INTRODUCTION
The Federal ministry of health Hepiq-c project in collaboration with Brain health initiative of Nigeria (BHIN) held a 2-day webinar on 3rd and 4th of June, 2020 with the theme ։ The effect of COVID-19 on the health and care management of older persons in West Africa. It was aimed at identifying the health care of older Adults, their challenges in the face of this pandemic and proposing possible solutions to them with help from the health care system in West Africa and the world at large.
The webinar was an interactive and educative one with guest speakers and panelists and attendees all over the world.
Participants at the webinar included։ Dr. Osagie Ehanire (Federal minister of health, Nigeria) represented by Dr. Adegoke (Director of health services), Dr. Salma Anas-kolo ( Director of family health, Federal ministry of health), Dr. Saidu Ahmed Dumbulwa (National coordinator Hepiq-C project), Dr. Temitope Farombi (Brain health initiative Nigeria), Francis LeGasse Jr, Prof. Temitope O. Alonge (Department of surgery, University of Ibadan, Nigeria), Barr. Tony Ojukwu esq (National Human Right Commission), Dr. Olowokere Olufemi (Geriatrics UCH, Ibadan), Prof. Adesola Ogunniyi ( College of medicine, University of Ibadan, Nigeria), Prof. Mamadou Coume, Dr. Lawrence Adebusoye (UCH Geriatrics, Ibadan), Prof. Stanley Okolo (WAHO) duly represented by Dr. William Bosu, Dr. Adebiyi Adebimpe (Director of Hospital Services federal Ministry of Health), Prof. Usman Ahmed (President of Geriatric Association of Nigeria), Prof. Olusegun Baiyewu, Dr. Hafiz khan (University of West London) and Dr. Ogugua Osi-Ogbu with about two hundred and fifty attendees.
The webinar aimed at evaluating current best practice guidelines for older person care in Africa, to help develop a protocol for appropriate and person centered treatment especially those with multi morbidities and to harness policies that will help strengthen our existing healthcare system during and after the pandemic.
The opening speech was done by Dr Temitope Farombi of the brain Health Initiative Nigeria, who welcomed everyone duly for the webinar and gave a brief in-depth overview on the epidemiology and present situation of COVID-19 on the health care system in Africa. From her findings she observed problems affecting the health care systems especially for older adults in Africa, some of which include։ Poor health care system, paucity of data in the demographics of death, not enough trained health personnel as well as Inequality of the health policy implementation in Africa.
Dr Adegoke handled the moderating session with each speaker speaking for 15 minutes.
During the virtual dialogue, the problems facing the health of older adults in west Africa were discussed as follows։
• Corona virus – a global killer accounting for over 60% of death in older populations (>60 years) from 2019 till date
• 71% of death in Africa region are from NCDs. This is an evidence that NCDs pose people at higher risk of complications from COVID-19
• Biological predisposition from lower immunity and poor nutrition status which contributes to their increase risk and poor outcomes in COVID-19
• Reduced functional capacity and pre -existing chronic illnesses, which makes them more likely to have multiple risk factors and co-morbidities
• Inadequate infection, prevention and control measures
• Economic distress with little or no pension as this has increased their financial incapability
• Weak social protection (social security and insurance)
• Lack of aged care homes, disrespect of older adults, risk of neglect, abuse, stigmatization- witch camps, health services not oriented to care for older Adults
• Older males are at greater risk than female counterparts
• Weakly enforced policies / low priorities to care of older Adult – often not mainstreamed into health service planning
• Discrimination in age-based triaging and rationing of ventilators or critical equipment in short supply or when there is large demand
• Reduction in service coverage in other areas due to concentration on COVID-19
In the light of the observations made by the participants the following recommendations were arrived at։
• Reorientation of primary health care as part of case management treatment for older Adults in this pandemic
• Training of health care workers on older Adults care (infection, prevention and control strategies for Pre COVID-19, COVID-19 and post COVID-19 stage)
• Encouragement of one career one patient health care system in health facilities
• The use of electronic consultation and use of home management as a new treatment protocol for older adults
• Activation of medical social units in all health care system in West Africa
• Introduction of indoor exercises, compliance with medications and adequate nutrition with rich intake of vitamin C and vitamin D as this are immune boosters especially in this pandemic
• Self-isolation by staying at home and implementing restrictions on visitations except they are medical personnel
• Provision and availability of improved test kits that produces rapid /accurate results within 24 hours
• Symptoms monitoring of all health staffs for appropriate intervention and isolation from the health center to avoid spread of COVID-19
• Prevention of anxiety and depression by engaging the older adults in virtual online meetings with their love ones also by promoting outside visits between families and the residents has this has been found effective in the USA
• Implementation of a policy that focuses majorly on the care and management of older Adults in our health care system
• Give much care to older people right in their homes (Home health care system)
• Teachings on home management of blood pressure, self-monitoring of blood sugar using a glucometer, use of inhaler for Asthma patients, keeping of a diary (for careers, families, so they can record all the measurements). So as to know how to monitor them and intervene at appropriate time
• Fumigation and a wash down of geriatric centers in health facilities
• Health education by the public health nurses on health and safety in home care of the co-morbidity
• Usage of nose mask, hand sanitizer and the use of PPEs at care service points
• Expand health work force across all regions – community health and social workers
• Efforts to prevent and control NCDs must continue
General strategies
• Develop strengthen and implement policy and legal frame work to protect and safeguard the health and human rights of older adult
• Advocacy to improve health of older Adult in west Africa
• Involve older adults in decision making process
• Public education to avoid stigma, neglect and abuse
• Provide older adult friendly health services
• Institute social protection measures – social reduction, disability privileges, health insurance
• Include health of older adults in national health sector performance monitoring
