How to improve healthcare delivery in Nigeria, by experts

Nigeria is currently ranked 187 out of 191 countries in the world’s health systems, according to the World Health Organisation. This low ranking for the country obviously reflects the state of the nation’s healthcare sector.

This sector is characterised by such problems as insufficient budgetary allocation, decayed infrastructure, low universal health insurance coverage, among others. It means that Nigeria has a lot to do to improve its health system and make healthcare delivery affordable and accessible to the millions of its citizens.

Nigeria’s primary, secondary and tertiary health institutions are besieged by challenges. Primary Health Care facilities are the people’s first point of contact with the health system, but insufficient service delivery, overburdened clinics with long queues, and poor quality of services have resulted in many people avoiding PHC facilities and going straight to hospital outpatient departments where services are perceived to be better. But the same scenario plays at these outpatient departments, and the patients are made to pay more out of their pockets because many of them are not covered by any health insurance.

Experts in the industry believe that for Nigeria to have improved healthcare delivery, the government must tackle these and other problems effectively by taking the following steps: increasing the budgetary allocation to the sector, deepening health insurance coverage, and encouraging collaboration to address the gaps identified in the sector.

Chibuzo Opara, Co-CEO DrugStoc Nigeria, says that the government should have a well-defined programme that sets the priority areas to be covered in the healthcare industry, rather leaving everything to chance. “There should be an agreement and a commitment between citizens and decision makers on where the country places universal healthcare among other important priorities.”

“In order to create a catalytic process within the system, we need to focus on tackling the issue of financial access to healthcare, holding individuals and entities accountable and measuring the impact of interventions and activities in the healthcare sector,” Opara said.

He spoke at a time that resident doctors at government-owned Lagos University Teaching Hospital (LUTH) are on strike in protest against unpaid three-month salaries and allowances. The doctors told BusinessDay that they had been informed by the Budget Office in Abuja, Nigeria’s seat of power, that the budgetary allocation for LUTH for 2018 has been exhausted.

“The federal government proposed 2018 budget for health is not up to the required 15% the WHO said we need to move our healthcare sector to the next stage,” said a medical expert who did want to the identified.

Nigeria’s health budget for 2018 was N304.2 billion, which is just 3.9 per cent of the total budget for the year, lower than 4.1 per cent for 2017 health budget. With such a dismal budgetary allocation to the health sector, it is not clear how far the country can go with the health sector.

“We need more commitments from our leaders to achieve the set goals because the poor state of health sector in the country is alarming giving room for increase in medical tourism and brain drain” he said.

The solution to the funding challenges, some of the experts say, is for specialised financing arrangement that can insulate the funds from political influence.

“We need to set up a dedicated fund for healthcare. People and right infrastructure make it happen, if we can get the demand sorted out, the supply will be easy,” said Clare Omatseye, president, Healthcare Federation of Nigeria.

The experts also stress the need to tackle the rot in infrastructure in the healthcare industry. They point at depilated hospital buildings, and obsolete equipment that make both proper diagnosis and treatment difficult, if not impossible.

Omatseye also hinges her hope on public-private partnership in the industry to help deepen financing the business of health delivery, “and not people dictating policy.” She says that Nigeria needs to get policies right, both in the public and private sectors but points out that the biggest problem is implementation of those policies.

“So we need to keep it simple, get guidelines, timelines, just like we do in the private sector for both achievements and non-achievement. If we are talking about disrupting innovation, it’s time to disrupt code, it starts with ourselves”,

Industry watchers say for Nigeria to achieve universal health coverage to deliver substantial healthcare, economic and political benefits across populations, healthcare provision should be considered as human right and no one should be denied access to it. They believe that no reason – financial, gender, geographical barriers or any other issues should be allowed create such a barrier to healthcare access.

ANTHONIA OBOKOH