Thursday, December 8, 2011

I used to hate politics....

It's been a while! Quite a lot has happened since my last post that I would love to share in detail. However, due to recall bias (poor use of the term but I must practice my research methods lingo or die), I am unlikely to remember everything I had hoped to share.

The majority of my time has been occupied with writing a 2000 word essay (or better phrased, critical analysis) discussing 'The political barriers to the sustainable financing of health systems in low-income countries'. This topic jumped out at me from a list of 7 options. Mind you there were a lot of other extremely interesting choices such as discussing HIV/AIDS as a security issue (is it a security issue??) but being a citizen of the great state of Nigeria, I couldn't help but think about our current health system.

You might know far more than I do on this topic; no contest, but I saw this as an opportunity to understand what a health system is, what keeps it going and the constraints it faces particularly in developing countries like ours. Without going into too much detail, it is clear from the literature that the challenges faced in development and maintenance of a good health system are created through politics. Of course it follows then that the solutions to these problems are also political! Indeed that is what I have found!

A good health system isn't just having doctors and hospitals, although these are necessary. Instead it is really about making healthcare available and accessible to all people. This means that regardless of your income, who you are (big-man syndrome??) or where you live, you have access to healthcare at the point when you need it. It also means that not only can you afford to access the care at that point, but that in getting care, you are not driven below the poverty line. How many of us have heard stories of families struggling to pay gargantuan hospital bills? Or of people dying  because they were turned away at a health centre due to lack of money? (I read one such story as a kid and never forgot.... the story ended with something like "as she stood  outside the hospital clutching her dying baby, it gave one final shudder and cry, stretched out (as if in pain) and died..." It sounds unbelievably dramatic but as the Yorubas say "aimoye" - only God knows how many people have died or been disabled similarly.

I had a discussion with one of my professors, a normal bubbly and enthusiastic lady. To be perfectly honest it wasn't the greatest conversation for other reasons but in the course of discussing a potential topic for my dissertation (due next year) she said point-blank: "universal [health] coverage is not on the Nigerian policy agenda". I could not agree or disagree...I had no idea! So slowly but surely, I am happening on a potential area of research for myself, the makings of what I hope will be a great dissertation. So I'm getting into politics after all. Ah well even Moses was once reluctant... lol

In Pursuit of what? Many things, but definitely change!!

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