The idea of a blog on health law and policy in Nigeria has been a dream waiting to be born since September 1st 2006, when I first moved to Canada to get a Master of Laws Degree in Health Law and Policy. In Canada, I realized that the dearth of health law and policy experts was not just a Nigerian problem. Canada was also in search for lawyers trained in health law and policy.
Naturally, settling into a field as broad as healthcare law was no easy task, considering the absence of any background training in this area in many Nigerian universities. Nonetheless, it was interesting to begin an intensive study of the myriad issues in the field through the lens of both Canadian and Nigerian law.
Health law and policy is a field that is still developing in many legal systems. Thus, it has been variously described as lacking its own organizing principles to set it apart as a distinct field. Gregg Bloche, writing on the Invention of Health Law, has described the field as a "chaotic, dysfunctional patchwork". For Mark Law and Carl Schneider, the "field grows by accretion" and as such lacks a "unifying idea or animating concern". The field embraces several other fields of law and distinct disciplines such as economics, tort law, contract law, insurance law, etc.
Hall in The History and Future of Health Care Law: An Essentialist View has asserted that the field should be recognized by its essential features which distinguish its legal features from those of other fields. These features include the experience of being a patient, the professionalism of health care providers, the treatment relationship between patients and providers and the existential stakes of medical care. Others are the nature of medical practice and the high cost of care and wide variability of need. Having identified these six features central to medicine and its practice, Professor Hall posits that these features give health care law its distinctive quality and are the foundation of the field’s doctrinal and interdisciplinary complexity.
However, the question that remains to be answered is whether these essential features provide the organizing principles needed to make health law and policy a distinct field of law; for, while on the surface Hall's essential features provide strong reasons why health law ought to be a field of law, these features remain reliant on a methodology or systemic framework that would bind the several distinct parts of health law and policy together and make it a truly coherent field.
Needless to say, the field is still evolving in Nigeria. There is as yet no coherent body of law to be described as medical law or health law and policy. However, it is doubtless that recent developments in the health sector in the country have set in motion the parametres for the development of this field. For example, the institution of the National Health Insurance Scheme has spurred several literature reviews, both in the field of law and associated disciplines. The publication of the Traditional Medicine Policy and the gradual movement towards a (formally recognized) pluralistic healthcare system has also generated literature reviews outlining both the feasibility of such movement and its legal and ethical implications. Another subject gaining attention is medical negligence, and there are myriad articles already published on the topic by Nigerian scholars. Then, we have emerging writers on AIDS and human rights law. Reproductive and sexual health law is yet another field carving out its own space in the Nigerian legal system. Presently, a journal on reproductive rights, The African Journal of Reproductive Rights (AJRR) is underway. The journal, which will focus on sexual and reproductive rights, women's rights, gender discrimination, gender equality, gender violence, gender empowerment, maternity rights, harmful traditional practices, international legal frameworks on reproductiverights and related issues, has a Nigerian as its editor. Today, we have Nigerians in prestigious schools in the West studying for Masters and Doctoral degrees in Health law and Policy. You will also spot a Nigerian professor specializing in health law and policy in many Western Universities. Thus, I can confidently say Nigeria is slowly moving towards a solid new field of law to be christened Nigerian Health Law and Policy.
Healthcare in Nigeria is an engaging topic. The narratives and statistics on the state of healthcare in the country are overwhelming. The issues we have had to deal with have ranged from the problem of access and affordability to the migration of health professionals to the West. Persistent health inequalities fuelled by workforce shortages, maladministration of health professionals, geographical discrepancies in access to healthcare, and the rising out-of-pocket expenditures for consumers have made healthcare inaccessible to a large percentage of the population.
What role can law and policy play in effecting a change in this narrative? Will an analysis of healthcare in Nigeria through the lens of law introduce a new turn to the dismal narrative? As a disclaimer, it is important to state clearly that this blog is not all about law; it is interdisciplinary and therefore accommodates a fairly broad range of policy issues, commentaries, etc. On this inaugural issue, I have posted below a few links to some interesting articles on healthcare in Nigeria.
Ensuring Effective, Qualitative, Affordable and Accessible Health Care for All Nigerians Beyond 2007
By Felix-Abrahams Obi
Naturally, settling into a field as broad as healthcare law was no easy task, considering the absence of any background training in this area in many Nigerian universities. Nonetheless, it was interesting to begin an intensive study of the myriad issues in the field through the lens of both Canadian and Nigerian law.
Health law and policy is a field that is still developing in many legal systems. Thus, it has been variously described as lacking its own organizing principles to set it apart as a distinct field. Gregg Bloche, writing on the Invention of Health Law, has described the field as a "chaotic, dysfunctional patchwork". For Mark Law and Carl Schneider, the "field grows by accretion" and as such lacks a "unifying idea or animating concern". The field embraces several other fields of law and distinct disciplines such as economics, tort law, contract law, insurance law, etc.
Hall in The History and Future of Health Care Law: An Essentialist View has asserted that the field should be recognized by its essential features which distinguish its legal features from those of other fields. These features include the experience of being a patient, the professionalism of health care providers, the treatment relationship between patients and providers and the existential stakes of medical care. Others are the nature of medical practice and the high cost of care and wide variability of need. Having identified these six features central to medicine and its practice, Professor Hall posits that these features give health care law its distinctive quality and are the foundation of the field’s doctrinal and interdisciplinary complexity.
However, the question that remains to be answered is whether these essential features provide the organizing principles needed to make health law and policy a distinct field of law; for, while on the surface Hall's essential features provide strong reasons why health law ought to be a field of law, these features remain reliant on a methodology or systemic framework that would bind the several distinct parts of health law and policy together and make it a truly coherent field.
Needless to say, the field is still evolving in Nigeria. There is as yet no coherent body of law to be described as medical law or health law and policy. However, it is doubtless that recent developments in the health sector in the country have set in motion the parametres for the development of this field. For example, the institution of the National Health Insurance Scheme has spurred several literature reviews, both in the field of law and associated disciplines. The publication of the Traditional Medicine Policy and the gradual movement towards a (formally recognized) pluralistic healthcare system has also generated literature reviews outlining both the feasibility of such movement and its legal and ethical implications. Another subject gaining attention is medical negligence, and there are myriad articles already published on the topic by Nigerian scholars. Then, we have emerging writers on AIDS and human rights law. Reproductive and sexual health law is yet another field carving out its own space in the Nigerian legal system. Presently, a journal on reproductive rights, The African Journal of Reproductive Rights (AJRR) is underway. The journal, which will focus on sexual and reproductive rights, women's rights, gender discrimination, gender equality, gender violence, gender empowerment, maternity rights, harmful traditional practices, international legal frameworks on reproductiverights and related issues, has a Nigerian as its editor. Today, we have Nigerians in prestigious schools in the West studying for Masters and Doctoral degrees in Health law and Policy. You will also spot a Nigerian professor specializing in health law and policy in many Western Universities. Thus, I can confidently say Nigeria is slowly moving towards a solid new field of law to be christened Nigerian Health Law and Policy.
Healthcare in Nigeria is an engaging topic. The narratives and statistics on the state of healthcare in the country are overwhelming. The issues we have had to deal with have ranged from the problem of access and affordability to the migration of health professionals to the West. Persistent health inequalities fuelled by workforce shortages, maladministration of health professionals, geographical discrepancies in access to healthcare, and the rising out-of-pocket expenditures for consumers have made healthcare inaccessible to a large percentage of the population.
What role can law and policy play in effecting a change in this narrative? Will an analysis of healthcare in Nigeria through the lens of law introduce a new turn to the dismal narrative? As a disclaimer, it is important to state clearly that this blog is not all about law; it is interdisciplinary and therefore accommodates a fairly broad range of policy issues, commentaries, etc. On this inaugural issue, I have posted below a few links to some interesting articles on healthcare in Nigeria.
Ensuring Effective, Qualitative, Affordable and Accessible Health Care for All Nigerians Beyond 2007
By Felix-Abrahams Obi
Nigeria trains and develops human resources for health, but loses them to other sectors within the country and abroad due to relatively higher remuneration, welfare and motivation packages... There is a loud disconnect between policy making process, research activities and ownership of research agenda by key stakeholders ...
Restoring Health To The Agenda, A Matter Of Life And Death
By Ike Anya
In this piece, as a network of Nigerian public health professionals, we put forward our analyses of some of the issues that should be paramount in the health agenda for the next 4 years...
By Ike Anya
In this piece, as a network of Nigerian public health professionals, we put forward our analyses of some of the issues that should be paramount in the health agenda for the next 4 years...
Full Article: http://www.nigeriansinamerica.com/articles/1693/1/Restoring-Health-To-The-Agenda-A-Matter-Of-Life-And-Death/Page1.html
NIGERIA: Local ARV manufacturers want state support
LAGOS, 12 October 2007 (PlusNews) - Local manufacturers of antiretroviral (ARV) drugs are calling for the government to increase tariffs on imported anti-AIDS medicines, and discourage aid agencies and foreign governments from donating free drugs, to help them continue producing medicines for Nigerians living with HIV.
Full article:http://www.irinnews.org/Report.aspx?ReportId=74766
NIGERIA: Construction of hundreds of local health centres suspended
DAKAR, 24 August 2007 (IRIN) - Recently-elected Nigerian President Umaru Musa Yar' Adua has suspended the construction of 774 healthcare centres throughout his country, drawing questions on how his administration plans to tackle the increasingly dire health care situation in Africa’s most populous nation. "Whatever the rights or wrongs of the suspension of the contract… the fact remains that Nigeria has in recent years spent less of its budget per capita on healthcare than any other African government,” Ben Foot, programme director for Save the Children in Nigeria said.
Full article: http://www.irinnews.org/Report.aspx?ReportId=73917
Full article:http://www.irinnews.org/Report.aspx?ReportId=74766
NIGERIA: Construction of hundreds of local health centres suspended
DAKAR, 24 August 2007 (IRIN) - Recently-elected Nigerian President Umaru Musa Yar' Adua has suspended the construction of 774 healthcare centres throughout his country, drawing questions on how his administration plans to tackle the increasingly dire health care situation in Africa’s most populous nation. "Whatever the rights or wrongs of the suspension of the contract… the fact remains that Nigeria has in recent years spent less of its budget per capita on healthcare than any other African government,” Ben Foot, programme director for Save the Children in Nigeria said.
Full article: http://www.irinnews.org/Report.aspx?ReportId=73917
NIGERIA: Children dying needlessly from measles and other preventable diseases
One of many efforts to vaccinate Africans LAGOS, 11 July 2007 (IRIN) - Measles is a preventable disease yet when it strikes in Nigeria it finds a ready pool of victims most of whom are children. In June more than 50 children died while another 400 were hospitalised in Nigeria’s northeast Borno state following a measles outbreak.
Full article: http://www.irinnews.org/Report.aspx?ReportId=73203
Full article: http://www.irinnews.org/Report.aspx?ReportId=73203
1 comments:
Hello,
This is truly an interesting blog. I am currently undergoing a masters program in the UK and writing my dissertation on Advanced Medical Negligence.
I have first experiences of medical Negligence in the Nigerian Health Care Service and feel like so any Nigerians that awareness needs to be created first because the average Nigerian who sits before a doctor puts his life in his hands as a professional in his field and does not know that to an extent he can question the actions and motives of his doctor, instead of seeing him as a 'god'. I will appreciate a personal communication forum. My email is justvie@hotmail.com. Hope to hear from you.Thanks.
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