At 54, Nigeria has come of age as a mature sovereign nation. As the country marks another independence day today, stakeholder's say the sector has witnessed some level of improvement especially in the area of polio which has been successfully reduced by 95 percent between 2013 and 2014.
The health professionals however, noted that the sector is still plagued with poor infrastructure, shortage of health personnel, weak private sector, unfavourable policies, long waiting time and lack of access to affordable healthcare delivery.
Excerpt:
Universal health coverage, answer to problems in health sector-NMA President, Dr. Kayode Obembe
In the assessment of healthcare delivery system in Nigeria at 54, if we are to put a healthcare parameter and basic health into consideration, for example the maternal mortality has reduced from 1500 per 100,000 lives from 500 to 700 per 1000 live births.
In the area of infant mortality, there is also a slit reduction but by and large this reduction is not up to the level that is being calculated under the Millennium Development Goals, MDGs. This reduction also reflected in the HIV and AID, TB among others. The reduction is not as much as expected under MDG.
If we are to consider the area of medical tourism you find out that the health system is not meeting the demand of Nigeria, meaning people still decide to go abroad and the fact of this is not far fetch.
One other parameter that we should be using in checking development is the coverage by National Health Insurance Scheme, NHIS, the target of this scheme as at 2005 is that by 2015, 100 percent of Nigerians would have been covered, but I can tell you that as we are talking now it has only succeeded in covering about five percent, this is considerably lower than expected and we are not performing well in this area. Look at the issue of National Health Bill, up till now this Bill has not been signed into law. So you find out that in the health sector we suppose to perform better but our current performance is not encouraging at all. We need to really work hard to ensure we improved because health is wealth.
The health of Nigerians is paramount in the agenda of any government. So we really need to do more.
Recommendation
Universal Health Coverage is the answer to all these problems. Let every Nigerian be insured and when you are insured you should be able to get treatment at least a basic health service must be provided for every Nigerian. Once you get that, then we are moving in the right direction and this can be made visually possible through community based health insurance scheme system and ensure that the National Health Bill is passed so that the funds that will go to primary healthcare will be channel through the healthcare scheme.
This is how it is practised in other part of the world like Netherland where their healthcare coverage is now 99.5 percent. I believe Nigeria can also achieve this through commitment.
Nigeria's healthcare system still largely deficient
-- Dr. Osahon Enabulele, Vice President, Commonwealth Medical Association
Truly, aside from recent successes in the containment of the Ebola Virus Disease as well as publicised improvements in some health indices like Infant and Maternal Mortality Rates, Nigeria's healthcare system is still largely deficient with Government at all levels yet to decisively address most of the basic challenges confronting the health sector, such as: Poor and decadent state of health infrastructure and equipment.
The Federal Government's promise in 2013 to institute a Health and Hospital Development Intervention Fund, HHDIF, as well as establish six regional world class hospitals have remained mere rhetorics.
At 54, Nigeria's health care system is still being undermined by the poor political commitment to health and the health care needs of Nigerians, by Nigeria's top political and public office holders. The health sector is also still blighted by poor budgeting for health at Federal, State and Local Government levels.
This has not been helped by the absence of constitutional justiciable health rights for Nigerians and the frequent recourse to foreign medical care by Nigeria's top political and public office holders, a situation that has led to the burgeoning phenomenon of outbound Medical Tourism with the attendant huge capital flight of over $800million to other countries.
At 54, Nigeria is yet to enact a National Health Act while Universal Health Coverage in Nigeria is still hovering around a miserable 7 percent coverage, far lower than rates seen in other less endowed countries like Rwanda, Tanzania and Ghana.
At 54, Nigeria is yet to witness massive investments in health research, particularly Public Health Research and other areas of operational research. The Ebola pandemic and the glaring absence of proactive research efforts (by African countries, including Nigeria) to develop a preventive vaccine or a drug cure for Ebola Virus Disease since its first outbreak in 1976, is a clear testimony of the poor priority for health research.
At 54, there remain huge deficits in health human resource.
At 54, Nigeria's health sector is still heavily challenged by the poor state of security in the country, including the security and safety of healthcare workers particularly in their workplaces; worsening mass poverty in Nigeria with attendant negative impact on the utilisation of healthcare services on account of poor financial access.
At 54, Nigeria still has weak and poorly integrated Primary and Secondary levels of care and a weak referral system, all of which largely contribute to the suffocation of the nation's existing tertiary health institutions with large crowds of patients, burn out of the few available medical doctors/dentists and other health professionals, and ultimate decline in productivity and efficient health service delivery.
At 54, Nigeria still has a largely chaotic drug procurement and distribution system.
We need to go back to the drawing board
--Pharm. Olumide Akintayo, President Pharmaceutical Society of Nigeria
IT is about the good, the bad and the ugly. The good is that for the first time in our national life, we had a situation whereby response to a national emergency, was fast.
The reaction in containing the Ebola Virus Disease outbreak by the Federal Government, Lagos state government and other state governments was very well appreciated and we must commend that laudable initiative. But beyond that there is really little to cheer.
I once said that the fundamentals of healthcare in Nigeria revolve around the propensity of one professional group to grab all the privileges and resources in the health sector.
We need to restructure the mentality of people who think that leadership of the sector is their birthright because indeed it cannot be the birthright of anybody. It is the particular endeavour at hand that will throw up who is most competent at leadership. Government has a responsibility in this direction to redress a number of problems in the health sector.
The other issue is about funding.
The way we are running healthcare in the country we will always experience systemic collapse.
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