The Role of local and state government in health care in Nigeria.
The Federal Ministry of Health / NCDC has one of the best policies and protocols to combat Covid -19 in the world. Feel free to include those you consider as saner climes. The protocols are extensive, simple and easy to implement. But what are the states doing?
Healthcare is not exclusively under the FG.
The states have larger responsibilities. The NCDC will provide the needed support and guidance. They work on what is on ground in each state. A lot of states in Nigeria have moribund health systems.
The states are meant to have
1. Commissioners of health
2. Permanent secretaries of health / research and planning
3. Chief Epidemiologists
4. Surveillance teams at LG level
5. Funds to implement simple protocols
While Lagos state can boast of Prof. Abayomi and his team, a lot of states cannot do the simplest things..gather and present data in a simple format.
NCDC will not take over the function of the ministry of health in these states. They should have disease / Epidemiology units.
NCDC will not enforce lockdowns or mass gathering protocols. If a state decides to flout the protocols then the state should be held responsible.
NCDC will not do surveillance functions at LG level, the agency can send workers to assist the state but their success is dependent..
States have the majority of responsibility for public hospitals, ambulance services, public dental care, community health services, and mental health care. Local governments play a role in the delivery of community health and preventive health programs, such as immunization and the regulation of food standards.
What is hard in implementing NCDC mass gathering or case management protocol? States cannot do these simple things? Do you want the FG to fully take over healthcare?