By Tajudeen Kareem
The story is told that six decades ago, the Saudi monarch came to Nigeria seeking medical care. Even so, presently Nigerians in diaspora are coming back home for surgery and treatment of difficult ailments.
Indeed, respectable Nigerians living abroad attest to the fact that despite all the seeming challenges buffeting the health sector here, Nigerian hospitals, indeed medical professionals are no push overs.
The following submissions on X (formerly twitter) are sobering. Dr Simi Official on @ simisola10 said people now leave the UK to get medical care in Nigeria. In reaction, Bashorun Oduduwa @ AEAdeola said: “Because there is no waiting time in Nigeria and Nigeria’s healthcare professionals are well trained. We need to amplify the good things about Nigeria more than the bad ones.” Abimbola King @ Harbimborlar gave his verdict: “This is 100 percent true. I knew a doctor who went to Nigeria for his surgery cos he cannot wait for 12 months. Nigeria will be better.”
No one will rightly say the health care sector in Nigeria has attained the ideal status. However, there is no denying the fact that there are genuine efforts to improve on the system and respond to emergent challenges, including inadequate funding, poor infrastructure, and a shortage of skilled healthcare professionals. Above all there are competing demands from no less critical sectors namely education, defence, social infrastructure, among others.
In the 2024 budget, the federal government allocated N1.33 trillion or 4.8 per cent to the health sector, up from N1.17 trillion budgeted last year. This gesture must be complimented by sub-national governments to keep Nigerians healthier.
More so, the federal government has rolled out the Nigeria Health Sector Renewal Investment Initiative described by Minister of Health and Social Development, Prof. Mohammed Ali Pate as “a comprehensive plan to revitalise the country’s healthcare sector.”
This is in recognition of the urgent need to invest in healthcare infrastructure, human resources and technology to provide accessible, affordable and quality healthcare services to all Nigerians. This initiative aims to address the existing gaps in the healthcare system and improve the overall health outcomes for Nigerians.
The key objectives of the initiative are to improve the physical infrastructure of healthcare facilities across the country, including renovating existing healthcare centres, building new hospitals and equipping them with modern equipment.
The shortage of skilled healthcare professionals has also been a significant challenge in the country.
“The initiative plans to address this issue by investing in the training and recruitment of healthcare workers. This includes providing scholarships and incentives for medical students, improving the working conditions for healthcare professionals, and attracting Nigerian diaspora healthcare workers to return to the country,” said the minister.
Recognizing the importance of primary healthcare in preventing and managing diseases, the initiative would focus on strengthening primary healthcare centres across the country. Top on the list is improving the availability of essential drugs, expanding immunization coverage, and implementing community health programs to promote preventive healthcare practices.
To sustain the improvements in the healthcare sector, the initiative will place emphasis on sustainable financing, by exploring innovative financing mechanisms, improving budget allocation to healthcare, and encouraging private sector participation in healthcare investments.
Indeed, experts and critics have agreed that Nigeria cannot continue to run a health sector system where patients have to look for cash when they fall sick or have to attend a health facility. On the reverse plane is the fact that government cannot provide free health care services! Indeed, the most pragmatic approach is to fast-track the coverage of health insurance in the country where population has peaked at 250 million.
While scaling up health insurance cover, government must also examine the need for Public-Private-Partnerships in running all tertiary and general hospitals nationwide.
For example, Garki Hospital, Abuja, is owned by the FCT administration but run by Nisa Premier Hospital under a PPP arrangement. It was accredited by the National Health Insurance Scheme, NHIS, in 2008 and currently has one of the largest number of enrolees in the FCT and the only PPP that accepts secondary referrals from other health facilities.
The hospital is also the only facility that carries out specialized surgery under the NHIS scheme. The hospital has over 187,000 patients registered on Electronic Medical Record application, 33,906 NHIS enrolees spread across 55 Health Maintenance Organizations, HMO. Under the FCT Health Service Scheme, the hospital attends to 8139 enrolees from three HMOs, its Private Health Insurance Scheme has 1831 enrolees spread across 35 organizations and it offers corporate services to 10,502 persons from 16 registered organizations.
A few months ago, the federal government announced the expansion of the health insurance system with the launch of a new health insurance package, Group Individual and Family Social Health Insurance Programme, GIFSHIP.
Former Minister of Health, Dr. Osagie Ehanire had stated on the occasion that the new insurance product is the outcome of wide-ranging and far-reaching reforms within NHIS to significantly increase the fiscal space for healthcare services. “GIFSHIP offers Nigerians opportunity to participate and benefit from the health insurance system. There’s opportunity for affordable individual enrolment, family unit or a group of people. Any of the enrolments can also be sponsored by well-meaning individuals, Trusts or organizations,” said Ehanire.
To return to the story of Nigeria’s premier teaching hospital – the UCH, its Chief Medical Director, Prof Abiodun Otegbayo said the hospital requires massive funding, from government and the private sector to enable it cope with the ever-increasing population of patients who throng the facility daily.
“In a year we welcome about 250,000 patients to UCH, including accident victims, people seeking to treat malaria and diarrhoea as well as sundry referrals from across the country and from outside Nigeria. Our average monthly bill for public power supply is N57m but to provide for interruptions we buy diesel worth N20m monthly,” he said. Indeed, these are daunting tasks for an institution that serves as a “college” and a “hospital” in a sprawling city as Ibadan.
But there are several other headaches as shortage of water, ageing equipment and facilities and most alarming, the inability to meet rising costs because many patients cannot or are unwilling to pay for health care services!
Despite these unsavoury environmental and peculiar factors, Nigeria’s tertiary health institutions are striving hard to discharge their mandates. They certainly can do better with drastic improvement in funding, more infrastructures and a highly motivated workforce.
Over the years, the infrastructures of UCH had dilapidated and were falling below the standard of when it was constructed. There is an urgent need to embark on massive rehabilitation, renovation and remodelling of the ageing structures. Even when physical structures had dilapidated, the tripod of Clinical Service, Research and Training waxed stronger,” said Otegbayo.
It is an open secret that government cannot adequately fund healthcare, so the hospital has counted on immense material and financial support from individuals, corporate bodies and agencies to add to what the government is providing.
To demonstrate the enormity of challenges faced by the hospital, between January 2019 till date, no fewer than 630 clinical staffs made up of 299 doctors, 265 nurses and other 66 comprising of radiographers, pharmacists, medical laboratory scientists and radiologists resigned their appointments, no thanks to the Japa syndrome.
Undaunted, management and staff have remained focused and committed to earn the hospital the award from the Presidency as the Best Public Hospital in the 2021.
For the Nigerian health sector, glorious days are around the corner, considering the zeal of practitioners and renewed attention by the government and sundry stakeholders.
• Kareem is a public policy analyst. He writes from Abuja.
