The Face of Nigerian health sector in 2021

 

 

 

AKOR SYLVESTER-Abuja

 

 

In every country of the world, the health sector is very strategic and critical to the development of the economy. In other words, no country can boast of greatness of any kind when it’s health sector is in a mess. That is the more reason why any government that has human face and also has the people at heart, must put the health issue at the front burner.

 

In Nigeria, health sector has not been having it so good as successive governments desipitate energy on other issues that do not have direct impacts on the people than health matters.

 

Taking a critical look at the health sector in Nigeria in the year ending, 2021, one would say that the year was a year of worrying health issues. Just like the previous years, disturbing health challenges was the order of the day. The preceding year 2020, was the arrival of the Global COVID-19 pandemic to the country.

 

The dreaded virus put the country in confusion as it was not prepared for it. That global public health challenge caught the country very much ill-The response to the pandemic was not easy with the country at the first time. Lives were lost to the pandemic even when the government in power was struggling to tackle the spread of the virus.

 

The National Primary Health Care Development Agency (NPHCDA) headed by Dr Faisal Shuaib was at the fore front for the COVID-19 vaccine distribution and the campaign to ensure that majority, if not all the citizenry are vaccinated against the dreaded virus. Alot of interventions came from other countries through the NPHCDA to Nigeria to curb the spread of the virus in the country. The country did not only witness the Delta variant of the pandemic but also the omicron variant which is presently spreading.

 

The nation’s health sector ever since has been struggling. of course, before the pandemic, our health systems were rather in shambles, and had been roundly adjudged as frail and dysfunctional.

 

The country’s hospitals were in disrepair, dilapidated and the workforce ill-motivated.

 

Notwithstanding the situation of the country’s health sector, it proved very resilient when confronted with the challenge of the Covid-19 pandemic.

 

The Nigeria Health sector managed the COVID-19 response commendably considering the limited resources available to it, though one can not give it hundred percent mark, because even when the country had the resources in abundance, the story was the same because of the cancer called corruption.

 

However, we cannot but say that the present leadership of the country played a vital role in ensuring that resources were made available for the reactivating and revamping of the health system including the health infrastructure.

 

But,  in spite of all the huge investments, not much has changed in the sector up to the end of the year. The sad narrative is that most of the dilapidations and systemic decay subsist. The situation remain the same. No much impacts have been made despite the enhanced budgetary provisions, the huge sums appropriated and released.

 

They were still demands and agitation for better welfare for health workers. This has been the song, not only in health sector, but other sectors of the economy.

 

In health, it is disappointing that the sector is yet to serve the people well. There were the usual episodic inglorious industrial unrest and strike especially the National Association of Resident Doctors, NARD. The 2021 NARD strike was the most protracted in recent time and it crippled the Hospitals across the country. The strike came when the country was seriously battling with the COVID-19 pandemic. Now,  if you may ask whether the issue that led to the stike is totally resolved, the answer is no.

 

Recall that the Federal Government released the sum of N1 billion each to almost all the 36 States and the FCT, and also release another tranche of about N950M each to all Federal Tertiary Hospitals as special Covid-19 Intervention fund, but there were virtually little or nothing in most of these hospitals compare to such humongous investment in the health sector in 2021. Most of these funds were not rightly and judiciously ultilised.

 

Further more, the year 2021 witnessed mass movement of healthcare professionals of different categories to other countries of the world for greener pasture. No wonder the President of the Nigeria Medical Association (NMA) Professor Innocent Ujah in a recent interview with Champion Newspapers in Abuja, said the issue of brain drain will remain with the country and the health sector as long as the country continues to pay deaf ear to the demands of the health professionals

 

He blamed government on the exedus movement of Nigerian Doctors to oversea for better jobs.

 

Ujah said the work environment in the country is hostile and unrewarding to medical Doctors who have gone through regorious and difficult studies in the universities to treat patients.

 

He said a situation where Doctors are found around the streets without job, and even when they are given the job, are not paid,  is uncalled for, urging government to wade into the issue in order  to better the lots of Doctors in the country.

 

The NMA boss said Nigeria has produced over 80.000 Medical Doctors, but lamented that out of this number, only less than 40.000 Doctors are currently working in Nigeria.

 

He said the medical  body had made the appeal to government to take action that would motivate Doctors to work in the country but did not get favourable result from the government till date.

 

He added that the insecurity in the country was another reason for the movement of Nigerian Doctors to abroad, advising government to put it’s house in good condition.

 

“We have cried to government before that Doctors are leaving. The practicing environment is hostile Nobody will stay in a place where there is no future. Nigerian Doctors are well trained and they are sort after everywhere. So when they leave, the implication will be so much. Nigeria has produced over, 80.000 medical Doctors but only less than 40.000 are working in Nigeria.This is because the environment is hostile to them. Doctors are not paid, some women are divorcing their husbands because they can’t cope with the family demands.Inflation is very high because there is no money.

“To worsen the matter, there is insecurity in the country. Ofcourse, nobody will go and work in a place that is not safe”

 

The NMA president said the state governments were not helping matters as they were not employing Medical Doctors on their believe that their salary is high.

 

“State governments are not employing Doctors because they believe that their salary is high. They leave the National Primary Healthcare Development Agency to choose community health extension workers who have no modicle of training”.,he said.

 

He urged government to motivate workers and create enably environment for them to strive,  maintaining that nobody would like to work in an unfriendly and unrewarding environment.

 

It was a matter of national embarrassment when it trended that Dubai and many other countries set up centres in hotels and in many other undisclosed places in Abuja and Lagos to massively recruit Nigerian healthcare professionals for their home countries.

 

Rather than address the root cause, the Nigerian Government reactionarily resorted to clamping down on such centres. Even this December, young and vibrant Nigerian healthcare professionals, the critical mass of the health workforce are still leaving the country in droves.

 

The disturbing aspect is that you cannot point to any tangible infrastructural intervention in the health sector in 2021 to support the much-touted Government interest to revamp the health sector and systems and to bring it up to par so as to meet the prevailing health challenges that the nation and her people are facing.

 

Just recently, the Minister of Budget visited the University of Port Harcourt Teaching Hospital for on-the-spot assessment of the utilisation of their own N950 million Covid-19 intervention fund.

 

Unfortunately, the Minister was disappointed at what happened. He was not shown anything reasonable as he left threatening that Federal Government will invoke the anti-graft agency to probe how the fund was used. So, managers of the Nigerian health sector are yet to make the most of the lessons derivable from the COVID-19 experience.Ofcouse ,Nigerians expect the drivers of health sector to take them to the rightful place in the sector.

 

Of the truth, one can simply say that the Nigerian health sector did not fare well in the year under review. The health systems are yet to be revamped, just as the systems are yet to be reformed. And to do this, there must be full commitment on the side of the government in place. Health must be given full attention for meaningful repositiining.

 

As it stands today, the President of the country, Muhammadu Buhari still travels abroad for medical checkups, the Doctors and other health workers are still going on strike frequently, people still pay out of pocket for health care, the Federal Government still allocates not more than six per cent of the annual national budget to the sector, over 70 per cent of primary health care centres nationwide are non-functional, less than four per cent of the population have received COVID-19 vaccination compared to 75 per cent in most developed nations among other anomalies.

 

Daily Champion investigation revealed among other things that the health care system remains weak as evidenced by lack of coordination, fragmentation of services, dearth of resources, including drug and supplies, inadequate and decaying infrastructure, inequity in resource distribution, and access to care and very deplorable quality of care.

 

WAY FOWARD

 

To achieve success in health care in this modern era, a system well grounded in routine surveillance and medical intelligence as the backbone of the health sector is necessary, besides adequate management couple with strong leadership principles.

 

Unarguably, problems in the health care system of any country abound to a certain extent.  Although health has the potential to attract considerable political attention, the amount of attention it critically receive varries from place to place. Therefore, full attention needs to be given to health sector in the year 2022.

 

Provision of timely information aimed at combating possible health menace among many other things is required in this coming year. This is because inadequate tracking techniques in the public health sector can lead to huge health insecurity, and hence endanger national security,

 

To avoid the various threats and communication lapses to strengthen the health work force planning, management, and training which can have a positive effect on the health sector performance, one requires timely and accurate medical information from a wide range of sources.

 

So, in the year 2022, much is expected from the present administstion of President Muhammadu Buhari, if the health sector must be given total reformation.

 

The differences amongst health professionals which includes salary and allowances issues must be sort out to bring about harmony in the sector.

 

The present Government should improve funding and track its investment in to ensuring value for money and to curb corruption as well.

 

That is one effective intervention that we can help mitigate medical tourism. Government must urgently put measures in place to mitigate the ugly mass exodus of healthcare professionals due to the treatment given to them in their home country.

 

Health professionals must be given their entitlement to discourage brain drain in the country.

 

Government, in this 2022 must be ready to honour agreements signed with health workers to avoid incessant strikes.

 

Arrears and allowances owed health workers or professionals must be cleared.

 

It was a good news that the president directed that the arrears of all the withheld salaries of health workers that embarked on strike previously, for whom the no work, no pay rule was evoked be paid.

 

In the same way, the National Income, Salaries and Wages Commission, this December released the approved revised hazard allowances for all categories of health workers.

 

Although there are misgivings about what was approved, that is also commendable because something better than N5000 has been offered by the government. It is indeed a step in the right direction to bring about peace in the health sector.

 

The government should make it mandatory for the Chief Medical Directors and the Medical Directors of the various federal tertiary hospitals and specialist hospitals to holistically adopt  the Quality Management System (QMS) and hence pursue, and attain international accreditation such as JCI and ISO for the services they render.

 

By the time government put the above in to consideration and pursue them vigorously, the health sector will be better for it in 2022.