Nigeria’s Public HealthCare Pitfalls and Solutions in Context By Olawale Rotimi-Opeyemi
“Nigeria faces some fundamental issues some us may not even take cognisance of. We have a population of N182million thereabout in 36 States of the country, but we only have 20 Federal Teaching Hospitals and 23Federal and State Medical Centres, some States like Lagos host more than one; 43 Federal and StateMedical Facilities for a population of 182million? That’s an average of about 4.2m people per hospital! Can our Teaching Hospitals and Federal Medical Centres accommodate fifty thousand patients each? We aren’t near standard healthcare system and no visible signs we are pressing close to it.”
A healthy nation is a wealthy nation. Adverse health effects have been linked to poor socio-economic growth and development. Nigeria’s public healthcare system has consistently failed to meet the health demand of her growing population due to poor facilities, insufficient medical experts, low funding, corruption and government instability. The 1988 national health policy designed to provide quality healthcare for all Nigerians declared publicly was reviewed in 2004 under the Revised National Health Policy officially launched in September 2004. The following are the thematic goals and objectives of the Revised Health Policy:
- Health and access to quality and affordable healthcare is a human right.
- Equity in healthcare for all Nigerians will be pursued as a goal
- Primary healthcare (PHC) shall remain the basic philosophy and strategy for national health development.
- Good quality healthcare shall be assured through cost-effective interventions that are targeted at priority health problems.
- A high level of efficiency and accountability shall be maintained in the development and management of the national health system.
- Effective partnership and collaboration between various health sectors shall be pursued while safeguarding the identity of each.
The above implies that the Revised National Health Policy is essentially designed to provide effective, quality, accessible and affordable health services to Nigerians. However, comparing the Revised Health Policy and the physical state of healthcare in Nigeria shows that the physical state of healthcare in Nigeria is the irony of what the Revised Health Policy states. In an essay published on Soil Erosion and HealthCare Delivery in Nigeria, healthcare structure in Nigeria was described as very ineffective and plays a key role in the poverty status of the country. Over the last two decades, Nigeria’s public healthcare system has deteriorated in large partly because of a lack of resources and insufficient health workers. Healthcare provision is the simultaneous duty of the three tiers of administration but so far, it has been characterized with government failure which cannot be overemphasized.Many lives have been lost to poor healthcare while others have sustained serious lifetime injury due to the same cause. Maternal mortality is increasingly high, Nigeria has one of the poorest 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 (Nigeria Demographic Health Survey 2004).
In developing countries with very poor healthcare system, like Nigeria, the average life expectancy is 40 years, with the lowest in Botswana, Lesotho and Swaziland which is 35 years, Nigeria has a life expectancy of 44 years compared to life expectancy of 82 in Japan and 80 in Switzerland (Population Reference Bureau, 2007). The pitfalls are not far-fetched, they include:
Lack of Sufficient Medical Facilities: We have a population of N182million thereabout in 36 States of the country, but we only have 20 Federal Teaching Hospitals and 23 Federal and State Medical Centres, some States like Lagos host more than one; 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.
Insufficient Medical Experts: Nigerian hospitals suffer from insufficient medical expert. The population of patients overwhelms the population of available doctors, hence, the available doctors are overworked while some patients die or face critical conditions while waiting in long hospital queues to meet with a doctor.The World Economic Forum has suggested that it would take economically developing countries 300 years with the existing infrastructure to achieve the same doctor to patient ratio that exist in many western countries.
Corruption and Political Instability: Corruption affects almost every sector in Nigeria, including the health sectors. Mismanagement of health funds by government has marred development of the health sector. Also, political instability which is characterized by clash of political interests has also weakened the growth of the health sector in Nigeria.
Poor Policy Implantation: Nigeria has ratified a few international treaties on health that could ameliorate her health sector but majority of them are usually not domesticated. More also, National policies made remain theoretic as they are not implemented by the government.
Lack of Basic Amenities: Nigeria lacks basic amenities. For example, Nigeria is one of the African nations with least access to an improved water source that could supply safe drinking water. In Sahara Africa, only 45 percent people in rural areas have access to improved drinking water source (UNICEF, 2005), thus 55 percent is exposed to unsafe drinking water which expose them to severe diseases.
Lack of Research Funds: Research is the bedrock of progress, the Nigerian government has little or no regard for research, not much research done in the health sector by Nigerians is upheld today. Research funding is not made available to medical practitioners to access.
Apparently, Nigeria has the resources to develop a global standard healthcare system, but the above mentioned problems have hindered the country from achieving this. Developing a global standard healthcare system is attainable if efforts are correctly channelled in the health sector. First, the infrastructural deficit in the health sector must be tackled passionately. There can be no development in the nation’s health sector if infrastructures are not put in place. Statistics have shown that we do not have enough hospitals to accommodate the growing population; therefore more hospitals have to be built and well equipped to cater for the populace.
Second, more medical staff must be employed into government hospitals nationwide. Currently, doctors are not sufficient compared to patients. This is a major problem that must be resolved at the shortest delay; the government must employ more doctors into its hospitals in order to meet the growing demands of patients. More also, corruption has eaten deep into the system, this must be stopped because people’s lives are involved, mismanagement of health funds exposes the lives of beneficiaries (patients) to serious danger. Conclusively, it is not enough to make policies, but more important to implement such policies. Policies and reforms in the health sector will remain theories until they are implemented for the masses’ benefit. Basic amenities that will reduce exposure to diseases should be provided and research funds must be made easily accessible to medical experts in order to advance the sector.
Olawale Rotimi-Opeyemi can be reached via email@example.com or 08105508224
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