Unconventional Medical doctor, Universal Health Coverage advocate and founder HealthProactivists.com Marietta lmadojiemu gave us an insight into her advocacy journey and her views on what’s needs to be done to achieving Universal Health Coverage in Nigeria
You termed yourself as an “Unconventional” medical doctor, what does that implies. Could you also tell us about your academic and professional journey
As a medical student or practitioner, there’s an impression that you have to stay confined in the hospitals waiting for calamity to strike before you step in to help. The training too makes you think that’s all you were called to do. Doctors and other health workers sacrifice a lot to ensure the best levels of care for Nigerians within their capacity. If you take a deeper look, you would realise that most deaths and emergencies could have been averted if a lot more work was put into preventive medicine and health system strengthening.
My journey to being a doctor started with a desire at age 9. I honestly didn’t know it would have to take this long. I literally planned for six years only, so I can go ahead to further my education and concentrate on works of impact. I ended up spending about 7years and a few months for no reason. I sincerely believe this is something that can be changed as no one needs to spend unnecessarily long years in school, even those reading medicine please (Laughs)
I graduated from the University of Benin in 2017, and did my housemanship at the Lagos University Teaching Hospital.
You are a passionate SDGs Advocate with core interest in Universal Health coverage. What does UHC implies and Could you tell us more about your inspiration to follow this path.
I had always had a yearn to make things, places or people better than I met them. Knowledge of the SDGs just made me more focused and gave me a guide to making impact. Seeing first hand the drawbacks in our health system and deaths due to lack of funds during practice pushed me to advocate for Universal Health Coverage(UHC). I remember vividly how, on so many occasions, I wrote on case notes of patients, ‘this or that test was not be done as a result of financial constraint’. It was depressing to persistently write those words. There were times the health team I worked with organized themselves to contribute money for patients or donated blood for children but these, as expected are not sustainable. These made me resolve not to stay silent.
UHC simply implies that everyone irrespective of status or location has access quality health care when they need it without any hindrance and without becoming poor in the process. The goals are to ensure; 1) Equity of access to needed healthcare 2) Financial risk protection 3) Quality healthcare. This is much needed in Nigeria for morbidity and mortality statistics to improve.
According to the World Bank and WHO, across the world at least 400 million people lack access to at least one, of seven, essential health services and 100 million people are tipped into or pushed further into poverty because of health spending. Isn’t UHC rather utopian and unachievable for the poor countries?
In fact, being a poor country should make UHC a priority goal for us if we are to have a chance at development as a Nation. WHO has already given cost effective ways of attaining this feat including smart investment in strengthening primary health care and encouraging mandatory pooling of funds for health (health insurance). Technology, when well utilized has also shown great potential of helping countries achieve health for all. Our aim in Nigeria now is to raise awareness about the importance of the UHC concept and acting on these methods which have proved extremely effective in other African countries like Rwanda.
You are the founder of the platform HealthProactivists.com , the convener of #UHCIsPossibleInNigeria, could you elaborate more on your activities and achievement through this platform.
The #UHCIsPossibleInNigeria campaign held from Dec 8-12th 2019 and aimed sorely to raise awareness on the role each sector has to play in ‘Keeping the promise’ in line with the theme of the UHC day 2019. It ended with a Tweetchat on that day Dec 12th 2019 facilitated by an expert in this topic- Dr Ifeanyi Nsofor, CEO EpiAfric and Director Nigeria Health Watch. The campaign got collaborations from 5 Non governmental health organizations including the one I currently volunteer with, SMILE with me foundation and 2 social enterprises. The campaign garnered support from a number of health influencers including DrZobo, Aproko doctor, DrJohnAfam, trendingmedic and award winning SDG advocates like Miracle Ewim, Dr Cassie Akinde, Dr Ekene Ahaneku and more. It had a total reach of over 289, 000 and made a total of over 610,000 impressions after trending on twitter for about 3 hours. People indeed got better understanding of what UHC was all about. Healthproactivists.com exists to aid in fighting Non communicable diseases through health education. Though a new platform, I envision empowering many Nigerians with information needed for the prevention and control of NCDs thus reduce mortality from these diseases. Nigeria has become a country with double burden of disease and more emphasis is being placed on infectious disease while our adults are having lower life expectancies due to deaths from these NCDs leaving families without breadwinners. There are plans to ensure that Healthproactivists.com undergo some expansion to increase impact in no distant time.
Whats needed to be done in achieving Universal Health coverage in Nigeria. What are the roles of the private sectors and NGOs to achieving this.
Currently a lot if being done including the signing up of mandatory state health insurance by various states. However, we need so much more. A major action Nigeria must take to achieve UHC is increase budget allocation to health, channel resources towards strengthening our primary health system and ensure accountability for all funds invested. We definitely cannot achieve UHC with less than 5% of the Nation’s budget going into health. Health is a priority and should reflect as such beginning with our budget. Only healthy citizens can earn, learn or contribute to National development.
What are the roles of the Private sectors and NGOs to achieving this.
The private sector involved in providing health to Nigerian citizens should have certificate of standards and strive to ensure the best standards are met by their organizations as in the National Health act. Health organizations are not just shops to mislead people and make money. Private sector employers also have a responsibility to ensure investment in health insurance for their employees to reduce and eventually eliminate catastrophic spending on health by these workers. NGOs play a major role in keeping our leaders and our health system accountable. They also engage in health education of the public on the importance of healthy preventive measures and safe practices to reduce disease burden and indirectly save money for many families. NGOs like Nigeria Health watch, SMILE with foundation, The Neo Child Initiative, Sebeccly Cancer support and more are currently doing this.
Your experiences volunteering for SMILE with me Foundation, and participating in various projects and outreach. What’s your advice to all young individuals championing and advocating for quality Health care in Nigeria and Africa.
Volunteering for me is genuinely a way of life. I literally light up at the thought of rendering my services freely to someone who would otherwise not be able to afford them. The smile on their faces after such projects is all I need to feel accomplished for that day. Engaging in numerous projects and outreaches since my undergraduate days and recently working with SMILE with me foundation this past year has blessed me with the opportunity to make a difference one project at a time. It has also taught me more about effective leadership, given me a closer view at the challenges Non profits face in making sustainable impact and added to my public health experience as a medical practitioner. It has also given me the gift of a powerful network of like minds driving passionately towards achieving the sustainable development goals and doing their bit to ensure Africa is not left behind.
I implore young champions and advocates for quality health care in Nigeria to continue in their fight and not grow weary from the challenges or slow progress towards positive results. Do your homework by reading and asking the right questions to know what has been done and what is yet to be done, so you can narrow your focus. Learn from experts both directly and indirectly as only then can you grow your own expertise. Your network will turn out to be one of your greatest resources, stay true to nourishing it and never forget, collaboration is key to greater impact, it is never just about us but about the progress we make together to achieve the goal.