Nigeria’s collapsed health sector
It is no longer news that the Nigerian health sector is in dire straits. Available data show that the country has one of the worst health records in the world. A 2014 World Health Organisation (WHO) report on healthcare delivery, which surveyed 200 countries, placed Nigeria at an abysmal 197th position, just ahead of Congo Democratic Republic, Central African Republic (CAR) and Myanmar. Its verdict was damning: “Nigeria lacks a serious approach to healthcare.”
This is obvious from the country’s budgetary allocation to healthcare. According to the Who, for countries to effectively fund the health sector, they need to allocate not less than 13 percent of their annual budget to the sector. Nigeria, one of the 194 member nations of the WHO, is a signatory to this recommendation, just as it also signed the 2001 Abuja Declaration by all African Union member countries which stipulates a budgetary allocation of 15 percent on the minimum to the health sector to be able to catch-up with other developed countries in healthcare delivery to their citizens.
Available figures show that since the declaration was made, Nigeria has not allocated more than 6.57 percent of its budget to health sector. Unsurprisingly, the proposed 2018 budget allocated only N340.45 billion, representing 3.9 percent of the N8.6 trillion expenditure plan to the health sector.
The consequence has been catastrophic as expected. Primary healthcare in Nigeria, which ought to be the first port of call for every citizen seeking medical care, are either ineffective or moribund thus pilling pressure on the tertiary healthcare facilities that are also grossly inadequate. Nigeria is the second-largest contributor to under-five and maternal mortality rate in the world. A recent UNICEF report indicates that 145 women die daily during childbirth in the country. In the country’s worst affected areas, 1 in 13 women die during childbirth. Nigeria also loses about 2,300 under-five year olds every single day, 25 percent of whom are new-born babies. More worrisome is the fact that more than 70 percent of the estimated under-five deaths in Nigeria are caused by preventable or treatable infectious diseases such as malaria, pneumonia, diarrhea, measles and HIV\AIDS
Similarly, the figures for cancer are even more mind-boggling. Nigeria has a cancer death ration of 4 in 5, one of the worst in the world. According to the WHO, over 100, 000 people are diagnosed with cancer annually in Nigeria, and about 80, 000 die from the disease, amounting to 240 daily. Furthermore, cervical cancer, which is virtually 100 percent preventable, kills one Nigerian woman every hour while breast cancer kills 40 Nigerian women daily.
The collapse of the Nigerian health sector is almost total as both government officials, no matter how patriotic they claim to be, fly abroad for every minor health problem and health workers also jostle to leave for greener pastures abroad where they could earn decent wages. For instance, Nigeria losses over $2.5 billion annually to what has now being termed “medical tourism”.
The collapse of health infrastructure isn’t limited to the ordinary citizens alone. Even in Aso Rock, where the clinic reportedly receives a budgetary allocation of N4 billion naira, the President’s wife and daughter recently alleges that the clinic couldn’t even boast of common syringe or paracetamol. For Mrs Buhari, even though the clinic was supposed to cater for the immediate health needs of the first family, ministers and presidential aides, her aides advised her not to use the facility because it wasn’t functional and they advised her to seek medical treatment abroad for any medical complaints. Currently, the president’s son was involved in an accident but had to be rushed to a private hospital in Abuja because no one has any confidence in the Aso Rock clinic.
Another repercussion of the poor funding of the health sector is in the area of training of doctors and other health workers. According to key insiders in the sector, beyond the attitude problem of our health workers is the issue of incompetence due to the poor quality of training received by doctors in residency training and even medical students in the universities. These insiders allege that the current mode of training is so deficient it throws out half-baked and incompetent.
Was it any wonder therefore that Prof Thomas Agan, Chief Medical Director (CMD), University of Calabar Teaching Hospital (UCTH) and Chairman, Committee of Chief Medical Directors of Federal Tertiary Hospitals in Nigeria alleges that over 90 percent of deaths in our hospitals are due to poor attitude of health workers?
What is more, due to the terrible working conditions, Nigerian doctors have been deserting the country in droves in search for better working conditions in other countries. According to the Nigerian Medical Association, more than 40, 000 out of the 75,000 registered Nigerian doctors were practicing abroad while 70 percent of those in the country were thinking of picking jobs outside. It also came to light recently that over 100 doctors resigned from the University College Hospital, Ibadan, in 2017 while about 800 resigned from Lagos state hospitals in the last two years.
Perhaps, we need to declare a state of emergency in the health sector and take radical steps to rebuild our healthcare infrastructure. One of such radical steps may be to ban foreign medical treatments for all government officials beginning with the president. Then, they will have no option than to take the issue of healthcare seriously.