Oluwatosin Adeyemo | Queen Margaret University, Edinburgh (original) (raw)
Papers by Oluwatosin Adeyemo
There is no gainsaying that health workforce (HRH) is the live wire of any well-functioning healt... more There is no gainsaying that health workforce (HRH) is the live wire of any well-functioning health systems. Nigeria currently accounts for the second highest number of maternal deaths worldwide and one attributable factor for this dire situation is the critical shortage of midwives especially in the rural areas. Nigeria urgently needs an effective HRH strategy to focus on improving recruitment; workforce performance; and most importantly, retention. Efforts targeted at retaining health workforce in rural areas have a multiplier effect because HRH performance and future recruitment endeavours are also invariably enhanced. What needs to be done is clear. It is time Nigeria went past rhetoric and empty political statements and began to do the needful — keeping the midwives.
Given that the Millennium Development Goals (MDGs) expire this year, there is no better time to r... more Given that the Millennium Development Goals (MDGs) expire this year, there is no better time to reflect and critical evaluate their impact on global development. The MDGs do not formally make mention of sexual and reproductive health (SRH) not until 2007, six years into the MDG era. The idea of SRH and reproductive rights was introduced in 1994 at the International Conference on Population and Development (ICPD). In practice, SRH concept is seen to be central to the general well-being of all peoples. Unlike the ICPD, the MDGs do not formally target SRH comprehensively. The sector-specific paradigm in which the MDGs were predicated steered the pursuit of these goals away from multi-sectorality in programme planning and implementation at the national level giving rise to vertical programming.
Hence, the MDGs might have created a dichotomy between HIV and SRH both by the adoption of a narrow vision of SRH only as maternal health and of HIV. This might have impacted negatively on the delivery and uptake of both HIV services and the broader SRH services in practice. While certain areas of SRH like HIV and maternal care have undoubtedly received increased funding, the opposite is the case for the other areas like contraception. In fact from 2000-2007, aid for family planning actually plummeted in proportional and absolute terms in spite of its centrality in preserving SRH of all peoples. It could be concluded that aid for broader SRH services declined in the MDG era at the expense of increases in that for HIV and maternal health. As we await the advent of the sustainable development goals, the right-based approach to comprehensive SRH services must be re-espoused for a lasting impact especially in resource poor settings.
Malaria is one of mankind’s oldest infectious diseases and it has been responsible for millions o... more Malaria is one of mankind’s oldest infectious diseases and it has been responsible for millions of death worldwide even though it is both preventable and curable. Out of the seven attempts made so far at global eradication of some human infectious agents, only one, the eradication of small pox, has so far succeeded. The WHO led Global Malaria Eradication Programme (GMEP) launched in 1955 eventually failed.After several decades of the abandonment of malaria eradication, Bill and Melinda Gates in Seattle on October 17, 2007 reignited the flame of malaria eradication once again and brought it back on the agenda of global health actors to the utter amazement of malaria experts.
The renewal of commitment to malaria eradication could be attributed to the new scientific strides made in the areas malaria vaccine development (RTS,S vaccine) and new malaria drugs, malaria control approaches based on the use of insecticide treated bed nets (ITNs); intermittent prophylactic treatment (IPT); artemisinin-based combination therapy (ACTs); indoor-residual spraying of spraying of insecticides (IRS); and the use of rapid diagnostic test kits (RDTs). And all of the above coupled with the unprecedented financial and technical capabilities available at the moment place the goal of malaria eradication within reach. The determinants of eradication progress are many but not limited to: funding; health systems support; new malaria vaccines; vector control; and the effect of climate change amongst others. Mr Gates reasons for malaria eradication may be legitimate, noble and even realistic. However, the concern is the availability of responsive, resilient, efficient and effective health systems to indefatigably deliver whatever answers we have got for malaria eradication.
Nigeria carries more than 30% of the global burden of mother to child transmission (MTCT). It is... more Nigeria carries more than 30% of the global burden of mother to child transmission (MTCT). It is adjudged that greater than a thousand children are newly infected with HIV each day, over 90% of these are infected through vertical transmission from their mothers. The answers to PMTCT scale up challenges in Nigeria are not only technical but also human, and require context-specificity. To scale up PMTCT services in Nigeria, it is not just about increasing spending although that is as well important. Governments, donors and all stakeholders must be ready to keep innovating strategies and reconfigure health services to meet the health needs of the different populations they serve and that is the way to make progress and sustain it.
TB still remains worldwide, the second greatest killer from only one infectious agent. Nigeria cu... more TB still remains worldwide, the second greatest killer from only one infectious agent. Nigeria currently ranks 11th among the 22 high burden nations that are responsible for 80% of the Global TB burden. DOTS programme has had some success in Nigeria but it hasn’t yet met the set targets and goals. The advent of drug-resistant TB strains converging with HIV epidemic has turned TB into a global public health disaster and what is direly required is sincere commitment from all stakeholders to speed up the scale-up of TB interventions at all fronts, faster case detection by screening at-risk populations, strengthening health systems to integrate services for tuberculosis and HIV in an efficient and effective collaborative model without duplication of efforts. The core lesson is that even though we need to continuously invest in what has yielded some results, we must be innovative in doing more so as to meet our goal of a TB free world someday soon.
There is no gainsaying that health workforce (HRH) is the live wire of any well-functioning healt... more There is no gainsaying that health workforce (HRH) is the live wire of any well-functioning health systems. Nigeria currently accounts for the second highest number of maternal deaths worldwide and one attributable factor for this dire situation is the critical shortage of midwives especially in the rural areas. Nigeria urgently needs an effective HRH strategy to focus on improving recruitment; workforce performance; and most importantly, retention. Efforts targeted at retaining health workforce in rural areas have a multiplier effect because HRH performance and future recruitment endeavours are also invariably enhanced. What needs to be done is clear. It is time Nigeria went past rhetoric and empty political statements and began to do the needful — keeping the midwives.
Given that the Millennium Development Goals (MDGs) expire this year, there is no better time to r... more Given that the Millennium Development Goals (MDGs) expire this year, there is no better time to reflect and critical evaluate their impact on global development. The MDGs do not formally make mention of sexual and reproductive health (SRH) not until 2007, six years into the MDG era. The idea of SRH and reproductive rights was introduced in 1994 at the International Conference on Population and Development (ICPD). In practice, SRH concept is seen to be central to the general well-being of all peoples. Unlike the ICPD, the MDGs do not formally target SRH comprehensively. The sector-specific paradigm in which the MDGs were predicated steered the pursuit of these goals away from multi-sectorality in programme planning and implementation at the national level giving rise to vertical programming.
Hence, the MDGs might have created a dichotomy between HIV and SRH both by the adoption of a narrow vision of SRH only as maternal health and of HIV. This might have impacted negatively on the delivery and uptake of both HIV services and the broader SRH services in practice. While certain areas of SRH like HIV and maternal care have undoubtedly received increased funding, the opposite is the case for the other areas like contraception. In fact from 2000-2007, aid for family planning actually plummeted in proportional and absolute terms in spite of its centrality in preserving SRH of all peoples. It could be concluded that aid for broader SRH services declined in the MDG era at the expense of increases in that for HIV and maternal health. As we await the advent of the sustainable development goals, the right-based approach to comprehensive SRH services must be re-espoused for a lasting impact especially in resource poor settings.
Malaria is one of mankind’s oldest infectious diseases and it has been responsible for millions o... more Malaria is one of mankind’s oldest infectious diseases and it has been responsible for millions of death worldwide even though it is both preventable and curable. Out of the seven attempts made so far at global eradication of some human infectious agents, only one, the eradication of small pox, has so far succeeded. The WHO led Global Malaria Eradication Programme (GMEP) launched in 1955 eventually failed.After several decades of the abandonment of malaria eradication, Bill and Melinda Gates in Seattle on October 17, 2007 reignited the flame of malaria eradication once again and brought it back on the agenda of global health actors to the utter amazement of malaria experts.
The renewal of commitment to malaria eradication could be attributed to the new scientific strides made in the areas malaria vaccine development (RTS,S vaccine) and new malaria drugs, malaria control approaches based on the use of insecticide treated bed nets (ITNs); intermittent prophylactic treatment (IPT); artemisinin-based combination therapy (ACTs); indoor-residual spraying of spraying of insecticides (IRS); and the use of rapid diagnostic test kits (RDTs). And all of the above coupled with the unprecedented financial and technical capabilities available at the moment place the goal of malaria eradication within reach. The determinants of eradication progress are many but not limited to: funding; health systems support; new malaria vaccines; vector control; and the effect of climate change amongst others. Mr Gates reasons for malaria eradication may be legitimate, noble and even realistic. However, the concern is the availability of responsive, resilient, efficient and effective health systems to indefatigably deliver whatever answers we have got for malaria eradication.
Nigeria carries more than 30% of the global burden of mother to child transmission (MTCT). It is... more Nigeria carries more than 30% of the global burden of mother to child transmission (MTCT). It is adjudged that greater than a thousand children are newly infected with HIV each day, over 90% of these are infected through vertical transmission from their mothers. The answers to PMTCT scale up challenges in Nigeria are not only technical but also human, and require context-specificity. To scale up PMTCT services in Nigeria, it is not just about increasing spending although that is as well important. Governments, donors and all stakeholders must be ready to keep innovating strategies and reconfigure health services to meet the health needs of the different populations they serve and that is the way to make progress and sustain it.
TB still remains worldwide, the second greatest killer from only one infectious agent. Nigeria cu... more TB still remains worldwide, the second greatest killer from only one infectious agent. Nigeria currently ranks 11th among the 22 high burden nations that are responsible for 80% of the Global TB burden. DOTS programme has had some success in Nigeria but it hasn’t yet met the set targets and goals. The advent of drug-resistant TB strains converging with HIV epidemic has turned TB into a global public health disaster and what is direly required is sincere commitment from all stakeholders to speed up the scale-up of TB interventions at all fronts, faster case detection by screening at-risk populations, strengthening health systems to integrate services for tuberculosis and HIV in an efficient and effective collaborative model without duplication of efforts. The core lesson is that even though we need to continuously invest in what has yielded some results, we must be innovative in doing more so as to meet our goal of a TB free world someday soon.