Ensuring professional harmony in troubled sector

The non implementation of the provisions of the National Health Act 2014, not too effective application of the new Drug Distribution Guidelines, planned review of the National Health Policy 2016 (NHP) and the need for Nigeria to achieve self-sufficiency in production of essential drugs have been in the front burner of national discuss. President and Fellow of the Pharmaceutical Society of Nigeria (PSN), Ahmed I. Yakasai, in a chat with journalists welcomed the idea of a reviewed National Health Policy 2016 (NHP), which he said is certainly overdue. The Fellow of Nigeria Academy of Pharmacy (NAP), Nigerian Institute of Management (NIM), Institute of Logistics Management of Nigeria (ILMN) and Institute of Chartered Institute of Commerce (ICIC) said the unnecessary professional rivalries and pecuniary interests which fuel the exemption of pharmacists in medicine procurement practices needs to be taken care of through a properly structured policy document which the National Health Policy 2016 perfectly epitomises. Yakasai who is also a two-time Commissioner in Kano State said the National Health system which provides the framework for standards and regulation of health services must now insist on having at least one registered pharmacist in charge of the pharmacy facilities in the 774 Local Government Areas (LGAs). The pharmacist among other things said pharmaceutical services would be boosted at primary care level with the provision of Section 11(3) (b) that now guarantees dedication of 20 per cent of the Basic Health Care Provision Fund (BHCPF) to procurement of essential drugs, vaccines and consumables for primary healthcare facilities. He appealed to the President Muhammadu Buhari led federal government to give immediate attention to the clamours of health workers including pharmacists to redress some pressing welfare demands. Yakasai also confirmed the approval of the Pharm D programme by the National Universities Commission (NUC), which will see pharmacy students bag doctorate degrees in Pharmacy. CHUKWUMA MUANYA, Assistant Editor (Head Insight Team, Science and Technology) was there. Excerpts:

• Yakasai appeals to Buhari on welfare demands, confirms approval of Pharm D programme by NUC
• PSN insists on at least one registered pharmacist in charge of facilities in each 774 LGAs

Health workers under the aegis of Joint Health Sector Union (JOHESU)/ Assembly of Health Professional Associations (AHPA) are still in talks with the government over unresolved industrial dispute and may go on strike anytime. PSN is a member of JOHESU. Where do you stand in the various welfare agitations of health workers in Nigeria?

We wish to appeal to the President Muhammadu Buhari led federal government to give immediate attention to the clamours of health workers including pharmacists to redress some pressing welfare demands.

These demands include: Immediate release of the circular on adjustment of the Consolidated Health workers Salary Scale (CONHESS) by the Salaries and Wages Commission (SWC); full payment of balance of arrears of the skipping of CONHESS 10 which remains outstanding since 2010 in some Federal Health Institutions (FHIs); proper implementation of the circular which prescribes sanctions on defaulting Federal Health Institution Managements which frustrate the promotion of health workers from CONHESS 14 to 15 as Directors; and issuance of enabling circular authorizing consultancy cadre for health professionals who have adhered to due process by scaling the hurdles of approval of the National Council on Establishment (NCE).

JOHESU is also demanding increase in the retirement age of health workers from 60 to 65 years and sponsoring an amendment bill to correct once and for all the litany of contentious provisions in the enabling statute that establishes teaching hospitals in Nigeria (cap 415 463 LFN 2004).

The PSN encourages the Federal Government to sustain the lofty ideals of the intervention championed by the late Minister of State for Labour and Productivity, Barrister Ocholi who calmed frayed nerves within the ranks of the various Health Sector Unions and Health Professional Associations that had threatened to go on strike in February.

While we agree the strike option should always be the last option, it is imperative the Pharmaceutical Society of Nigeria also appeals to the Federal Government to understand the plight of aggrieved health workers who also want reward for labour and have patiently endured in long-suffering especially after firm assurances were extracted from former President Goodluck Jonathan at a series of consultations which peaked with two different meetings with the former President in February 2015.

The PSN strongly commends and urges JOHESU/AHPA to continue to embrace dialogue with government as it remains optimistic that dialogue will ultimately be fruitful and productive in public interest.

The PSN believes now is the time to give all care-providers unlimited latitudes to showcase their potentials and skills in a larger bid to enhance their competencies in areas of specialization. As players in the global arena we must continue to align with the modern objectives and targets of healthcare, which places a huge premium on all health workers in the value chain.

We call on all the appendages of government including the Office of the Secretary to Government of the Federation, Head of Service of the Federation, Budget Office, Federal Ministry of Health, Federal Ministry of Labour and Productivity and all others involved in negotiations with JOHESU/AHPA not to allow a breakdown in negotiations as everything humanly possible must be done to avert another strike of health workers which can only hurt our economy as well as inflicting morbidity on the generality of our people.

The Society has for some time now been seeking for the institution of the Pharm D programme in Nigerian universities by the NUC. How far?

I must seize this discourse to express my profound gratitude to God who makes good things possible. To His glory I can confirm to you that the Pharm D programme is now approved by the NUC. Recall that this programme had been canvassed since 1999 when the Annual General Meeting (AGM) of PSN approved it in Enugu.

Incidentally, the immediate Past President and National Executive Committee (NEC) who worked assiduously on the Pharm D concept had struck an agreement to have a Pharm D stakeholder’s workshop on November 23, 2015. It turned out this was my first official duty to coordinate as President of PSN.

Now that this is approved, I enjoin all the faculties of pharmacy to brace up for this challenge in the collective bid to improve our service to consumers of health.

Permit me to specially acknowledge the role of the Pharmacy Council of Nigeria (PCN) Registrar and the members of the immediate past PCN who genuinely supported our aspiration in this regard. Finally, I convey our kudos to Prof. Julius Okojie, the Executive Secretary and Management of NUC for deeming it fit to give this most important approval.

It is believed that a new National Health Policy will help address the myriad of problems affecting healthcare delivery in the country. The Federal Ministry of Health appears to be working on a new National Health Policy. What is the position of PSN on this policy?

The PSN welcomes the idea of a reviewed National Health Policy 2016 (NHP), which is certainly overdue.

In tandem with the philosophy of the document and a dire need to promote the health of Nigerians to accelerate socio-economic development of the nation, a holistic approach and attitude needs to be brought to bear on the totality of endeavours with regards to the health policy.

To facilitate a grasp of this I will take them as follows: Human Resources for Health (HRH) at Primary Health Care (PHC) level; Use of Medicines and Vaccines at PHC level; and Public Private Partnerships (PPP) at PHC level.

How do you mean by HRH?

It is usually assumed that too much sophistry is not a requirement in the human resource layout at primary health care level. While this may be true in some regard, an inclination towards safety and an impactful health system suggests otherwise after more critical appraisal. The desire for a safety net is particularly germaine in the use of medicines, which may become poisons if not well handled.

Today the National Health Act 2014 vis provisos in Section 11(3) (d) dedicates 10 per cent of the Basic Health Care Provision Fund established in Section 11 (2) to the development of human resources for health. The Federal Ministry of Health must see a compelling need to embrace new thinking and a fresh attitude by inculcating all cadres of health professionals and workers into the health system.

Government must in this new dispensation see a need to redress the perennial challenge of poor management in human resource for health by employing the appropriate personnel to coordinate centrally at the Local Government Areas (LGAs) 774.

In the domain of pharmaceutical services which will be boosted at primary care level with the provision of Section 11(3) (b) that now guarantees dedication of 20 per cent of the Basic Health Care Provision Fund (BHCPF) to procurement of essential drugs, vaccines and consumables for primary healthcare facilities. The reality of a BHCPF is that hundreds of billions of naira should be available for drug and vaccine procurement which will come with emerging new challenges of good medicine management, drug quantification and perhaps the most fundamental to consumers of health the task of reducing drastically the out of stock syndrome which has traditionally made the primary care facilities most unattractive to clients.

The National Health system, which provides the framework for standards and regulation of health services must now insist on having at least one registered pharmacist in charge of the pharmacy facilities in the 774 LGAs.

In the spirit of the Poison and Pharmacy Act, the PCN Act and existing National Drug Policies these pharmacists will ensure proper medicine management and other tenets of Good Pharmacy Practice (GPP) which will trickle down the value chain through support personnel in pharmacy and other health cadres to the envisaged 10,000 primary care facilities all over the country.