Building A Solid Healthcare System In Nigeria


By Akunna Ejim

Good public health is vital in any country, not only for the purpose of maintaining a healthy populace, but also as a matter of national security. A healthy country is a wealthy country, with a thriving human resource the country can invest in to move the nation to greater heights.

Nigeria is undoubtedly blessed with its fair share of human resource, to the tune of 166.2 million at the last count in 2012. This means that the Nigerian population is 2.35 per cent of the total world population, or to put it in better perspective, one person out of every 43 people on the planet is a Nigerian resident.

Nigeria is also a country laden with mineral and agricultural resources, and at the top of the most visible and influential African countries. Rampant corruption, misappropriation of funds, a total disregard for the equitable distribution and utilisation of resources, and the shocking impunity with which the agents of destabilization propagate the backwards status quo has ensured the stagnancy and retrogression of Nigeria.

Nigeria produces oil but has virtually no refineries to speak of, and to add insult to injury, still engages in the importation of fuel. The power sector is a topic for another day, with the seeming helplessness of successive governments to find a solution to ensure something as basic as constant power supply, while generator importers and distributors smile to the bank. Citizens are left with the burden of making daily budgets for diesel, fuel, or kerosene, dealing with the ever-present cacophony of noise from different generators, and coping with the noisome fumes.

Saying that the Nigerian health sector is in shambles is tantamount to saying the sky is up above. This is the unadulterated truth, fact, reality, right-in-your-face, that Nigerians have to contend with, in addition to the other litany of inconveniences. Despite having some of the very best  healthcare professionals in the world, the lack of development of the public healthcare system has eroded the little confidence the general population have in the Nigerian healthcare system. Even the leaders who ought to lead by example are most guilty of this lack of faith in the Nigerian healthcare system, which is why they excel at flying themselves and their cronies to other countries with highly developed healthcare systems at the slightest sign of any health issues.

Why won’t the average Nigerian follow suit? Those who can afford it go to industrialised western countries to get treatment for health problems, while those with smaller pockets go to places like India, with cheaper healthcare. It is very shameful that Nigerians have to go to India for procedures like kidney transplants, when we have some of the best and brightest physicians in the world. Having lived in the United States for some time, it is a matter of fact to report that Nigerian physicians are some of the best in the country. Yet, the same physicians would be seriously hampered and handicapped in Nigeria due to the lack of basic framework and infrastructure to support a sustainable and meaningful health sector.

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The health sector in Nigeria is deeply fragmented, with only a small fraction of the healthcare coming from a unified and organised center. The health ministry provides policies and regulations meant to guide the implementation of healthcare, but this is mostly bureaucratic posturing that gets lost as you drill down to the core of healthcare practices in the country. Private hospitals provide at least 70 per cent of the healthcare in the country, with the rest coming from federal, state, local government, and even, community-funded health institutions.

The federal allocation for the health sector is laughable in a country with no infrastructure to carry the most basic necessities such as steady power for hospital equipment (where available), good roads to transport patients to and from the hospitals, emergency medical service and personnel (if you dial 911, you’re on your own), or even water for proper sanitation. The wards in some of the hospitals are so run down and bare they look like they would be sources for new outbreaks of diseases. To worsen the situation, allocation of funds never makes it through intact as the greedy leaders meant to utilise it for the welfare of the people pare it down to a small fraction of its original size.

This is basically why doctors, nurses, and healthcare workers in these institutions are paid a mere pittance not commensurate with the high level of stress and daily exposure to the diseases in the health centers.  Some of them do not get paid for months at a time, when they are the frontline workers in the healthcare system as it is in Nigeria today. The suffering is real, a trip to LUTH, or any of such healthcare centers will sober even the most jaded person. The queues are long, the equipment outdated, the facilities understaffed, the necessary medication is often lacking, and most of the patients cannot even afford the drugs or treatment.

Remote areas and rural communities are almost relegated to the background and have to fend for themselves. Some of these areas are not even connected to the national grid, and so have no power whatsoever.  The federal government has no say in how states utilise their allocations, and cannot mandate them to spend a certain amount on healthcare, making it difficult to gauge the effectiveness of any campaign for improvement on a cohesive nation-wide level.

Also, the lack of medical intelligence nullifies any effort to identify sectors with disease outbreaks in a timely manner, to contain and treat incidences of infectious disease outbreaks, and reduce the frequent occurrence of such in the country.  The manner of drug supply is also cause for concern. Most of the pharmacies in the country are not regulated, and even the tomato seller could also sell medication like pain killers, multivitamins, tetracycline, antibiotics and so on. A complete overhauling of the healthcare sector is long overdue and will help alleviate the suffering of the masses.

akunnaya 25

Culled from TheNEWS magazine