Nigeria is one of the nations of the world with the least healthcare spending per head when compared with other countries, especially in Africa. Limited access, inequitable distribution of facilities, limitation of both material, fi nancial resources for health, strikes and inter-professional discord, and limited aff ordability for the average citizen are some of the challenges plaguing the health sector. Campaign promises For a proper assessment, a lowdown of the Buhari’s campaign promises becomes imperative.
\Th e All Progressives Congress promised among others to; Prioritise the reduction of the infant mortality rate substantially; reduce maternal mortality rates to the levels acceptable by the World Health Organisation; reduce HIV/AIDS and other infectious diseases drastically and improve life expectancy by an additional 10 years on average through our National Healthy Living program; increase the number of physicians from 19 per 1000 population to 50 per 1000 through deliberate medication education as epitomise by nations such as Ghana. Increase national health expenditure per person per annum to about N50,000 (from the less than N10,000 currently); and also Increase the quality of all federal government owned hospitals to world class standard by 2019.
Th e party also promised to invest in cutting edge technology such as telemedicine in all major health centres in the country through partnership programmes with communities and the private sector; provide free ante-natal care for pregnant women; free health care for babies and children up to school going age and for the aged; and free treatment for those affl icted with infectious diseases such as tuberculosis and HIV/AIDS; boost the local manufacture of pharmaceuticals and make non adulterated drugs readily available.
Set an eff ective prosecution and punishment systems, for those importing or adulterating drugs in the country; the enhancement of the Epidemiological Units/ Centres for Disease Control to meet up with Global standards in containment of disease outbreaks, proper vaccine storage and research; and above all, create an insurance policy for our journalists as the nation faces hard times and our journalists face more dangers in the discharge of their investigative work, to educate Nigerians in their rights and responsibilities.
Health sector in the last two years In an exclusive interview with Blueprint, National President, Nigeria Medical Association (NMA), Dr. Mike Ogirima, said improvement in the health sector in the last two years “is a mixed grill.” According to him, “mixed grill in the sense that in some aspects there are improvements, while in other places there are no improvement. Recently Nigeria moved from position 187 to 140 in the health index worldwide. Th is was just released by the World Health Organisation (WHO).
“Th e government has initiated rehabilitation of 10,000 primary health centres; I hope they will be able to complete that before the end of four years. Th e other issue is that there is a plan; I do not know whether it has been carried out, but some tertiary health institutions will be re-equipped with modern equipments. “Government has also been able to maintain immunisation transit.
Th ere ‘Medical tourism still on the high side’ Adewole For Governor Abdullahi Umar Ganduje, his score card and stellar performance speaks for themselves, since he started calling the shots in Kano state is relative peace in the health sector, because when the minister came on board he was able to coordinate joint health professionals in the health sector for a meeting to fi nd a way of fi nding relative peace in the sector. On this note I think these are the achievements in the health sector. “I also think a lot still needs to be done.
A lot needs to be done in the area of personnel development, building up the capacity of the staff . Residency training programme for doctors have been in comatose. Of course this programme is where our specialist are trained. Right now a lot of our doctors who are intended to go into the residency programme are not employed. So the minister also set up a committee, whose reports have been submitted for the past six months on review of residency training programme, and up till now we are still waiting for the white paper on that committees report. “Infrastructures are not in the best condition.
If you go to any teaching hospital, of course all the structures are dilapidated. We need these structures to be rehabilitated.” Funding Th e World Health Organisation (WHO) says for Nigeria to be seen to prioritise healthcare, it must at the least spend a minimum of N6,908 per Nigerian in a year, which when multiplied by 180 million people will amount to N1.2 trillion. Th is therefore implies that if N1.2 trillion is budgeted and spent on healthcare for a year, as against the current N304 billion being allocated to healthcare for 2017, it will go a long way in solving signifi cant health issues in the country. If N304 billion is spent on the health of over 180 million Nigerians, that will amount to N1,688 per citizen for the whole year.
It is in eff orts to close the huge health funding gap by governments to its citizens, especially in developing and underdeveloped countries, that the WHO recommended that countries should allocate at least 13 per cent of their annual budget to the health sector for eff ective funding. All member countries, including Nigeria signed towards the recommendation. Also, an Abuja Declaration, signed in 2001 by all member countries of the African Union, including Nigeria, who was the host of the meeting, recommended that for the continent to be equivalent with other nations of the world in terms of healthcare provision, at least 15 per cent of their annual budget, be allocated to the health sector.
In the 2017 healthcare allocation, only a meagre 4.17 per cent was allocated to the health sector. By AJUMA EDWINA OGIRI DEMOCRACY DAY “Generally the health sector is poorly funded in Nigeria. We need government to improve funding through budgetary provisions, because we were part of the African group that signed the law that our health budget should not be less than 15 percent of the total budget. Nigeria health budget is still far below 5 percent. So, we urge government to do more in terms of funding,” Ogirima said.
On medical tourism In 2016, President Buhari declared that it would discourage medical tourism through revitalising the country’s healthcare system and putting stringent measures in place for government offi cials to travel for medical treatment abroad, except extremely needed. Unfortunately, President Muhammadu Buhari broke the promise barely a month later in early June 2016 when he was fl own to London to be treated for an ear infection, and made another trip recently, also for medical treatment. Medical tourism is soaring higher, as Nigeria gulps $1 billion annually on medical tourism.
Commenting on medical tourism in Nigeria, the NMA boss posited: “We have a lot of specialist in the country, but of course the issue of the President’s health is a personal issue. Every patient has the right to a second child opinion. Th e president, being the father of the nation cannot be exempted if he is doing it within the ambit of the medical practice. One cannot say much about it because it’s a standing issue.” Challenges Th e medical practitioner further noted poor funding, poor working environment, lack of appropriate motivation or welfare backing and the ability to maintain peace between the various professionals in the health sector, as the major challenges facing healthcare in the country. National Health Insurance scheme (NHIS) “In terms of scope, the NHIS is taking care of just about 3 percent of the population.
But in terms of the impact, for those patients that are enrolled, they can access health without paying out of their pockets. So we want the scope to be widened, and services under the scheme enlarged. “Th e scheme should be improved on expanding towards state workers, the non formal sectors; the farmers, artisans among others. Government should fi nd a way of enrolling these group of people. Th e government should also fi nd a way of improving on the services that are off ered through the national health insurance scheme beyond common ailments,” he explained.
Rivalry in the health sector Addressing the issue of rivalry between health professionals in the sector, the NMA President said, “where human beings exist, you should expect some rivalries. But, the laws are there to guide the extent at which diff erent professionals should co-habit, so if those laws regulating them are not well harmonized so that there are no oppositions from each of the laws, then incessant crisis will be there. Th e government should also try to see that transparently they engage each professional group in the health sector. Government should also implement agreements that has been reached with each professional group. When these are done, there w
