“It is my greatest desire that we improve the healthcare system in Nigeria and provide affordable healthcare for local communities at the grassroots so that people can have access to the care they need, when they need it, in ways that are user-friendly’  Adaku Efuribe

The 74th UN General Assembly took place in New York last September; high level meetings were held and Universal Health Coverage (UHC) was a hot topic for the week. As expected, Nigeria had a delegation of Government representatives, NGO’s and individual advocates who are working towards achieving SDG3 and UHC in attendance. So how do we implement new policies and what are the key drivers to providing UHC for all in Nigeria?

As an advocate for UHC/SDGs, I have been lending my voice over the years calling the Nigerian Government to action towards implementing UN SDGs agenda and achieving UHC.I have studied and participated in primary healthcare provision in developed economies and can say for sure healthcare provision is very expensive, but I believe we can up our game towards providing primary health care for everyone at the point of need.

Some developed economies have used the tax system to ensure their national health service does not run out of funds, a percentage of all earnings is taxed and put aside in a ‘pot’ to supplement the health budget. From a lay man’s point of view, just like the banking system, we all bank our money at different times and we withdraw money at different times, so for a contributory  healthcare system, everyone will not fall sick at the same time, some will experience life threatening sickness at some point in their life, some would have long term conditions like CVDs, Diabetes, etc.while others would only go through emergencies or minor ailments/major diseases.

In Nigeria for instance, we have a few HMO schemes covering the organised private and public sector. The ‘common man’ on the street does not have any sort of health insurance whatsoever, which leaves them at the mercy of chance. In an unfortunate event of serious illness like cancer or organ failure, they find themselves in a situation where they cannot pay for medical services hence resorting to luck to stay alive. A lot of unavoidable deaths have occurred due to lack of funds to pay for medical treatment.

The public primary care providers are underfunded and the issue of corruption has eaten deep into the fabric of the healthcare system where funds allocated for medical equipment’s, pharmaceuticals etc. are diverted for personal use.

What plans does the present Government in Nigeria have to provide Universal Health Coverage and in so doing, contribute to the economic growth of the Country?

Sustainability can be defined as meeting the needs of today without compromising the needs of tomorrow.

‘As articulated in SDG 3, health is crucial for sustainable human development, both as an inalienable human right and an essential contributor to the economic growth of society. Health contributes to national development through productive employment, reduced expenditure on illness care and greater social cohesion.

We believe that universal health coverage (UHC), delivered through an adequately-resourced and well-governed health system, will be capable of addressing these and other health challenges. Universal health coverage must ensure equitable access to affordable, accountable, appropriate health services of assured quality to all people.

These must include promotive, preventive, curative, palliative and rehabilitative services. UHC must be supported by policies and services addressing the wider social and environmental determinants of health for individuals and populations’. Sustainable Developments solutions network

Keywords for providing health systems that work!

• Well Governed Systems- Are there systems and policies in place that can be retained and continued
• Promotive- Do we have health promotion strategies in place to promote good health and wellbeing
• Preventative- Are we taking preventative measures seriously, screening, vaccination, reducing CVD risk through lifestyle management?
• Curative- When we fall ill or in times of emergency, do we have access to affordable healthcare, or does sickness lead to poverty?
• Palliative and rehabilitative services- For terminally ill patients, do we have plans for social prescribing and support? For people engaged in substance misuse, do we have plans for treatment, rehabilitation and integration back into the society

WHO uses 16 essential health services in 4 categories as indicators of the level and equity of coverage in countries: Where does Nigeria rank in the indicators?

Reproductive, maternal, newborn and child health:

• family planning
• antenatal and delivery care
• full child immunization
• health-seeking behaviour for pneumonia

Infectious diseases:

• tuberculosis treatment
• HIV antiretroviral treatment
• Hepatitis treatment
• use of insecticide-treated bed nets for malaria prevention
• adequate sanitation.

Noncommunicable diseases:

• prevention and treatment of raised blood pressure
• prevention and treatment of raised blood glucose
• cervical cancer screening
• tobacco (non-)smoking.

Service capacity and access:

• basic hospital access
• health worker density
• access to essential medicines
• health security: compliance with the International Health Regulations.

The Nigerian Government can do more to improve health outcomes and tackle poverty, by increasing coverage of health services, and by reducing the impoverishment associated with payment for health services. We can subsidise the payment for health services and provide emergency health care at the point of need by ensuring we are constantly reviewing our health policies and implementing proven international strategies. The Health budget does not in any way reflect the health needs of Nigerians, this needs to be reviewed.

As Individuals, if we take health promotion seriously, and change our lifestyle habits, then we can make changes that would reduce the cost of health as well. 

Providing Affordable Healthcare in Nigeria should be everyone’s business

It is my greatest desire that we improve the healthcare system in Nigeria and provide affordable healthcare for local communities at the grassroots so that people can have access to the care they need, when they need it, in ways that are user-friendly’ 

The 74th UN General Assembly took place in New York last September; high level meetings were held and Universal Health Coverage (UHC) was a hot topic for the week. As expected, Nigeria had a delegation of Government representatives, NGO’s and individual advocates who are working towards achieving SDG3 and UHC in attendance. So how do we implement new policies and what are the key drivers to providing UHC for all in Nigeria?

As an advocate for UHC/SDGs, I have been lending my voice over the years calling the Nigerian Government to action towards implementing UN SDGs agenda and achieving UHC.I have studied and participated in primary healthcare provision in developed economies and can say for sure healthcare provision is very expensive, but I believe we can up our game towards providing primary health care for everyone at the point of need.

Some developed economies have used the tax system to ensure their national health service does not run out of funds, a percentage of all earnings is taxed and put aside in a ‘pot’ to supplement the health budget. From a lay man’s point of view, just like the banking system, we all bank our money at different times and we withdraw money at different times, so for a contributory  healthcare system, everyone will not fall sick at the same time, some will experience life threatening sickness at some point in their life, some would have long term conditions like CVDs, Diabetes, etc.while others would only go through emergencies or minor ailments/major diseases.

In Nigeria for instance, we have a few HMO schemes covering the organised private and public sector. The ‘common man’ on the street does not have any sort of health insurance whatsoever, which leaves them at the mercy of chance. In an unfortunate event of serious illness like cancer or organ failure, they find themselves in a situation where they cannot pay for medical services hence resorting to luck to stay alive. A lot of unavoidable deaths have occurred due to lack of funds to pay for medical treatment.

The public primary care providers are underfunded and the issue of corruption has eaten deep into the fabric of the healthcare system where funds allocated for medical equipment’s, pharmaceuticals etc. are diverted for personal use.

What plans does the present Government in Nigeria have to provide Universal Health Coverage and in so doing, contribute to the economic growth of the Country?

Sustainability can be defined as meeting the needs of today without compromising the needs of tomorrow.

‘As articulated in SDG 3, health is crucial for sustainable human development, both as an inalienable human right and an essential contributor to the economic growth of society. Health contributes to national development through productive employment, reduced expenditure on illness care and greater social cohesion.

We believe that universal health coverage (UHC), delivered through an adequately-resourced and well-governed health system, will be capable of addressing these and other health challenges. Universal health coverage must ensure equitable access to affordable, accountable, appropriate health services of assured quality to all people.

These must include promotive, preventive, curative, palliative and rehabilitative services. UHC must be supported by policies and services addressing the wider social and environmental determinants of health for individuals and populations’. Sustainable Developments solutions network

Keywords for providing health systems that work!

• Well Governed Systems- Are there systems and policies in place that can be retained and continued
• Promotive- Do we have health promotion strategies in place to promote good health and wellbeing
• Preventative- Are we taking preventative measures seriously, screening, vaccination, reducing CVD risk through lifestyle management?
• Curative- When we fall ill or in times of emergency, do we have access to affordable healthcare, or does sickness lead to poverty?
• Palliative and rehabilitative services- For terminally ill patients, do we have plans for social prescribing and support? For people engaged in substance misuse, do we have plans for treatment, rehabilitation and integration back into the society

WHO uses 16 essential health services in 4 categories as indicators of the level and equity of coverage in countries: Where does Nigeria rank in the indicators?

Reproductive, maternal, newborn and child health:

• family planning
• antenatal and delivery care
• full child immunization
• health-seeking behaviour for pneumonia

Infectious diseases:

• tuberculosis treatment
• HIV antiretroviral treatment
• Hepatitis treatment
• use of insecticide-treated bed nets for malaria prevention
• adequate sanitation.

Noncommunicable diseases:

• prevention and treatment of raised blood pressure
• prevention and treatment of raised blood glucose
• cervical cancer screening
• tobacco (non-)smoking.

Service capacity and access:

• basic hospital access
• health worker density
• access to essential medicines
• health security: compliance with the International Health Regulations.

The Nigerian Government can do more to improve health outcomes and tackle poverty, by increasing coverage of health services, and by reducing the impoverishment associated with payment for health services. We can subsidise the payment for health services and provide emergency health care at the point of need by ensuring we are constantly reviewing our health policies and implementing proven international strategies. The Health budget does not in any way reflect the health needs of Nigerians, this needs to be reviewed.

As Individuals, if we take health promotion seriously, and change our lifestyle habits, then we can make changes that would reduce the cost of health as well.

According to statistics, only 20% of traders earn on Forex, while the rest either accept forex losses or ingloriously leave the foreign exchange market. Each trader has his own reasons for failures and major losses. But at the same time, there are the most popular traps that many participants in the foreign exchange market fall into. Knowing the reasons why traders fail, you can significantly increase your chances of success by circumventing the pitfalls of the market.

Reluctance to Plan Your Trade

Regardless of which financial market and assets a trader chooses, without planning, his chances of success are 0.01%. And this micro-percentage is given to banal luck. The first thing a trader must do before opening a trading position is to draw up a trading plan and clearly follow it. In a documented plan, a trader must consider the estimated return on investment, as well as the rules of money management.

Non-observance of Trade Discipline

This is the most common cause of forex trader losses. Most successful traders built up their capital from a series of several large profitable trades and many unsuccessful operations in which they were able to minimize their losses. But trading in this way is very difficult. Such trading requires to be able to withstand emotions. It is enough to start losing hope, and one failure can entail a whole series of transactions, the result of which will be a loss of money. To effectively cope with the pressure of emotions, a trader needs to create a trading plan and follow the rules of money management. After creating a plan, it is recommended to visit the Alpari forex trading broker to start trading conveniently.

Inability to Adapt to the Conditions Offered by the Market

After creating a plan for each of the transactions, a trader will be able to calculate all possible options for the development of the market situation and reduce the risk of losing a deposit. But even so, some market actions become an unpleasant surprise for traders. Therefore, even the most unlikely scenarios should be considered. Not a single trader has yet been able to predict market behavior with 100% accuracy. The ability to adapt to market requirements allow traders to succeed and find new ways to earn money.

Weak Risk Management

Some traders fundamentally do not use stop orders in their trading. They are afraid that the deal may be closed ahead of schedule. But the problem here is not the stop loss tool itself, but the trader who placed the stop order too close to the price.

A successful trader can immediately say how much of his capital is in danger and always uses stop loss in his work. Professional traders divide their accounts by parameters of profitability and potential risk. They choose the most suitable size of the trading position and also use various trading strategies, which avoids uncontrolled losses.

In most cases, new traders want to invest their funds in high-risk assets. But experienced traders are pickier and allocate only a small part of their funds to such assets, preferring stability and constant income.

At a period when Nigeria is struggling to meet its revenue target for 2020 national budget, the oil industry which contributes over 70 percent of its revenues lost 22 million barrels in six months or $1.32 billion to crude oil pipeline vandals. That should  be a serious source of concern to not just the stakeholders but the states in the Niger Delta where these criminals operate.

Multinational leading upstream petroleum operator Shell Petroleum Development Company loses about 15,000 barrels per day to oil theft and vandalism.  This amounts to $900,000 or 275 million naira daily to these acts of sabotage.

Aiteo Eastern Exploration and Production, an indigenous player has had to shut down its operations at the Nembe Creek Trunk Line which is responsible for a sizable chunk of crude oil exports due to vandalized pipelines.

For every ruptured pipeline, the affected oil company conducts investigations, deploys boats for inspection, pays for containment and other post spillage activities which cause production downturn as operational targets are not met due to this paralysis. The losses also include environmental pollution, soot which affects the health of human and animal habitants of the communities.

Shell reported 17 oil spills in 2017 and 111 in 2018 replacing 1,160 illegal theft points. In seven years it has had to replace 1,300km out of its 4,000km pipeline network. Most cases of oil spillage are as a result of interference as the oil majors are accused of not carrying their host communities along as partners in development, unlike what happens in other climes which makes their youths vandalize pipelines as a means of protest.

The complicit cycle of corruption has made it possible for the vandals to get crude oil once it is pumped by the oil companies for delivery to the local and foreign markets. Using hacksaws, drillers to make holes and bombs, galvanized pipelines buried underneath are connected to waiting vessels  which will sell the stolen crude to foreign buyers which include refineries.

This criminal activities are also causing Nigeria a negative impression as investors will be wary of committing fresh investments in an environment where their projects are exposed to daily risks.

Poverty is a contributing factor at the heart of vandalism. Due to neglect of the Niger Delta Region whose mineral wealth has been used to develop other parts of the country to the chagrin of its inhabitants, they have taken to crude oil bunkering not minding the negative effects on their immediate environment as well as their existence as a means of survival as refineries, petrochemical plants and other allied industries to create jobs for its youths, state of the art infrastructure are  not in existence.

The Nigerian National Petroleum Development Corporation which operates joint ventures with all the oil companies which operate in the region should do orientation every week on the local TV and radio stations in Ijaw, Urhobo, Itshekiri, Igbo, Ikwerre, Ibibio and other languages spoken by citizens of the Niger Delta states on the dangers of crude oil pipeline vandalization.

Efforts have been made using deep technology to combat this menace. A young Nigerian student Innovator Tayo Sadique from the prestigious Obafemi Awolowo University, Ile-Ife has created a solution Musscomm Spillsat. Spillsat is an oil spill, gas leak and vandalization detection system. It utilizes a balloon satellite to collect aerial data that is processed and used to provide real time analytics to oil and gas companies.

Spillsat should create a mobile and web application for oil and gas operators which will use machine, deep learning and computer vision capabilities in facial recognition for identification and monitoring of  pipeline vandals in real time even under dark cover when carrying out their nefarious activities, reporting the actual amount of barrels per day stolen, environmental impact assessment of the oil spillage or gas leak while integrating the blockchain to track the stolen oil from the point of production to domestic and foreign buyers in order to aid their arrests by officers of the Nigerian Navy and Civil Defense Corps.

Soil is a living material and the condition, quality, and behavior play a key role in construction projects. All structures, buildings, gas, and chemical plants, harbor, airports,  roads, bridges, dams and even life itself are based on the soil. The soil is the natural foundation that supports all structures and investments. 

As a result, Geotechnical engineers and Engineering geologists have to perform geotechnical investigations to obtain information on the physical and chemical properties of soil and rock underlying a site to design earthworks and foundations for proposed structures, and for repair of distress to earthworks and structures caused by soil conditions. Geotechnical investigation enables the assessment of the suitability of the soil materials in the site by providing vital data for informed site development decision making and planning.

However, the paradox is that soil is the most important yet most neglected in construction projects in Nigeria. Despite the importance of Geotechnical investigation, for both engineering properties and environmental constituents it is one of the most overlooked parts of the construction planning stages. It is not easy to understand why, but one can speculate that the reason is that asset owners and their consultants want to save money, while the Architects do not want to take liability for the soil conditions of the site.

Again, most clients see soil investigation as a waste of funds despite being the cheapest activity in the construction process, hardly is the cost of soil test up to one percent of the cost of construction. Some contractors too ignore the importance of proper soil investigation and analysis and base their design on assumed bearing capacity and rate of settlement. 

A geotechnical investigation generally includes surface and subsurface appraisal of a site. Occasionally, geophysical methods are used to obtain preliminary qualitative data about sites. Soil Investigation usually involves in-situ testing such as the standard penetration test and cone penetration test. Additionally, site investigation will often include soil sampling and laboratory testing of the retrieved soil samples. Test pits,  trenches, and large diameter borings may also be used to learn about soil conditions at depth for direct visual and manual examination of the soil and rock stratigraphy. The extent of investigation depends on whether the area is built up or not and the size of the structure.

Geotechnical investigation helps geotechnical engineers to correlate varying physical and Engineering properties of soil, which can vary from place to place and from layer to layer even within the limits of the proposed structure. Soil characteristics can change considerably within a small area. Weather, climatic changes, and site management can in the future affect the bearing qualities of the soil if the foundation is not designed properly to the bearing capacity of the soil, then they will fail and so will the structure too. 

An early geotechnical investigation help to determine the bearing capacity of the soil which determine the  soil’s load sustenance capability, helps understand the rate of settlement of the soil which affect the rate at which any structure placed on it settles and stabilise, to select a type and depth of foundation, to select suitable construction technique , to predict and resolve probable foundation problems, to determine if the land can be subjected to subsidence and cause sinking of the building, to determine water table which affects humidity within the foundation and greatly affects the character of a soil which varies considerably with water content, mineral or chemical composition of the soil that might affect the choice of construction materials.

Whatever type of soil one encounters, peat, gravel, clay, silt, sand, or loam soil, understanding the soil properties of a site helps make good construction decisions leading to the success of the project. Therefore,  the structural engineers can efficiently and accurately design the structural elements for the long term viability and soundness of the project. The geotechnical investigation also helps to determine whether there is a need for soil stabilization and the foundation depth to attain the required soil bearing capacity.

In summarising the benefits of geotechnical investigation before any project starts are as follows:

•  Asset owners and Developers can be informed of potentially problematic soils in the area of their own particular sites. This implies that damage that could be caused by these soils at the inception of the project can be minimized. Thus the associated costs are known from the outset, thus enabling owners and developers to make informed decisions regarding the most appropriate foundation system for the project.
• In urban development projects there could be the possibility of a group of neighbors owners agreeing to treat a large area of soil on a once-off basis, and sharing the cost of the required treatment process (e.g. the impact rolling of a site located on collapsible soil).
• In general, early geotechnical investigation reduces maintenance costs, resulting from problematic soils during a project life cycle.

In light of the above, it is clear that asset owners and property developers are taking a huge risk without first performing a rigorous geotechnical investigation of the proposed site.