Nigeria’s Healthcare of Woes
In this report, Odimegwu Onwumere unearths that less than 40% of Nigerian women have access to healthcare leading to some maternal and mortality deaths. The reports also shows nervousness that lack of research funds, basic amenities, too many poor policy implantation, corruption and political instability, insufficient medical experts, lack of modern medical facilities are amongst many woes bedeviling the healthcare system in the country
Laughable healthcare in Nigeria has been driving hundreds of thousands of her citizens to seek for quality medical care abroad, especially those who can afford it, thereby leaving the impoverished citizens to their fate, to putrefy in hospitals in the country known for their obsolete equipment. Worried by the extreme shortage and allotment of healthcare professionals in Nigeria, which has seen to different health challenges especially maternal and mortality deaths (where 36% of Nigerian women have access to health care system) due to dearth of feasible primary healthcare centres in the country, experts assembled in Abuja, the country’s seat of power, on a three-day workshop, which commenced on July 18 2017, to look into the circumstances.
The derisory healthcare has generated some significant reports of some of the citizens with minor illnesses ending up in the morgue, because of lack of life-saving and modern technologies in the Nigerian hospitals. This is no longer news. Connoisseurs opinion is that hardly can one find such modern equipments as "Heart Defibrillators, Holter monitor, and Bronchoscope, which is used to perform Bronchoscopy" and many others in the hospitals across Nigeria. Some added that apart from lack of modern equipments, "unrestricted and unethical practices" thrive among doctors practicing in the country. Those in this line of thought believe that in rational countries of the world, doctors are not allowed to practice after one year of internship after medical school as it obtains in Nigeria; they are allowed to practice after 3 years of residency (after medical school).
They added that in those countries, (people go to medical school after graduating first from the university). But in Nigeria, the case is different. “This results in the roll out of too many half-baked or unqualified doctors that are not well groomed to practice in Nigeria.” While these minds talked to some newspapers editors recently, they added, "Government laissez-faire attitude towards healthcare, ignorance, socio-cultural issues, fake drugs, affordability, incessant strikes by healthcare workers for non-payment and so on, are fad in Nigeria.”
According to them, “It can be observed that the staffers at the Federal Ministry of Health seem to have more interest in spending time and energy with public sector shenanigans than in demonstrating medical expertise that they have been trained for. Therefore, attention and concern of the health of Nigerians had been replaced by selfish interests of those who run the Ministry of Health at the Federal level.”
The raging debate however suggests that the healthcare woes in Nigeria are due to decades of unsuitable measures taken by the successive governments to arrest the situation.
Shortage And Allotment Of Healthcare Professionals?
According to Nigeria Demographic Health Survey 2004: Maternal mortality is increasingly high in Nigeria and the country has one of the maternal and child health indices in the world with maternal 800-3000 deaths per 100,000 live births, life time risk of dying from pregnancy related complications of 1:8 compared to 1:10 in developing countries.
A media data, March 16, 2016, lectured that there's a population of N182million Nigerians in 36 States of the country. According to the source, “These populations share just 20 Federal Teaching Hospitals and 23 Federal and State Medical Centres. Some States like Lagos host more than one.”
Adding, the source asked, “43 Federal and State Medical Facilities for a population of 182million? That’s an average of about 4.2m people per hospital. Apparently these facilities are too small to cater for Nigeria’s population.”
Why Universal Health Coverage Failed In Nigeria?
In the three-day summit that was tagged Human Resources for Health Summit and was organised by the Federal Ministry of Health in partnership with global health cohorts, the keynote was dubbed “Strengthening Human Resources for Health Towards Revitalization of Functional Primary Healthcare Centres in Nigeria.” Factors hindering service delivery, to health workforce challenges, to attaining the nationwide objectives, such as that of Sustainable Development Goals (SDGs), to achieving Universal Health Coverage, characterised the discourse. The Minister of State for Health, Osagie Ehanire while speaking at the conference, harangued the need for the authorities to enliven the comatose healthcare system in the country.
Ehanire said, “All the initiatives to achieve Universal Health Coverage will be appropriate if the right numbers of people with the right skills are in the right place at the right time with the right attitude to provide the right service at the right cost.”
Investigations nonetheless revealed that unfavourable environment has led to many health professionals from Nigeria to migrate to Organisation for Economic Co-operation and Development (OECD) countries in search for greener pastures. A representative of the World Health Organisation (WHO), Ibadat Dhillion frowned at this, saying that Nigeria has lost much of her health workforce to OECD countries.
Dhillion said, “Nigeria’s health centres have been in shortage of manpower, whereas a country like Jamaica enjoys medical personnel in her health workforce who are Nigerians in the indices of 25 percent. Nigerian migrant health personnel to OECD are in the ratio of 60 percent.”
N1500 On Nigerian’s Healthcare Per Year?
In sound climes, health benefits are seen as a fundamental human right that must not be deprived the individual. For instance, pundits said that elections in countries like the USA and UK are won or lost “on the debate of Health from NHS to the Affordable Care Act.”
But this is not the same with Nigeria. Nigeria is a country without National Health Act implemented. This, if implemented, is supposed to help in bettering healthcare delivery in the country. With the huge mineral resources sales that go to its coffers, authorities said that the Federal Government (FG) spends about N1500 (about 4 USD) per Nigerian’s health care a year.
That might sound hilarious. Conversely, Nigeria’s Minister of Health, Isaac Adewole literally wept concerning this, at the Maiden Edition of Health Communication Conference organised by Association of Nigeria Health Journalists, ANHEJ in Abuja, July 13 2017.
In Adewole’s words, “Nigeria is still far below the Abuja Declaration, a commitment by the African Union Heads of Governments to ensure that at least 15 per cent of National Budgets are allocated to the health sector.
“In 2017, the Health Budget (Nigeria’s) is only around 4 per cent of the National Budget. Though, this represents a slight improvement from around 3.73 per cent in the 2016 budget, the numbers are worrisome. This would mean that only about N1, 500 (One Thousand and Five Hundred Naira only) is being spent on the health of every Nigerian per year.”
Adewole was worried that unless the country imbibed the spirit of funding major part of its health programmes, Nigeria might not get out of the health conundrum, at least, soon. Buttressing his views, he gave instances where approximately 70 per cent of the resources to contain HIV come from foreign donors.
According to Adeowle, “99 per cent of the commodities were paid for by outsiders, so we must put our money. When we look at family planning, the large part of the money is from outside. Immunisation, the vaccines all come from outside. This country must wake up; we must put our money in health and create a positive way for the health of this nation.”
Upon Billions Of Dollars Launched?
Just as Adewole said that Nigeria depends on donors to curb her healthcare challenges, research has shown that the donors have spent trillions of naira to boost Nigeria’s healthcare system and fight diseases such as malaria, diarrhoea, measles, cholera, hepatitis, polio, and so many others; yet Nigeria is thus far to solve her health unresponsiveness.
This issue gets some Nigerians cracked. One of them who claimed anonymity, said, “The deplorable state of the Nigerian healthcare system is sad; the healthcare system in Nigeria by every indication is third world standard.
“In spite of the large budget and funds from donor countries and organizations, there is nothing to be proud of as most of the resources are flagrantly embezzled by certain group of people, who run the affairs of the Ministry as personal property.”
For example, just on February 16 this year, N40 billion (70 million Euros) to improve healthcare in Nigeria was launched by European Union (EU) of which the Federal Ministry of Health, in collaboration with the Ministry of Budget and National Planning and the National Primary Health Care Development Agency (NPHCDA), were running round for implementation.
According to official data, “50 million Euros of the grant disbursed through the United Nations Children Fund (UNICEF), aim to ensure that by 2020, 80 per cent of the wards in Adamawa, Bauchi and Kebbi States will have a functional primary health care centre, providing round-the-clock services to three million children under the age of five, as well as almost a million pregnant women and lactating mothers.
“Also, 20 million Euros disbursed through the World Health Organisation (WHO), will support the strengthening of health care systems towards achieving universal health coverage in Anambra and Sokoto States.”
The EU Ambassador to Nigeria and ECOWAS, Michel Arrion, while speaking at the event, said, "The focus is especially on providing services to poor, marginalised, rural women and children, saving the lives of mothers and children and improving their health and nutrition through a sustainable primary healthcare delivery system.”
For UNICEF Nigeria Representative, Mohamed Fall, “This will help Nigeria on the road to achieving the Sustainable Development Goals agreed at the United Nations in 2015 by all the world’s nations, including Nigeria.”
It is consequently assumed by some opinion leaders in the health sector that the standard of healthcare delivery Nigerians yearn for will not be reached till a drastic searchlight is beamed at the Federal Ministry of Health, which is supposed to be where Nigeria’s health woes emanate from.
Odimegwu Onwumere is an award-winning journalist based in Rivers State, Nigeria. He contributed this piece via: [email protected]