Dr. Ehanire, minister of health
I started the week with the sad news of the passing on of a professor last week. The learned man died in a public hospital where he was rushed to after an accident. He died because the hospital did not have a cannula.
A cannula is that little thing that is used to administer IVF into the body. It costs N200, yet an hospital did not have it, so a Professor of Urology died. A man who was trained at great cost, yet he died because a public hospital did not have so basic a tool.
My bosom friend passed away on the 5th of January. This time in a rural private hospital. He died because there was no oxygen.
He had heart failure. Anyone who knows will tell you that first line treatment for heart failure includes oxygen, but this facility had no oxygen, so my friend died before his time.
This is the state of our health facilities, whether private or public! Recall that in his speech announcing the overthrow of President Shehu Shagari on December 31, 1983, Col. Sani Abacha, among other reasons for the overthrow of the government was that “Health services are in
shambles as our hospitals are reduced to mere consulting clinics without drugs, water and equipment.”
Thirty six years later and twenty years spent under democratic governance beginning from 1999, can it be truly said that our hospitals are no longer “mere consulting clinics without drugs, water and equipment?”
A few realities stare us on the face. Contrary to the recommendations of the World Health Organisation, WHO, of one doctor to 600 patients,
Nigeria currently has a ratio of one doctor to 6, 000 patients. There are not enough bed space in the hospitals, while the generator powering the hospitals may go off during critical surgical operations at the risk of patients lives. Many of the hospitals do not have enough drugs supplied to the Pharmacy Departments thereby forcing patients to go outside the hospitals to buy drugs which quality may not be guaranteed.
In fact Nigeria has repeatedly ignored the commitment it made alongside other African countries 19 years ago on funding of health care services for its citizens.
Nigeria hosted the Heads of State of member countries of the African Union (AU) in 2001 who made the“ Abuja Declaration” under which the
leaders pledged to commit at least 15 percent of their annual budgets to improving their health sector.
Since the declaration, Nigeria has not attained the pledged funding benchmark as the federal government has never voted more than six percent of its annual budget to the health sector.
The highest percentage since the declaration was in 2012 when 5.95 % of the budget was allotted to health.
In the 2018 federal government allocated N340.45 billion, representing 3.9 percent of the N8.6 trillion expenditure plan to the health sector. The allocation was less than the 4.16 percent and 4.23 percent made to the health sector by the administration in the 2017 and 2016 budgets.
In July 2013, Nigeria again hosted over 50 African Heads of State in a special summit that was tagged‘ The Abuja + 12 meeting”, which reviewed the progress made on the promise of the Abuja Declaration on health funding. Nigeria was also found wanting.
Because of the low budgetary allocation to the health sector the country is beset by poor primary health facilities, lack of functioning cancer machines or treatment centres, poor health emergency responses and low coverage of the health insurance scheme, among other issues. Various statistics also show that Nigeria has one of the worst health care delivery records in the world.
WHO said one – third of more than 700 health facilities have been destroyed in the country and about 3.7 million people are in need of health assistance.
Apart from poor health interventions apparently caused by lack of funds, the sector has also experienced series of industrial actions by
its workers over unpaid salaries and other administrative anomalies.
When Nigerians welcomed the year 2019, they had high hopes and expectations of a better healthcare system, despite failures of the past years. Nigerians were optimistic of the fulfillment of the
presidency’ s promises to provide standard, quality, affordable and accessible healthcare to all, in order to achieve universal health coverage, as stipulated by the World Health Organisation(WHO). There were projections by experts and stakeholders in the healthcare industry on how the Federal and State Governments could achieve
universal health coverage by putting the right strategies in place.
But with the look of things, Nigeria is still far from achieving better and standard healthcare system for her citizens, compared to her African counterparts and other developed climes.
The United Nations’ member States had earlier agreed to
try achieving universal health coverage(UHC) by 2030, as part of the Sustainable Development Goals, which requires that all individuals and
communities receive the health services they need without suffering financial hardship. This includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care.
The UHC also provides everyone access to services that addresses the most significant causes of diseases and deaths, and ensures that the
quality of those services is good enough to improve the health of the people who receive them, thereby protecting people from the financial
consequences of paying out of their own pockets to reduce the risk of being pushed into poverty.
Whereas, African Union leaders, as measures to achieve the UHC, on April 2001, converged in Nigeria, which resulted to the Abuja
Declaration of committing at least 15 percent of their yearly national budget to healthcare, following the widespread shortfall in their budget for health.
While seven countries– Rwanda, Zambia, Malawi, Burkina Faso, Botswana, Niger and Togo have met the Abuja target, Nigeria has failed to meet up, as it has continued to allocate less than six percent of its annual budget to the health sector, with that of 2019 standing at 4.1
per cent, that is N365.77 billion, out of the country’ s total budget of N8.83 trillion.
While various statistics puts Nigeria as one of the worst in
Healthcare delivery records in the world, the World Health
Organisation has rated it 187th out of 191 countries in terms of health care delivery.
The health body also placed Nigeria as the third highest in maternal and infant mortality rate globally, with about 70 percent of the country’ s population still spending out – of– pocket for health services till today, according to Budgit, a platform analyzing Nigerian budgets and public data. What can we do to arrest the situation? First we must work to meet the
target in the“ Abuja Declaration” which smaller countries like Zambia and Togo among others have met.
We must embark on aggressive equipping of our hospitals. Let our leaders make our hospitals work in the interest of the poor masses that voted for them.