Healthcare in Nigeria

Basic challenges with healthcare in Nigeria today and a few ideas to tackle some of them

The Nigerian healthcare sector generally consists of all the organizations that provide medical services, manufacture medical equipment or drugs, provide medical insurance, or otherwise facilitate the provision of healthcare to patients in Nigeria.

Due to the type of government system in Nigeria, there are three tiers for healthcare provision in the country; namely:

· Primary healthcare

· Secondary healthcare

· Tertiary healthcare

The federal government has a responsibility to organize tertiary health services. Meanwhile, the state government provides secondary health services, and the local government is expected to take care of primary health services.

The World Health Organization (WHO) ranks Nigeria 187 out of 190 in World Health Systems only ahead of Democratic Republic of the Congo, Central African Republic and Myanmar

Nigeria as a country is undoubtedly known to be blessed with both natural and human resources but the World Health Organization (WHO) ranks Nigeria 187 out of 190 in World Health Systems only ahead of Democratic Republic of the Congo, Central African Republic and Myanmar. Using performance indicators including overall level of health, distribution of health in populations, responsiveness and distribution of finance. Clearly, there is much to be done in Nigeria. Although there has been enormous improvement in the last few decades, Nigeria continues to suffer crippling shortages in the healthcare sector and increase in the rate of health tourism. It is reported that Nigeria loses around $1 billion to health tourism each year.

Some of the challenges facing the healthcare sector in Nigeria include but are not limited to the following;

• Corruption
• Lack of funding for healthcare
• Lack of regulatory oversight, compliance, enforcement of standards
• Mass exodus of qualified healthcare personnel

Corruption

In the last 4-years, the current administration has maintained that it is winning the war against corruption in the country but there appears not to be much to show for these efforts. Monies budgeted for healthcare institutions often end up being diverted for other uses. A scandal involving a healthcare facility located in the presidential villa in the recent past underscores this point. It is evident that government may not have the ability to judiciously manage funds allocated to healthcare and therefore these monies should be channeled more to the private institutions either directly or by way of Public Private Partnerships (PPP).

The president and top government officials continue to seek healthcare abroad. Most of these trips are paid for using tax payers money and such trips cumulatively starve the health sector of much needed funds.

Lack of funding for healthcare

The president and top government officials continue to seek healthcare abroad. Most of these trips are paid for using tax payers money and such trips cumulatively starve the health sector of much needed funds. Nigerian Doctors are among some of the best when they practice outside the country and it goes to show that if the environment in the country was conducive, these Doctors would prefer to ply their trade at home rather than abroad. The president needs to lead by example by banning medical tourism especially among government officials (whether using personal or government funds) and instead challenge them to create an environment where even the limited available funds are judiciously deployed and perhaps the spiral of death can be cut short and the sector placed back on a growth path.

Lack of regulatory oversight, compliance and enforcement of standards

Without a regulatory framework that both guides and serves as the basis for enforcement, the health sector is bound to drift of in different directions. Much of my personal experience has shown that treatment protocols are either non-existent or not readily accessible by healthcare providers. This is largely why the experience of patients would differ from one provider to the next. While a regulatory body does exist, there is a lot of work to be done in this area starting with the basics of providing clear cut guidelines that should act like a bible for anyone who wishes to practice healthcare in Nigeria. It is my assumption that the quality of healthcare will largely improve across board.

Mass Exodus of qualified healthcare personnel

This is largely due to very poor remuneration. You see, Nigerians are some of the smartest people anywhere in the world. They know this and bid their time to transfer all of these abilities that would otherwise have been used to develop the country to go somewhere else where the pay is better and the working conditions are favorable.

“but why are you leaving the country now? after all we have put into this project, you are basically setting the company back by a whole year!”

In the last 5 years, Nigeria has experienced a kind of Exodus of qualified medical personnel who leave for the US, UK and other destinations including Saudi Arabia and other parts of the middle-east in search of better opportunities. A personal experience I had with a Doctor who had barely practiced for 4-years in the country was particularly painful. We had worked on a project where she was the lead adjuster for medical bills for her organization. After a year, the project was adjudged a success and the competence she had built using her knowledge and the technology we provided suddenly went up in a cloud of smoke when she dropped the bombshell that she was leaving for the US. I called her aside and asked “but why are you leaving the country now? after all we have put into this project, you are basically setting the company back by a whole year!” She answered simply and said she felt under-appreciated. She had asked for a raise which was denied and her ask was no where near what her colleagues would earn in neighboring Ghana. She went on to say “if they would only increase my salary by 100,000 Naira (~$278 USD) I would gladly stay!”

It is therefore fair to assume that the take-home pay of many medical personnel, is not enough to get them to the bus-stop and the only way to stem the tide of this exodus is an upward review of the pay-packages for medical personnel, at least for a start.

In conclusion…

These thoughts I have shared are in no way exhaustive but the main aim is to start a discourse which could perhaps lead to key stakeholders taking the bull by the horn (so to speak) and reverse the decline in the state of healthcare in the country.