By Chimezie Godfrey
The Nigeria Medical Association (NMA), has reiterated its commitment to building stronger collaboration with government at all levels and has offered policy advisory options that will help combat the deadly COVID-19 disease.
In a statement on Sunday, the President, Dr Francis Faduyile commended the effort of government, agencies and stakeholders, especially the Nigeria Centre for Disease Control, NCDC, in tackling the spread of the pandemic.
He disclosed that the association is ready to synergize with government at all levels and to contribute in making policies that will assist in the defeat of the virus in the country.
“The Nigeria Medical Association (NMA) in response to the fast-emerging, highly infectious disease COVID-19 caused by SARS CoV-2, is committed to building stronger collaboration with Government at all levels and with other stakeholders, collating and disseminating new information; facilitating the deployment of new technologies and above all proposing policy options with the best chance of success for sharing with policy makers.
“We commend the efforts of the Nigerian Centre for Disease Control (NCDC) to incorporate the high throughput ROCHE platforms (3nos.) and GeneXpert machines (400 nos.) in both the public and private sectors into the testing architecture for the country.
“Over time commencing with this communication we will be supporting policy makers and stakeholders with evidence based policy perspectives that will help defeat the virus in our country.”
According the NMA President, the association is presenting the government with a policy option advisory which include the social distancing policy, scaling up of COVID-19 testing capacity in Nigeria, among others.
“In line with above commitment, the NMA urges that the federal and state governments consider the Continued and enhanced enforcement of all measures to maintain physical distancing of at least 2m in public spaces and avoidance of public gatherings larger than 20 persons.
“Although Universal use of face mask when outside, even with home-made cloth masks is desirable, it is however not a guarantee for full protection against contracting the infection. The enforcement of the wearing of face masks must be in addition to other mitigation measures.
“Increasing access to clean water and handwashing to provide significant infection and mortality risk reduction.
“The policy of lock-down should be implemented but should be accompanied by large scale public enlightenment down to the grassroots. It should also be accompanied by the distribution of palliatives for the most affected segments of the population: informal sector, small businesses, the extremely poor, and the vulnerable,” he said.
Faduyile emphasized the need for government to scale up testing capacity for COVID-19 in Nigeria.
He said as a way of tackling the ongoing community transmission, the NMA calls for massive upscaling of testing or mass screening using RDT and further confirmation with PCR method, concentrating mainly in areas with high disease burden.
He said this would give the policy makers an exit window and strategy about when to begin relaxation of the lock down, adding that this is even as the concept of the asymptomatic carrier has gained prominence.
“Government should expedite policy of creating more isolation and testing centres different from existing hospital facilities in the country and multiple locations within states and FCT.
“Strengthen Sample collection, management and referral network as well as decentralise the process to facilitate effectiveness and efficiency.
“Rapidly expand the laboratory network including skilled human resource, quality assurance and surveillance mechanisms across the country,” he said.
Faduyile pointed out that policy makers should consider the deployment of critical care infrastructure, adding that critical care for COVD-19 patients should be at the designated Treatment Centres which should be located outside the existing tertiary health institutions.
“This is one lesson we should learn from the management of the COVID-19 in Italy. Managing them in existing health facilities could lead to an escalation of nosocomial spread and which could spell doom for other patients in the hospital.
“Creation of regional intensive care centres to cushion the effects of manpower deficits. These centres should be well equipped with the latest tools in critical care including management of various organ failures.
“Expedite action on the operationalization of various concessionary healthcare financing arrangements including supporting members of the NMA to access financing from CBN plan,” he said.
Faduyile said that another important policy option put forward by NMA is for policy makers to consider the strategic deployment and training of human resources for health in COVID-19 pandemic.
According to him, there is need for capacity building by way of short courses in all states and FCT involving all cadres of health personnel including support staff.
“There should be prompt development of training manual on critical care management which should be made uniform in the country and simplified into SOPs and Treatment guidelines; the requisite specialty groups would assist in Quality Assurance.
“Facilitation of the use of Telemedicine including webinars on online platforms for knowledge sharing, training and learning for Nigerian based health personnel on COVID-19 pandemic.
The NMA President further stressed the for protection of healthcare workers, urging the government to immediately implement the proposed comprehensive incentive packages for health workers including life insurance, enhanced Hazard allowance and tax relief.
“State governments should do likewise to their healthcare personnel. The Federal Government is urged to support sub-national governments to ensure that healthcare delivery anywhere in Nigeria is incentivized and personnel motivated in the COVID-19 period and beyond,” he said.
Faduyile further disclosed that the Nigerian Medical Association is unveiling a support program tagged, “Save Our Private Health Practitioners Initiatives” for the sole objective of raising financial and material support (donations of quality PPEs and infection control consumables) to the tune of ₦500 million.
He said the fund is targeted at assisting private healthcare practitioners all over the nation in the containment and management of COVID-19 outbreak.
