health sector is not spared. The health indices are poor. A 2003 estimate puts Nigeria’s infant mortality rate at 71 per 1000 live births and life expectancy at 51 years. In 1993, there were 5,208 persons per doctor and for many years, less than 3% of the GDP was spent on health care. Infectious diseases remain a major problem and preventive measures are rudimentary, almost non-existent. Public health institutions are mere spectacles of what they should be: most are under-staffed; the out of stock syndrome is rampant; health workers embark on work to rule campaigns incessantly and many health centers are death traps.
The need for alternatives, for other viable options to the existing health care framework was borne out of necessity, out of the quest for survival. There was no intention to compete with public health institutions. Faith-based health institutions provided that viable alternative to rescue the masses from the doldrums prevalent in the nation’s healthcare system.
The ECWA (Evangelical Church of West Africa) medical directorate (EMD) has for many years provided quality healthcare to the ordinary Nigerian. It is a beacon of hope to many. It is a well-planned department of ECWA intended to be efficient in healthcare delivery. It adopts a holistic approach to the care of the person. Thus the recruitment process to the leadership of the EMD is a very thorough and competitive one.
The director of the EMD reports to the leadership of ECWA. He has several deputy directors reporting to him. These deputy directors head various health organizations run by the EMD. The EMD anticipated the problems being encountered by the public health institutions and set out to serve as a model that will bring sustainable healthcare development. Several consultations were made. Existing health policies were critically examined. The reasons for successes and or failures of several health programs were debated. A common standpoint was reached. Several departments were set up to meet different needs.
The School of Health Technology was set up to train community health extension workers. 55% of Nigeria’s populace lives in rural areas with significant health needs. Graduates from this school are trained to meet these peculiar needs.
The ECWA Community Health Program is spread through many states of the federation and is made of primary/secondary health centers. This program often traverses very difficult terrain to bring healthcare to the grassroots. It is a ready employer of graduates from the School of Health Technology.
The ECWA Evangel Hospital is a center of excellence for residency training in family medicine. There are several consultants (local and foreign) in different fields of medicine who facilitate this training. This hospital also serves as a referral center for many hospitals (including government teaching hospitals) in northern Nigeria. It is at the moment undergoing transformation to become the Bingham university teaching hospital.
The Vesico-Vagina Fistula (VVF) center is located within the Evangel hospital premises. It is one of its kinds in the country. It was borne out of necessity as many women develop fistulae due to a complex interplay of several factors. According to a retrospective study done on 899 women with obstetric VVFs in this center (check American Journal of Obstetric and Gynecology, 2004, April), the typical VVF patient was small and short; had been married early but was now divorced or separated; was poor, uneducated and from a rural area and had developed her fistula as a primigravida during a labor that lasted at least 2 days and which resulted in a stillborn fetus. This center has significant overseas sponsorship and the latest technology and expertise are employed in the repair of the VVFs of these helpless women.
The Family Health program is sponsored by the Packard foundation. It seeks to provide viable options for the family as a whole. It trains health workers and collaborates with many health institutions especially in northern Nigeria. It aims to reduce maternal morbidity and mortality especially in northern Nigeria. It organizes training workshops for emergency post-abortion care, seminars on family planning, universal precaution, cost-effective ways of managing sexually transmitted infections and so on.
Christoffel Blindenmission (CBM) supports the ECWA Eye hospital, Kano. It is a large eye referral center sited in the second largest city in Nigeria. There are consultant ophthalmologists and others, who help dispense health and train doctors from Nigerian universities undergoing their fellowship training, theater nurses and primary eye care personnel. World-class surgeries are done here. It is a resource center for many eye care projects spread throughout the West African region.
The School of Nursing and Midwifery supplies well-trained and much-needed nurses to the depleted workforce.
The ECWA Hospital, Egbe, also serves as a center of training for family medicine. It has for a long time collaborated with researchers from other Nigerian university to carry out groundbreaking studies. It provides affordable quality healthcare to people in its community.
The EMD has other subsets, which has for a long time been serving the people.
The EMD is involved in several collaborations to achieve its objectives. There is no disconnect with other institutions. It collaborates with the WHO, UNDP, the Packard foundation, EngenderHealth, the Netherlands TB and Leprosy program and so on to bring quality healthcare to Nigerians.
The EMD is not alone in its quest to provide sustainable healthcare development. There are other faith-based initiatives that aim to serve this purpose. This pool of faith-based health organizations provide succor from the turbulence experienced in healthcare delivery in Nigeria.
The lack of space will not allow us the luxury of elucidating the impact the EMD has made on the ordinary Nigerian. The results, however, as overwhelming as they seem, have not made EMD rest on its oars as new opportunities to influence the health polity are continually being sought after.
We present our example. We present this viable option for developing countries.
Community health workers: Vanguards of hope for sustainable healthcare development in developing countries- the ECHP experience
Ifeolu Joseph Falegan, MD;CertFH;DipCS, Admnistrative Office, ECWA Community Health Program, and Department of Obstetrics and Gynaecology, ECWA Evangel hospital, ECWA Evangel Hospital Compound, Zaria Byepass, PMB 2238, Jos, Plateau State, Nigeria, +2348033296006, faleganji@yahoo.com
Nigeria is a large country of about 150 million people with 45% urbanization, life expectancy of 51yrs and infant mortality rate of 71/1000 live births. The dearth of healthcare professionals, political instability, dwindling funds from government and widespread poverty, among others, have made quality healthcare non-existent in many communities. The ECWA (Evangelical Church Of West Africa) Community Health Program (ECHP) with headquarters in Plateau State brings healthcare to the grassroots predominantly through community health workers (CHWs). The program is spread through several states of the federation with more than 110 primary healthcare clinics and maternity centers. Each state has a supervisor; all the supervisors report to the director of the program in a monthly planning and evaluation meeting. The CHW is key. He is highly motivated and innovative. He carries out a needs assessment with the help of community members and plans a program to meet these needs. Such needs and plans are critically examined at the monthly meeting. The ECHP provides seed money as revolving fund. The community provides the infrastructure. Community members form a clinic development committee. Hospital bills are kept at a minimum. There is no support from the government. The program is self-sponsoring. We have seen results. In a community in Bornu state (northern Nigeria), the rate of diarrheal diseases decreased by 62%; hookworm infestation decreased by 86%; and deaths from malaria decreased by 41% after appropriate interventions. A CHW will share our experience, extol the place of the CHW and reveal our aspirations.
Learning Objectives:
At the end of this session, the participant will be able to
1.Articulate clearly the role of the CHW in bringing quality healthcare to underpriviledged communities;
2.Discuss the need for policy-makers in developing countries to fully involve CHWs in sustainable healthcare delivery and
3.Develop a healthcare plan for a rural community of 5000 people.
Keywords: Sustainability, Developing Countries
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
CHWs as Integral Members of the Healthcare Team
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA
Nigeria is a large country of about 150 million people with 45% urbanization, life expectancy of 51yrs and infant mortality rate of 71/1000 live births. The dearth of healthcare professionals, political instability, dwindling funds from government and widespread poverty, among others, have made quality healthcare non-existent in many communities. The ECWA (Evangelical Church Of West Africa) Community Health Program (ECHP) with headquarters in Plateau State brings healthcare to the grassroots predominantly through community health workers (CHWs). The program is spread through several states of the federation with more than 110 primary healthcare clinics and maternity centers. Each state has a supervisor; all the supervisors report to the director of the program in a monthly planning and evaluation meeting. The CHW is key. He is highly motivated and innovative. He carries out a needs assessment with the help of community members and plans a program to meet these needs. Such needs and plans are critically examined at the monthly meeting. The ECHP provides seed money as revolving fund. The community provides the infrastructure. Community members form a clinic development committee. Hospital bills are kept at a minimum. There is no support from the government. The program is self-sponsoring. We have seen results. In a community in Bornu state (northern Nigeria), the rate of diarrheal diseases decreased by 62%; hookworm infestation decreased by 86%; and deaths from malaria decreased by 41% after appropriate interventions. A CHW will share our experience, extol the place of the CHW and reveal our aspirations.
Learning Objectives:
At the end of this session, the participant will be able to
1.Articulate clearly the role of the CHW in bringing quality healthcare to underpriviledged communities;
2.Discuss the need for policy-makers in developing countries to fully involve CHWs in sustainable healthcare delivery and
3.Develop a healthcare plan for a rural community of 5000 people.
Keywords: Sustainability, Developing Countries
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
CHWs as Integral Members of the Healthcare Team
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA
Faith-based health initiatives: Panacea for sustainable healthcare development in developing countries- the EMD model
Ifeolu Joseph Falegan, MD;CertFH;DipCS, Admnistrative Office, ECWA Community Health Program, and Department of Obstetrics and Gynaecology, ECWA Evangel hospital, ECWA Evangel Hospital Compound, Zaria Byepass, PMB 2238, Jos, Plateau State, Nigeria, +2348033296006, faleganji@yahoo.com
The health situation in Nigeria is representative of what exists in many developing countries. There is poor planning, lack of commitment by government to improve the poor health indices, apathy of the corporate community to the people's health needs, and widespread decay in the existing health infrastructure. Health workers go on strike incessantly, drugs are not available in many public hospitals and there is widespread quackery. The ECWA (Evangelical Church of West Africa) Medical Directorate (EMD) is a faith-based initiative designed (after several consultations and research) to turn the tide and bring sustainable healthcare development free of decay, bureaucratic bottlenecks and epileptic services to Nigerians. The EMD is made up of several institutions: the School of Health Technology which trains community health workers; the ECWA Community Health Program which brings health to the grassroots; the Evangel Hospital which runs one of the best Family Medicine training program in the country; an Eye Hospital where world class eye surgeries are done; the Vesico-Vaginal fistula center (one of its kind in the country), the Family Health Program sponsored by Packard foundation, the School of Nursing and Midwifery and the Egbe ECWA Hospital, among others. The EMD collaborates with the WHO, Engenderhealth, the UNDP, the Packard foundation, the Netherlands Leprosy and TB program, Christoffel Blindenmission and so on to bring quality healthcare to the people of Nigeria. Our success is the outcome of the implementation of evidenced-based policies. This presentation will share our experience and our hope for the future.
Learning Objectives: At the end of this session, participants will be able to
Describe the prevailing health situation in developing countries;
Articulate, clearly, the place of faith-based initiatives in providing healthcare in such countries;
Advocate increased participation of faith-based health initiatives in developing countries; and
Plan, as a beginner, a small scale health program for people in his faith community.
Keywords: Developing Countries, Faith Community
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
Multi-faith Collaboratives: Partnerships To Improve Health Outcomes
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA
The health situation in Nigeria is representative of what exists in many developing countries. There is poor planning, lack of commitment by government to improve the poor health indices, apathy of the corporate community to the people's health needs, and widespread decay in the existing health infrastructure. Health workers go on strike incessantly, drugs are not available in many public hospitals and there is widespread quackery. The ECWA (Evangelical Church of West Africa) Medical Directorate (EMD) is a faith-based initiative designed (after several consultations and research) to turn the tide and bring sustainable healthcare development free of decay, bureaucratic bottlenecks and epileptic services to Nigerians. The EMD is made up of several institutions: the School of Health Technology which trains community health workers; the ECWA Community Health Program which brings health to the grassroots; the Evangel Hospital which runs one of the best Family Medicine training program in the country; an Eye Hospital where world class eye surgeries are done; the Vesico-Vaginal fistula center (one of its kind in the country), the Family Health Program sponsored by Packard foundation, the School of Nursing and Midwifery and the Egbe ECWA Hospital, among others. The EMD collaborates with the WHO, Engenderhealth, the UNDP, the Packard foundation, the Netherlands Leprosy and TB program, Christoffel Blindenmission and so on to bring quality healthcare to the people of Nigeria. Our success is the outcome of the implementation of evidenced-based policies. This presentation will share our experience and our hope for the future.
Learning Objectives: At the end of this session, participants will be able to
Describe the prevailing health situation in developing countries;
Articulate, clearly, the place of faith-based initiatives in providing healthcare in such countries;
Advocate increased participation of faith-based health initiatives in developing countries; and
Plan, as a beginner, a small scale health program for people in his faith community.
Keywords: Developing Countries, Faith Community
Presenting author's disclosure statement:
I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.
Multi-faith Collaboratives: Partnerships To Improve Health Outcomes
The 133rd Annual Meeting & Exposition (December 10-14, 2005) of APHA
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