The health sector in 2017

Last year was not really a good one for the health sector in Nigeria, as the country suffered a lot of setbacks. In this piece, AJUMA EDWINA OGIRI recaps major events of 2017.

Epidemic outbreaks
The first epidemic outbreak was meningitis. It killed over 1,166 people between December 2016 and June 23, 2017. Children between the ages of five to 14 years accounted for 6,791 cases out of a total 14,513 cases reported in 24 states. Zamfara, Sokoto and Katsina states , which were the most affected in terms of casualties, accounted for about 89 per cent of the cases. Lack of vaccine to contain the disease led to its spread across the country. Within the same period, more than 500 persons also contracted Lassa fever in about 17 states and 104 died.

While Nigerians were still battling with these familiar diseases, then came a new and unfamiliar ‘visitor’; Monkeypox. The outbreak of Monkeypox , which was first reported in Bayelsa state in September, was described as a rare viral zoonotic disease; an infectious disease that spreads between animals and humans, with symptoms similar to smallpox, although in a milder form. It is defined by the appearance of rashes all over the body of the patient, often starting from the face and then spreading down to other parts. From Bayelsa, it spread to 15 states across the federation, including Rivers, Cross-river, Akwa-Ibom, Lagos, Ogun, Ekiti, Delta, Enugu, Abuja, Imo, Niger, Nasarawa, Kano, Benue and Edo states, with a total number of 94 suspected cases.

There were also confirmed outbreaks of cholera in seven states and they were Borno, Kebbi, Zamfara, Kano, Lagos, Oyo, Kwara and Kaduna states. A total of 1,558 suspected cases of cholera were reported, including 11 deaths from five local government areas. About 50 per cent of suspected cases were males and 49 per cent, females.

Osotimehin’s death
The Former Minister of Health, Professor Babatunde Osotimehin died on Sunday, June 4, 2017. Osotimehin, who was a Minister from December, 2008 to March 2010, reportedly died at the age of 68 in New York.

NHIS saga
The Minister of Health, Prof. Isaac Adewole, suspended the Executive Secretary of the National Health Insurance Scheme (NHIS), Prof. Usman Yusuf, via a letter with reference number C.4051/T/132, dated 6th July, 2017. Thereafter, he constituted a panel headed by the Permanent Secretary Ministry of Health to investigate allegations bothering on contracts splitting, appointment of new staff under the cover of secondment, and abuse of due process.

The panel had, through a letter marked DHS/876/1/T/38, dated July 18, invited the suspended NHIS boss to appear before it on July 20, 2017, at the agency’s Board room to clear his name. However, Prof Yusuf, declined the invitation. Eight other top management staff of the agency were also suspended for corruption allegations.

Prof. Yusuf, who took over the state-run health insurance provider in July 2016, was initially suspended for three months on July 6, 2017 by the Minister of Health, to allow for fair and uninterrupted investigation of the various allegations levied against him. The panel however found the suspended ES “culpable in many areas” of his performance and consequently, the minister suspended him indefinitely, pending a final decision by President Muhammadu Buhari.

However, there was a new twist to the drama, after the suspension of the ES, as reports indicated that N19 million allowance was paid to the 21-member probe committee from the Treasury Single Account (TSA) of the NHIS on September 14, 2017. The payment details showed that the immediate past Permanent Secretary of the Ministry of Health, Hajiya Binta Adamu Bello, who was the chairperson of the committee, was paid N1,280,000, and each of the 13 directors on the committee was paid N960,000, while the four assistant directors received N640,000 each.

In the meantime, a new acting Executive Secretary, Ibrahim Attarhiru, has been managing the affairs of the agency.

Revitalisation of Primary Health Care centres
The Federal Government flagged off a scheme to revitalise over 10,000 healthcare centres across the country. The Minister for Health, Prof Adewole, during the commissioning of the Model Primary Healthcare Centre, Kuchigoro, Abuja, said that government plans to make qualitative and affordable health services available to Nigerians.

The project under the National Primary Healthcare Revitalisation Initiative (NPHRI), through the National Primary Health Care Development Agency (NPHCDA), and the Federal Ministry of Health, promises to make at least one primary healthcare centre fully functional to deliver services especially for children and women in each of the wards across the country. According to the minister, 110 PHCs are expected to be renovated in the first phase. So far, many PHCs across the country are still in dilapidated states.

Launch of new family planning logo
The federal government through the Ministry of Health, had launched a new family planning logo to encourage and help Nigerians identify places where to get the services. The minister for health said the new logo, “Green Dot” is to ensure that 7.3 million women have access to family planning. It is also aimed at reducing maternal and infant morbidity and mortality. According to him, the family planning service is also meant to check population explosion, as Nigeria is reportedly on the verge of it and if not checked, it could have a negative impact on the country.

Strike! Strike! Strike!
Health workers going on strike is not surprising to Nigerians anymore, as it has become a continuous ritual. Last year wasn’t any different as doctors and other health workers went on numerous strikes, which paralysed the activities of public hospitals for weeks. The National Association of Resident Doctors went on a-10-day strike in September, to protest the unfulfilled agreements between the federal government and its association. After much deliberation with the health minister and Minister of Labour, Chris Ngige, the strike was suspended.

The Joint Health Sector Unions, JOHESU, an allied union of all health workers also began their strike some days after the doctors suspended theirs. The strike also lasted for ten days. Though the strike was suspended after deliberation with the government, the union is still accusing the government of bias and as such, it recently passed a vote of no confidence on the minister of health.

2018 proposed health budget
On November 7, 2017, President Muhammadu Buhari presented the 2018 budget estimate of N8.62 trillion to the National Assembly. Out of this sum, a total of N340.45 billion was voted for the health sector; less than the N359.2 billion that the country spends on medical tourism annually. This represents a meagre 3.9 per cent of the total budget, lower than the 4.1 percent in 2017.

With the N340 billion allocated to the health sector, it means the federal government plans to spend approximately N1,893 on the health of each citizen annually. This low budgetary allocation is coming against a backdrop of the recent outbreaks of Monkey pox in several states in the country, high rate of malnutrition, especially in the North-east, high maternal and child mortality rates, and the fight to end polio.
This, coupled with World Health Organisation (WHO) rating of Nigeria as 187th out of 191 countries with the worst healthcare delivery, and the third highest in infant mortality in the world is a low mark.

The Nigerian Senate has however vowed to allocate more funds to the sector so the nation can commence the implementation of the 2014 National Health Act from the 2018 fiscal year.