The Lagos State Government has developed and launched guidelines for the development of safe and lawful abortion services within the ambit of the state’s criminal law.
The Permanent Secretary, Lagos State Ministry of Health, Dr. Olusegun Ogboye, presented a 40-page policy document tagged “Lagos State Guidelines on Safe Termination of Pregnancy for Legal Indications” at a stakeholders’ engagement on Tuesday.
Dr. Ogboye said the need was borne out of the desire for evidence-based data and information for health workers in public and private sectors.
Ogboye explained that while therapeutic termination of pregnancy is permissible under the law in Lagos State, the post-procedure absence of clear guidelines has stalled the effective implementation at appropriate levels of care resulting in preventable deaths.
His words: “In 2011, the Lagos State House of Assembly updated the criminal code, providing for abortion to save the life and protect the physical health of the woman.
“While physical health is covered under the Lagos legal framework, services conforming to the law have not been available in the procedure of the State health sector.
“This document provides information on relevant laws applicable in Lagos State while providing standards and best practices with regards to legal indications, pre, and post-procedure care, methods, the and monitoring.
“I must state here that this document has undergone wide consultation with relevant technical stakeholders within the legal and health service context in the State.”
Ogboye said the follow-up development of the guidelines commenced in 2018 with the Safe Engage project led by the Lagos Ministry of Health and hosted by the Society for Obstetricians and Gynaecologists of Nigeria (SOGON), with support from the Population Reference Bureau (PRB).
He noted that stakeholders in the state’s health sector worked with key opinion leaders in Lagos and the southwest region to develop a tailored advocacy tool for terminations within the legal context.
He also pointed out that the advocacy messages on the Safe Engage project focused on ensuring that safe abortion services were available within legal indications in Lagos, and domesticating the Violence Against Persons Prohibition, VAPP, Act supporting women to terminate a pregnancy caused by rape or incest.
“To guide the implementation, one of the follow-up outcomes recommendations of the project was the adaptation of the National Standards and Guidelines for Safe Termination of Pregnancy within Legal Indications within the Lagos State context.
“The Federal Ministry of Health had developed and disseminated the national guidelines on safe termination of pregnancy which highlights the compendium of conditions and circumstances under which termination of pregnancy could be instituted.
“The guideline was intended to build the capacity of health professionals to identify pregnancies for which legal termination could be instituted.
“Marie Stopes International in Nigeria in collaboration with the Population Reference Bureau proposed to support the State government to adapt the document.”
Further, Ogboye said that the process for National guidelines adaptation included technical meetings to discuss sections of the law supporting safe abortion and conditions permitted within the legal framework to save the lives and the physical health of mothers; and validation meetings with the broader stakeholders to review the document.
“All that hard work has culminated in today’s dissemination of the guidelines. We hope this dissemination today will help guide health providers to provide this service within the ambit of the law”, Ogboye stated.
The Country Director, Marie Stopes International Organisation Nigeria, MSION, Mr. Emmanuel Ajah, stated that the development and dissemination of the policy document have once again proven that Lagos is leading the way for State-level intervention to stem the tide of unsafe abortion and give women and girls improved health outcomes.
Noting that abortion in Nigeria is not illegal but restrictive, Ajah said significant numbers of health providers are unaware of the legal indications for safe termination of pregnancy.
He stressed the importance of healthcare providers with the responsibility to determine when the life of the woman is in danger as prescribed in Nigeria’s laws need to have the right understanding and make those critical decisions based on sound medical judgment and not on religion, culture, or other biases.
“The domestication of this policy provides that needed guidance to healthcare providers on medical conditions in pregnancy that pose a high risk to the woman’s life and health if the pregnancy progresses to term, and on the standard management of abortion within the extent of the law in Lagos state.
“This policy is a demonstration of the commitment of the Lagos state government to improving maternal health, especially mitigating the impact of unsafe abortion practices in the State,” Ajah stated.
The Vice-Chancellor, University of Medical Sciences, Otukpo, Prof. Innocent Ujah, who was one of the Consultants who developed the document, said the enunciation, deployment, providing, and use of the guidelines will preserve the lives of pregnant women and women whose physical or mental health would be compromised with the continuation of their pregnancies.
On her part, a Professor of Law at the University of Lagos, Prof. Ayodele Atsenuwa explained that the Lagos State Criminal law of 2011 only prohibits unlawful abortion.
Atsenua observed that the document clarifies and explains what lawful termination of pregnancy means in the context of the law adding that education of law enforcement officers is important with regards to providing and understanding the context of the law.
Buhari Approves Three Orthopedic Hospitals In Edo, Two Other States
President Muhammadu Buhari has approved the establishment of three additional orthopedic hospitals.
Health Minister, Osagie Ehanire, made the announcement on Wednesday at the inauguration of the Primary Health Care(PHC) Leadership Challenge at the State House.
The event was organised by the Nigeria Governors’ Forum (NGF) in collaboration with development partners.
Ehanire disclosed that the President approved siting of the orthopedic hospital in three regions.
“North-East has one; the North-Central has one and the South-South has one; in Benin, Jos and Jalingo respectively”, NAN quoted him saying.
Finance Minister, Zainab Ahmed said N471.9 billion had been disbursed to states under the $1.5billion World Bank-Assisted States Fiscal Transparency Accountability and Sustainability (SFTAS) Programme.
She added that all the 36 states had fully domesticated the fiscal reforms in their public financial management system.
Ondo Hospital Rations Fuel, Patient Dies During Surgery
A middle-aged-man, Sunday Samuel, has accused the Ondo State Trauma and Surgical Centre, Ondo Town, of negligence after his wife died during a surgical operation at the facility.
The deceased, Fola, was reportedly diagnosed with breast cancer.
The mother of four was thereafter placed on medication for about a month in the hospital ward before she was taken to the theatre for surgery on Monday, July 25.
According to her husband, the operation was disrupted by power outage, as the medical facility repeatedly switched between electricity and generator.
He also lamented that the hospital failed to provide a standby oxygen cylinder before embarking on the surgery, as none was available when they needed it during the operation.
Sunday said, “My wife had breast cancer and was admitted to the Ondo State Trauma Centre, where she was stabilised for close to a month.
“On Monday, July 25, she was taken from her ward and moved on a wheelchair into the theatre room around 10.30am. Shortly after they moved in, power supply went off, and they had to call the person in charge of the generator to switch it on.
“I was even surprised that the man was just pouring fuel into the generator. The power came back 30 minutes later and they switched off the generator.
“After an hour, the light went off again. That was when we started looking for the man in charge of the generator but we could not find him. So, I had to put on the generator myself; imagine a big hospital like that.
“All this was happening while the surgery was ongoing. About one hour later, the person in charge of the generator switched to normal power again. About one hour and 30 minutes later, one of the doctors rushed out to call someone in our presence to get oxygen.
“I was sitting directly opposite the theatre with my mother-in-law and a friend and did not see anyone take the oxygen into the theatre. It was later that they came out to tell me that my wife did not make it. That was when I broke down in tears.”
Sunday, a security guard, frowned on the decision of the hospital to manage the fuel in its generator at the expense of his wife’s life.
He noted that all the demands of the hospital were met before Fola was taken to the medical centre.
“We bought oxygen the previous week when she was still in the ward. It was not as if she needed oxygen, but they said she might need it at night. So, I paid for it and they went to purchase it and placed it by her side. For more than five days, she did not use it. It was one morning that I arrived that they said she was unconscious in the night and had to use oxygen. We also bought two pints of blood; one was used before the surgery and the other was meant to be used during the surgery. So, if it was fuel that they needed, I would have got it too, instead of rationing their fuel. I wondered why they should manage fuel while carrying out a surgery at the expense of someone’s life. My wife had the chance of surviving if those scenarios had not played out,” he added.
A member of the family, who witnessed the incident and identified himself as Tunde, said the deceased was getting better before she was considered for the surgery.
He said, “When they brought her here, she could barely walk. But she later started recuperating. She was already walking, eating and even visiting the restroom by herself some days before the surgery. Her file is there to prove this. A nurse even confirmed to us that she was already getting better and capable of undergoing the surgery and that something of such should not have happened.”
The Information Officer of the medical centre, Tope Akinjide, said the hospital did not carry out any surgery on Monday.
But when confronted with evidence by our correspondent, he confirmed that it was true that the patient was operated on that day.
He said, “I am into administrative matters and not clinical matters. And from my own desk, surgery is carried out on Tuesdays, Wednesdays and Thursdays. Nevertheless, by their own discretion, they could have booked it for Monday. The surgery department has the right to schedule their operation. I have just confirmed the personality and the core subject matter of the case. It is true.”
Akinjide said a senior surgeon at the hospital told him that the survival chance of the patient was low.
“The issue is that when I spoke with the senior surgeon, he said the patient in question was in the ward for some weeks, and she had been critical, a late presentation of the case. The patient was having breast cancer and she took some pints of blood. More so, he said the patient’s oxygen was still intact, saying it did not get exhausted overnight,” he added.
Akinjide, however, did not respond to the allegations that the hospital was switching between electricity and generator while the surgery was ongoing.
He said he would contact the Deputy Chief Medical Director of the hospital for comprehensive details of the incident.
He had yet to do so as of the time of filing this report.
UK Licenses 266 Nigerian Doctors In Two Months, Total Hits 9,976
The General Medical Council which licenses and maintains the official register of medical practitioners in the United Kingdom licensed at least 266 Nigerian doctors in June and July, 2022.
The implication is that at least three Nigerian doctors were licensed per day in June and July 2022 despite the moves by the Federal Government to stop the exodus of doctors and health workers in the country amidst worsening brain drain of the professionals in the country.
A continuous monitor of the GMC register, it was noticed that the number of Nigeria-trained doctors in the UK currently stands at 9,976.
The figure does Again, Buhari Jets Out To London For Medical Appointment For 13th Time include other doctors of Nigerian origin who did not undergo medical training in Nigeria.
Presently, Nigeria has the third highest number of foreign doctors working in the UK after India and Pakistan.
The country however suffers a shortage of doctors.
The Medical and Dental Council of Nigeria noted that Nigeria now has over 100,000 doctors who have registered with the council.
Worryingly, Nigeria with a population of over 200 million citizens, indicate the percentage ratio of doctors to patients still falls below the World Health Organisation’s recommendation of 1:600.
A poll by NOI in 2018 also showed that 88% of Nigerian doctors are considering work opportunities abroad, but experts say the figure may be higher due to the rising insecurity and economic crunch.
Other popular destinations for Nigeria-trained doctors include United States, Canada, Qatar, Saudi Arabia and Australia.
The PUNCH reports that the Nigerian Medical Association has continued to call on the Federal Government to provide a thriving environment for doctors and health workers to curb the massive brain drain.
Currently, doctors in Nigeria under the aegis of the Nigerian Association of Resident Doctors have issued a two-week ultimatum to the government over poor welfare and failure to implement the new hazard allowance rate that was signed in December 2021.
The doctors had gone on strike for close to 60 days in 2021.
In an interview with The PUNCH, the Publicity Secretary of NARD, Dr Alfa Yusuf, said, “Government should declare a state of emergency on the health care sector, address the challenges, improve remuneration and good working conditions and address security issues.”
When asked about the causes of brain drain, Yusuf said, “Poor remuneration, poor working facilities, insecurities including assault on doctors and burn out from over work, among others.”
Also, the immediate past President of the Medical and Dental Consultants Association of Nigeria, Prof. Ken Ozoilo, said, “It is unfortunate that the government has once again failed to live up to expectations, but this is typical.
“This kind of attitude on the part of government and its agents feeds the notion that the government does not listen to workers unless they are on strike.
“Predictably, we are going into another round of NARD strike at a most difficult time and the government is squarely to blame.
READ ALSO: Why Nigerians Suffer Poor Healthcare – WHO
“Brain drain will sadly continue and will get worse. There is no measure put in place by the country yet that is capable of stemming the tide. Even the new hazard allowance fails miserably in this wise as it is a far cry from the demand of health workers.
“The NARD strike is not inevitable, but it is unlikely that agents of government responsible will act on time to avert it.”
Efforts to get the Minister of Health, Osagie Ehanire, proved abortive as calls and messages forwarded to his line remained unanswered as of the time of filing this report.
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