The Sorry State Of Nigeria’s Health Sector And The Agitation For A 21st Century Comprehensive Health Care Delivery System In Nigeria

By

Benjamin Ogbebulu

benjaminogbebulu@yahoo.co.uk

 

 

 

 

It’s an acknowledged fact that Nigeria’s Health sector is in shambles and this issue aside the energy problem and other related developmental issues need to be address and fix as quickly as possible by the new administration under president Yar’Adua PDP led  government. In many places in Nigeria , our Hospitals especially primary Health centres are far away from where people live and  some are with expired drugs , dilapidated structures, corrugated roots , covered with cobwebs and in many places, have become inhabitants of domestic animals.   From research, in some tertiary and secondary health centres , ordinary water supply are not available , patient relatives have resort to buying water in jerry cans  and health workers have to wait endlessly for essential drugs and disposable gloves faced with irregular power supply .

 

According to 2003 National Demographic Health survey , our immunisation coverage is put at 13% and that led to some of the reasons why some Nigeria children are dying everyday of preventable illness. Also, the rate at which women are dying of preventable and avoidable complications of pregnancies across the entire nation is alarming . Nigeria accounts for 10% of the global estimate of maternal death , even though according to World Health Organisation, our population only accounts of 2% of the world population, no wonder why our train qualified Doctors and Nurses are all eager to leave the country and travel abroad.

 

REASONS BEHIND  THE BRAIN DRAIN { MIGRATION OF HEALTH WORKERS ABROAD}

 

It is sad  to note that Nigeria and indeed Africa  are loosing their experienced  Health workers to developed countries as a result of Neglect of their Health sectors and particularly in Nigeria , mismanagement of resources, lack of priority , lack of respect for human lives by our leaders , low wages , poor motivation, persistent shortages of basic medical supplies, poor working conditions, outdated equipments, lack of efficient and effective coordination,  limited career opportunities and above all , economic reasons are among the most important factors responsible for this brain drain.

 

 

REFORMING THE HEALTH SECTOR

 

Reforming the health sector is the responsibility of the Federal Ministry of Health. The National Health Bill should be revisited by the National Assembly while the introduction of National Health insurance scheme { NHIS} by the past administration is welcome by  Nigerians. However, it  has not been   efficiently  coordinated,  handled and effectively implemented as those assigned for this project, lack the will, vigour, commitment and aggressiveness and this writer urge the government to create conducive  enabling environment to allow qualified experienced Nigerians in Diaspora to fully participate and assist in a manner that will yield positive result for the nation.

 

While most Nigerians will argue that the debate and struggle about reforming and improving Health care Delivery system in Nigeria should not be left alone to politicians and their cronies, but should involve Health professionals both at home and abroad, The media, to educate the masses of their rights  and  responsibilities and advice the masses not to abuse the system and ensure equity prevails.  Today, in Nigeria, basic health care is becoming very difficult and expensive to obtain by average common people in the country and government expenditure on health as a population of the total spend on healthy as a whole is small.

 

  Although, some significant steps have  been taken by the past administration, president Yar’Adua administration has to give Nigeria people the 21st century comprehensive efficient and effective health care delivery system.  Management of health services in Nigeria should be decentralised with emphasis on the village Health  care system .             There should be increased access to care services by making primary Health care available to all Nigeria in respective of status, religion and sex. Nigerians deserves a good health care delivery system and the government should ensure the availability of safe and good quality essential drugs and NAFDAC  as a  regulatory body should be commended in this area. The development of a National Health information system should be encouraged to facilitate Health planning and management. Disease prevention has to be strengthened and health promotion in areas such as HIV/AIDS. STDS should be addressed and their should be integrated Nutrition programme to focus more on sustainable food programme for the needy as obtained in South Africa.

 

As  part of putting Health high among developmental issues on the political agenda of this administration, various ministerial tasks teams and committees with wide range representations should be organised . Their recommendations should be further consolidated by the senate committee on  Health and Ministry of Health and inform the key policy articulated in the white paper of the senate committee on Health . A detailed Health policy document should be presented to Nigerians incorporating views from stakeholders reflecting the present day new realities and trends in the National Health situation of the country including regional and global initiatives such as NEPAD and the Millennium development goals {MDGS}. The main policy trust should focus on efficient and workability of the  National Health System and its management: National Health care resources, National Health interventions and services delivery, National Health information system, partnership for health development, Health research and Health care laws in Nigeria.

 

The National Health reforms should carry forward the Health strategies of the National Economic empowerment and development strategy {NEEDS} new partnership for Africa development {NEPAD} and the MDGS. Primary Health care should be the cornerstone of Health development in Nigeria and a revised working document should be developed for the revitalization of the implementation of primary Health care as part of Government contribution to reach the MDGS.  Health service management should be  decentralised an d states should enhanced the Health management boards responsible for the direct services delivery while the ministry of health should continue to  focus on policy formulation , standard setting and monitoring and evaluation. Community participation should be strengthened through the Village Health committees {VHC}. The establishment of VHC should be emphasised in the current Health reforms.

 

 

As the private sector provides nearly 70% of Healthy care delivery in Nigeria which deprives vast majority of Nigeria primary Health care, efforts should be on for increased public –private participation in Health care delivery with a frame work for collaboration. This writer argues that prescription for malaria and typhoid should be free for those who cannot afford it. The need for collaboration between public and private sectors should be addressed by the Health sector reform and a comprehensive frame work should be developed to operationalised it. There should be contractual agreement in the areas of security, laundry, equipment supply, maintenance and direct service supervision.

 

The World Health Organisation effort with president Yar’Adua  PDP Government should be devoted to building capacity in National and state Health policy making , regulation and strategic planning.  Support should be provided for the conduct of health policy and plan development clinics to state level officers to ensure that each state is able to develop a policy and plan to carry forward the national agenda.

 

Furthermore, training should be given to Federal Ministry of Health { FMOH} and state Ministry of Health { SMOH} staff in the use of modern equipments for health programming as this will strengthen Health programming capability  to address the issue of access , especially for the poor  and vulnerable population . In order to ensure that the health system continues to perform at optimal capacity, training should also be provided to some SMOH staff in health system development and in continuation of the public-private sectors partnership to enhance access to primary health care, catalytic funds from national government or World Health Organisation should be provided as a way of generating evidence for the suitability of PPP in the health care delivery system in Nigeria. All Nigerians  wants is a 21st century   affordable health care delivery  system  for both the  poor and  the  rich as the nation has the resources and manpower to realise this great dream, all it requires is the political will of  president Yar’Adua PDP led government and hopefully this administration with not fail and Nigerian at home and abroad will be proud of the nation’s Health care delivery system.

 

Benjamin Ogbebulu  is a  political analyst,  activist , researcher , writer and administrator based in London, England.