Have you ever visited a government hospital in any part of this country? You would recoil at a number of occurrences there, yes, healthcare services in Nigeria are on a poor scale, with numbers of Nigerians dying just because they can’t get good treatment. Those who can help it prefer private hospitals, while those who can afford it prefer to be medical tourists, visiting India and a number of other countries for treatment. This i find as a sad contrast to what was obtained in the past where our teaching and government hospitals used to be the Jewel of Africa. This was before the Shagari years before our hospitals became mere consulting clinics, things became much worse after that as a number of our hospitals now serve more as mortuaries than as healing havens.
Truth is that Nigeria has a big health problem on its hands; healthcare coverage is below 8 percent,basic healthcare services are lacking, secondary health facilities are underperforming, and, whilst tertiary health institutions are tottering. Nigeria’s Healthcare system is like no other, one of our many permanent flags of defeat, despite the huge resources at the nation’s disposal.
Where do we begin? Or is it a question of how do we begin? For example, are we to expect miracles when our government allocates less than an average of 4.1 percent of its budgetary allocations to healthcare in the past seven years ( 2016(4.23) 2017 (4.17) 2018(3.9)2020(4.16) 2021(4.36) and 4.34 for 2022 against the required 15 percent as mandated in the “Abuja Declaration” of 2001?
Thus it is important to trace all or most of the challenges of healthcare provision in Nigeria to funding. Funding is indeed basic and it is a shame that government after government has defaulted in implementing Abuja Accord whereas smaller countries like Kenya and Rwanda are doing far better than us. Funding is the reason why numerous doctors are leaving this country in droves in search of greener pastures to become at most times second class citizens in other countries. Recall how only last year over 500 doctors attended a headhunt programme arranged by the Kingdom of Saudi Arabia, intelligence reports would confirm that this particular type of brain drain is occurring on a daily basis. It is the reason why a majority of those not chanced or interested in leaving run private hospitals where they refer a number of patients to.
Another challenge is that of human resources, healthcare in Nigeria is presently undergoing a peculiar human resource crisis. Our physician density, that is the number of doctors to the population (0.17) is actually one of the lowest in Africa if not the world. This is made worse in the light of the increasing flight of our healthcare workforce as described above. Coupled with this is the alarming regularity of industrial actions and strikes carried out by the numerous associations within the sector. Issues such as the welfare of staff operating in the healthcare sector remains a nagging problem, there are other issues such as training and capacity development, compared to smaller nations too, ours is a near write off!
Then there is the issue of corruption, yes we know that what most governments give to the health sector is not encouraging, I have harped on that, however, there is a tendency that even at that, huge amounts of these funds are fleeced by corrupt individuals. You name them, permanent secretaries, GMD’s etc. It is for this reason that dispensaries are at various times empty and a patient will have to purchase drugs outside the hospital, even though provision for free or at most subsidised drugs have been made. One will recall the hoopla generated by the First Lady’s exposé on the state of the clinic in Nigeria’s seat of power, now if such was Aso Rock’s predicament, how worse then will our imagination of what obtains outside be, where the GMD or CMD and what have you are Lords unto themselves? What about the ‘roforofo’ fight between Professor Isaac Adewoye, and Professor Usman Yusuf of the NHIS? Both traded accusations of fraud and abuse of office, somewhere, corruption triumphed while the citizenry lost.
Finally, there is the challenge of medical tourism where our nation’s healthcare sector has lost billions of Naira to India and other countries. A situation where the elite and even the middle class have lost all hope in the nation’s healthcare sector and have placed such hope on doctors abroad is indeed sad, and it is not that a number of such ailments are treated there, no,many Nigerians still die despite the huge amounts spent abroad but let’s not blame them much, for with some of the aforementioned reasons above, it seems that the probability of dying abroad is lesser than what obtains here.
All said here, the solution to the nation’s health challenges is for government at all levels to take decisive action. Political will is key or chief in our plans to revamp the healthcare sector. As a means of goading the politicians who will drive such will, citizens must demand more from the politicians; politicians and parties must be voted in or out by how or where they stand on healthcare. We say “Health is Wealth” but ours won’t be except we begin to move in the right direction.
Nigeria Will Triumph