Nigerian health sector: The desired wind of change | Independent Newspapers Limited
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Nigerian health sector: The desired wind of change

Posted: Apr 20, 2015 at 12:00 am   /   by   /   comments (0)

By Donald Ikenna Ofoegbu

Healthy citizens, make a healthy and wealthy nation. That is why nations of the world serious about achieving great wealth, prioritizes health matters and devote enormous resources to the sector; from huge financial resources, to ensuring that the sectors’ manpower are kept happy. Over the years, this has not been the case of Nigeria. Despite the volumes of strategic health documents and commitments signed by previous

Khaliru Alhassan

Khaliru Alhassan

governments (at federal and state levels) to improve health sector funding, the budgetary allocation to the sector still remains low; as medical staffs more than often go on strike actions; hospital wards still lack sufficient facilities and skilled manpower; the sick in many communities especially in the rural villages still travel miles to access medical care; while the supposed rich in the urban cities spend fortunes to travel abroad in search of better health services. According to figures quoted by the Nigerian Medical Association, more than 5,000 Nigerian patients travel abroad for medical treatment every year; spending over N120bn ($800m) annually on foreign medical trips. For those that cannot afford such, they simply resign themselves to faith rather than complain to a supposed responsible government.

From the Ebola outbreak, it has become obvious to all, that access to adequate healthcare and sanitation facilities is suppose to be a right to everyone regardless of tribe, economic status, legal position, state or location. This making the issue of “availability” the pounding question; availability of the legal framework, availability of dedicated resources, availability of full utilization, capacity and availability of knowledge and most of all, availability of a responsible government with the will to act, rather that offer appealing speeches.

Despite the enormous resources in Nigeria, recent figures published in World Health Statistics 2014; show Nigeria dragging positions with nations recovering and experiencing wars and mass genocide. The reports which collates hospital records across different locations of countries shows that despite the efforts being made, Nigeria still records among the highest nations with the lowest life expectancy along with nations like Sudan, Afghanistan, Libya, Rwanda, Liberia, etc. Today Nigeria records the second highest maternal mortality rate in the world after India. The same applies in the rate of infant and child mortality rates. According to the WHO statistics for 2014, 1 in every 13 pregnant women dies from avoidable cause in Nigeria. This is most true as most hospitals lack sufficient hospital beds to accommodate women in labour. Medical staffs especially in government hospitals are more than often over stretched; take the frustration out on patient, and in some cases induced to work negligence, which in many cases have led to the death of patience especially pregnant women and babies. With 1 (one) midwives attending to over 20 (twenty) pregnant women, contrary to WHO recommendation of 1 to 4 patients, in hospitals that lack water facilities, medical staffs are not only at the risk of losing their minds from work overload, but are also at the risk of contacting transmittable diseases despite being owed arrears and under paid by their governments.

Though other causes of the high mortality rate particularly the maternal and infant deaths can be traced to the poor level of female education (especially in the Northern and Southern part of the country), as well as socio-cultural, and religious barriers that prevent increased sensitization,  access and practices of family planning, immunization, sex education, female education, etc. A lot can be traced to economic inefficiency from the part of the various governments; as they fail to make health facilities accessible and affordable to the larger population.

There is therefore the need for decision-makers, MDAs, CSOs, faith based organisations and other stakeholder and relevant audience to support and implement actions for the holistic reform of the health sector to reposition the health and developmental need of the people. This can be achieved when stakeholders; especially the government elect; pays critical attention to ensuring the full implementation of the relevant laws, acts and signed treaties relating to health sector improvements. It should be recalled that since 2001, the allocation to the health sector in Nigeria has been on the downside. Barely 6% of the aggregate budget annually is allocated to the health sector, despite several re-affirmations by both past and present governments to commit 15% of the national budget to the health sector. While South Africa and Ghana have their average percentages of public health expenditure as a total government spending to be 10.8% and 10.7% respectively, Nigeria lingers at 6.5% from 2007 to 2014. Therefore, there must be clamor for increased budgetary allocation to the health sector as stipulated by the AU Abuja Declaration. Thanks to the outgoing administration for the National Health Act 2014, we yet hope that it does not end up in the shelves like many other bright policy documents in the country. There is need to urge the government elect and the administrative states to consider the full enforcement via adequate financing of the health sector, while the MDAs in collaboration with CSOs ensure effective monitoring and evaluation of expended funds and project while ensuring wider sensitization.

Professional health associations and Health Based CSOs should also be factored into the deliberation of the Medium Term Sector Strategy (MTSS) for the sector for proper planning. There is also the need to ensure the proper capturing of the sector financing; as leakages of fund and project duplication will continue will exist where proper accounting and documentation of all donors funding for health interventions are not collated and reported. Such framework will ensure better planning, monitoring, evaluation; accountability and transparency in the sector.

While seeking for other innovative ways of funding the health sector; to increase accessibility and affordability, the health insurance coverage as geared by the processing bill should be fast tracked, so that all Nigerians will have rich health insurance coverage. The private health sector needs also to be encouraged via fiscal and monetary incentives.

Medical collages in Nigeria need to be properly funded with more skilled staffs and learning equipments. While many may argue that the Nigerian medical manpower is already well trained, retention of the team within the country still remains a problem. Hence there is the need for the coming government to take more proactive approach to provide better working conditions with the Nigerian medial workers; an approached arrived at by negotiated resolve with all the medical groups, not some.

While the burden of providing healthcare have been more on the neck of the federal government, the Nigerian citizens need to wake up from the traditional docility and demand for improved health care delivery from the state governments as well as their local government, as staying health is the basics to the fundamental right to life we all deserve.

• Ofoegbu, wrote in from Abuja