Dr. Omasanjuwa Edun is the Team Leader for the Nigerian Urban Reproductive Health Initiative, NURHI, Lagos State office. In this interview with APPOLONIA ADEYEMI, he highlights the obstacles hindering uptake of family planning and the way out
What are the barriers hindering the uptake of family planning and how do you convince people of reproductive age to adopt family planning?
Some of the barriers against family planning, FP are cultural barriers, which is basically why some people or some school of thoughts believe that our culture is against Family Planning.
This is especialy when we have some culture saying “God is the one that gives children and God is the one that takes.”
Hence, people in this group believe that we should not play God by using FP. At the same time, we also need to understand that part of our culture is bringing up responsible children. So, we should not confuse the number of children to the quality of children that we bring into the world.
In as much as we want to give birth to children, the real advice in Family planning is that we should be looking at bringing in children that we can take care of responsibly in such a way that when these children grow up, they are responsible enough to take care of us in future.
We have come to realize that some of the things we call culture are actually grounded. If you hear people saying, “You need to give birth to all of the children that God has destined you to give”.
So, you keep on having children as much as you can; but looking at it critically, we would understand that it doesn’t work anyway, because we cannot give birth to all the children in our womb.
You know that a woman has millions and millions of eggs and it is practically impossible to give birth to all the children, I mean all the eggs a woman has in her reproducing system. We know that these cultures are information that have been passed down from generation to generation, but you also understand that it might not necessarily be true.
What we always ask is: what value are these children going to bring to this family? Are we having children for the sake of having children?
Or are we having children that we are going to provide for including quality livelihood and wellbeing, in such a way that when these children grow up, they are responsible and they can take care of us in our old age?
Gone are the times when we needed a large family to cultivate our land.
We are now into a modern age where the numbers of children does not necessarily determine your strength; the number of children does not determine the wealth we have. In any case, you will find out that the more children you have, the higher the tendency of your potential to remain in poverty.
So, we have to realize that the time is changing and the environment in which we live in is also changing. We also have to change as individuals and our culture also has to change.
We ought to realize that culture is dynamic and culture changes, and we need to move with the times and realize that Family Planning is something that we need to embrace. if we look from an- other angle, the way technology is going , we will have a problem in our hands if the number of children we have do not find job in the future.
You will agree with me that technology is taking a lot of our jobs today.
If we go to the banking sector, people can’t find job, people are losing their job, because computer has come.
One of the factors making some people to reject FP commodities is many of its acclaimed side effects. What is your take on this?
There is no FP without side effects. Just like any other drug.
Even paracetamol has side effects, but then, what are the benefits of taking FP commodities? Let’s not forget that each of these side effects have ways that they can be managed.
For instance, what we advise people to do is, if you take up a method that is not suitable for you, you have the option of going back and when we assess it and find out that it is not good for you, we can change the method to the one that is most suitable for your body.
So, it’s not compulsory that you must stick to a particular method. We have drugs that we can use to manage the side effects.
So, after a while, it becomes normal and some side effects that consumers experience overtime will disappear on their own without having to take anything.
But the thing is, we need to educate women to expect these side effects which are not a threat to their life, but when it gets to a point where it becomes intolerable, then instead of having to complicate it with going to a somebody who is not trained, they should go back to the service provider that gave them the service in the first place or go to a trained service provider that is closest to them to report the case so they can be treated and addressed properly.
On the issue of Catholics which are advocating only for the natural method of FP to be used. Is anything wrong with that particular method which this church prefers?
Absolutely, no!. Family planning is about uniform choice and it is entirely voluntary.
So, as Catholics, give their members or congregation the option to choose what they as an individual decides is best for them.
They are not preaching against FP, but on the contrary, they are not giving members the ability to have power or the ability to choose whatever method they want.
They can promote a particular method which they believe is most efficient or effective, but limiting members to just that method without actually informing them that there are other methods is not really a good idea.
Every woman at one stage in her life should plan her family through whatever means they decide, whether natural, modern, whatever means they want to plan her family with.
It could be abstinence or any other method because in the absence of family planning, the consequences are grave.
How will you assess the performance of the government with regard to awareness on FP?
For Lagos state, the government is doing a lot to promote FP. In the few years that we have worked in Lagos State Government, they have done a lot in sensitising the communities, supporting outreaches and doing campaigns, especially during what they call the Maternal and Child health week when they promote the use of family planning.
S o m e – times they do “stand alone programmes” that talks about reproductive health, maternal health that also helps promote FP.
The Lagos State Government is doing a lot to ensure that the FP becomes a social norm in Lagos state.
What is NUHRI doing on religious front to make FP acceptable?
From the religious angle, it is still a struggle.
What we have done as a group as NURHI is what we have been able to to put together.This is what we call the “interface forum,” where we put together people, leaders from various religious camps from the Muslim religious camp and Christian religious camps as well from different denominations – the Pentecostal, the Catholics in a group and we take message of FP.
We advocate to them to encourage their congregation to support FP and we have gone a step ahead to developed a book called “The Christian Perspective on Reproductive Health and Family Planning.”
Religious leaders have an important influence over the lives of the people that they lead. So, by the time we are able to address the religious issues, we will see a remarkable increase in the number of people that adopt FP because the awareness in Lagos state is fantastic.
We have about 99 per cent of people who are aware of FP but still did not use it because they still do not know all of these limitations that we just listed.
If we are able to break these barriers especially the religious and traditional barriers, we will see that the uptake of FP will increase; we will see women living better lives.
We will see an improvement in the standard of living of women in the community and then we will definitely see a growth in our economy.
Scientists link western diet with kidney stones
Scientists said western diet, widely acclaimed to be unhealthy, could be linked to high prevalence of kidney stones. A study by the Mayo Clinic found kidney stones increased more than 300 per cent in women and 100 per cent in men within 30 years.
Although, the increase in kidney stones can in part be explained by improvements in medical imaging technology, medical experts linked it to the same dietary factors driving increases in colon cancer, heart disease, diabetes and obesity.
Kidney stones (renal lithiasis, nephrolithiasis) are hard deposits made of minerals and salts that form inside your kidneys.
Kidney stones have many causes and can affect any part of the urinary tract — from kidneys to the bladder. Often, stones form when the urine becomes concentrated, allowing minerals to crystallise and stick together.
Passing kidney stones are hard masses that form in the kidneys and take a painful route through the urinary tract when exiting the body. Passing out kidney stones can be quite painful, but the stones usually cause no permanent damage if they’re recognised in a timely fashion.
Depending on the situation, one may need nothing more than to take pain medication and drink lots of water to pass a kidney stone. In other instances — for example, if stones become lodged in the urinary tract, are associated with a urinary infection or cause complications — surgery may be needed.
The Mayo study examined first-time presenters of kidney stones from residents in Olmsted County, Minnesota in the United States (US), from 1984 to 2012, focusing specifically on differences between gender and age group. Previous studies of kidney stones were less accurate because they relied on diagnostic codes or survey questions to identify patients with stones.
‘30% of Nigerians suffer tooth decay’
Dr. Olurotimi Olojede is the former President of the Nigerian Dental Association (NDA) and the Secretary General of the African Regional Organisagion of World Dental Federation. In this interview with APPOLONIA ADEYEMI, he discusses factors fueling tooth decay, mouth odour, teeth extraction and measures to improve oral health generally
What are the common tooth problems in Nigeria?
Basically, in Nigeria, we have two major tooth problems. One has to do with the hard tooth structure and the second is the soft tissue. The hard tooth structure has to do with any disease that will affect the enamel. We call it cavity conformation or dental caries and we have the disease of the soft tissues or supporting structures of the teeth. It may be the gum, which is the periodontal disease and other parts of the tooth.
Race and environmental factors tend to affect the prevalence or occurrence of these dental problems at a particular point in time in different environments.
There is also oral cancer. Some may be benign while some are malignant.
Are they very common?
They are common; the only challenge we have is that patients don’t come to the hospital because some of the oral cancers are not painful at the onset and the swelling is gradual.
Some people carry the swelling for between eight to ten years and sometimes fifteen years until when they start to have deformation or cosmetic embarrassment. That’s when they seek medical advice and by that time it’s almost late. In fact, a very serious damage must have been done and surgery to correct that is very expensive.
What is the burden of dental caries in terms of available data?
If we are to look at available data, we will be talking about 25 per cent to 30 per cent of our population that comes down with dental caries.
Dental caries or cavities, which are also known as tooth decay, is a breakdown of teeth due to acids made by bacteria.
The cavities may be a number of different colours from yellow to black. Symptoms may include pain and difficulty with eating.
It’s a cross-sectional thing; it cuts across male, female, children and adults. If children takes things that will lead to it, it will happen. If adults, too take some of those things that will lead to it, adults too will develop it.
Specifically, what are the causes?
The four major things interplay in the development of dental caries; if one is missing out of those four major things, dental caries will not occur.
Number one is that it is not the quantity, but the frequency of the intake of refined sugar that is behind it.
Secondly, a susceptible tooth could also develop caries; that is to say that some teeth are made to have caries because of some things happening in them.
Then, the immunity of the patients is also very important and finally, bacteria in the saliva is another major problem leading to caries. All of us have bacteria in our saliva. So, when there are those enabling environment in the patient’s mouth, the patient will develop caries. We all have different species of bacteria in our mouth. Those four factors are very germane to the development of caries.
How can people prevent developing caries?
That’s why I said, it is not the quantity of refined sugars consumed that causes it, but the frequency. Even if you are taking it in small quantity, but also taking it frequently, the refined sugar will increase your risk of developing tooth decay. If you engage in taking refined sugar from morning till night, under one month, you will develop carries. Whereas, I might just sit down before my wife’s refrigerator before my lunch and take all the cakes there. You will realize that I will not have dental caries while someone taking tom-tom on regular basis throughout the day will have dental caries.
So, it’s the frequency of the intake of sugary diet that fuels tooth decay. For example, if before you leave your house in the morning, you drank tea or coffee with sugar and milk; When you get to work, you had another coffee or at meeting, they served you meat pie and soft drinks.
Thereafter in the afternoon you say, “Oh!, I’m really hungry. Can I have soft drinks,” which also contains refined sugar. Similarly, before you go to bed, you say, “Oh! You must give me my coffee” with milk and sugar. Before you know it, you have challenged your mouth regularly, eight to twelve hours with sugary substances.
Therefore, if you do that consistently for one month, you will have to get a good deal with your dentist.
One paramount method of prevention is, whether there is complaint or not, you must make sure you see your dentist every six months or twice a year.
You must also brush your teeth twice a day, first thing in the morning and last thing before you go to bed at night.
Similarly, you must make sure that you avoid what is called ‘in-between’ meals. You have taken breakfast, then you see somebody taking chin-chin, you take a little; someone is eating When you’ve taken your breakfast, you should relax. When you want to take snacks, take snacks and rinse your mouth and end it there.
Much more than that, you ought to involve in principles of hygiene; it’s very important and that is why I said that you shouldn’t wait until you a have a complaint before you visit your dentist.
In addition, you should use what is called medium toothbrush. In the market, there are trademarks, showing types of toothbrush; we have soft, medium and hard brushes.
Look on the packet, you will see medium for adults and then, you ask your dentist to teach you how to brush your teeth. It’s very important; we call it oral hygiene instruction.
If you do all that, you can keep your teeth for a lifetime, except you have trauma.
Adelusi-Adeluyi: Use digital platforms to improve patient outcomes
An appeal has gone out to healthcare professionals in the country to leverage communication and networking in order to improve the net worth of health service given to the patients.
To underscore this approach, they were urged to become early adopters in the use of digital health platforms that will positively improve patient outcomes.
This was the unequivocal submission of leading health practitioners at the launch in Nigeria of the IQVIA HCPSpace a digital healthcare platform by leading global provider of information, innovative technology solutions and human data science, IQVIA, formerly known as Quintiles IMS.
IQVIA HCPSpace is a web and mobile based platform designed to bring together all specialties and sub specialties of doctors, pharmacists, nurses, medical laboratory scientists, and all other healthcare professionals, where they can connect with peers, follow key opinion leaders (KOLs), discuss medical cases, establish public/private groups, view videos for increased knowledge, earn Continuing Professional Development, CPD points from content provided by approved bodies and KOLs, find jobs and career opportunities across multiple regions in Africa and the Middle East.
Chairman of the occasion and President, Nigerian Academy of Pharmacy, Prince Julius Adelusi-Adeluyi noted that IQVIA’s HCPSpace is a bridge-building tool that will encourage collaboration among healthcare providers whilst driving efficiency, performance and capacity utilisation as well as innovation in the nation’s health space as a whole.
“I would like to commend IQVIA for trying to crack a problem that has remained with Nigeria for quite a while given the numbers of government committees that had been set up in the past to solve the challenge of interprofessional collaboration and promote harmony in the health space. This tool will be a blessing to the nation as it will radically alter Nigeria’s health landscape for good and help to reduce unnecessary competition among professionals,” Adelusi-Adeluyi stated.
Chairman of the IQVIA HCPSpace Advisory Board, Dr. Femi Olugbile, pointed to the growing domestication of technology for personal and professional use across the world as well as creating a sense of team in community via multi-specialty task performance and problem solving tools.
“All over the world, there is an increasing awareness that communication and collaboration are essential ingredients for the creation of a thriving, high-achieving healthy work force.
Providing the reason for the platform’s existence, Country Manager, West Africa, IQVIA in General, Pharm. Remi Adeseun recalled that a communiqué was issued at the end of the Inter-Professional Collaboration Symposium organised by the Nigeria Academy of Pharmacy in collaboration with the Pharmaceutical Society of Nigeria, PSN. The event which held on May 11 2017 at the University of Lagos, encapsulated an 8-point resolution, and underscored the need to deepen the concept of universal communication and collaboration among healthcare professionals via tools that are yielding documented benefits and gains in the healthcare sector across the world.
“We are very confident that the
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