Call­ing on Pres­i­dent Buhari to re­form health­care

Nige­ria cur­rently has one of the worst doc­tor-pa­tient ra­tios in the world. The coun­try has ap­prox­i­mately one doc­tor to 5,000 pa­tients.

Financial Nigeria Magazine - - Contents -

The Nige­rian health­care sys­tem is tee­ter­ing on the brink of col­lapse. Un­like pol­i­cy­mak­ers who are ac­cus­tomed to ac­cess­ing health­care out­side the coun­try, the re­al­ity of the wors­en­ing state of pa­tient care in the coun­try hits home ev­ery day for mil­lions of Nige­ri­ans. While Pres­i­dent Muham­madu Buhari was re­ceiv­ing world-class med­i­cal care in Lon­don, so many peo­ple died from pre­ventable causes in Nige­ria. One of such cases was my brother who died at the age of 27 on Sun­day, July 30.

When I left our home in Adikpo, Benue State, a few days ear­lier, Fabian was hale and hearty. The day be­fore he died, he had se­vere headache and was ad­mit­ted at a hos­pi­tal at about 6pm. The doc­tor who ex­am­ined him wrote down a pre­scrip­tion and left the hos­pi­tal. Un­for­tu­nately, the med­i­ca­tions were not avail­able at any of the phar­ma­cies that fam­ily mem­bers fran­ti­cally vis­ited that night. My brother's con­di­tion grew worse the fol­low­ing day, and with­out proper in­ter­ven­tion by the hos­pi­tal, he even­tu­ally died.

A few weeks after Fabian was buried, I was ill and went for a med­i­cal check-up at a rep­utable hos­pi­tal in Ikeja, La­gos. After the med­i­cal ex­am­i­na­tion, the doc­tor told me the test re­sults were fine. But based on the symp­toms I re­ported, she made a du­bi­ous di­ag­no­sis, sug­gest­ing that I “might have a bac­te­rial in­fec­tion.” Dis­sat­is­fied and dis­ap­pointed, I went to see a car­di­ol­o­gist with whom I had pre­vi­ously con­sulted. Dr. Sam's (not his real name) di­ag­no­sis was that I was hav­ing panic at­tacks. It's any­one's guess what the pre­vi­ous doc­tor's er­ro­neous di­ag­no­sis and treat­ment could have cost me.

My ex­pe­ri­ence is hardly unique. There are count­less cases of med­i­cal mal­prac­tice, re­sult­ing in death or in­jury to pa­tients. The rea­sons for this are wide-rang­ing, from in­ad­e­quate fa­cil­i­ties to knowl­edge gap and some­time just neg­li­gence on the part of health­care providers. For in­stance, the pre­scrip­tion the doc­tor in Adikpo had given was rid­dled with spell­ing er­rors. In­deed, when I showed it to Dr. Sam, his first ob­ser­va­tion was the wrong spellings. How a med­i­cal doc­tor would wrongly spell med­i­ca­tions re­ally both­ered me, quite apart from the giv­ing a pre­scrip­tion that was un­avail­able at the hos­pi­tal dis­pen­sary or nearby phar­ma­cies in treat­ing a med­i­cal emer­gency.

If the life of ev­ery Nige­rian means any­thing to the gov­ern­ment, this is the time to re­form the health­care sys­tem. A new poll re­leased last month by NOIPolls in col­lab­o­ra­tion with Nige­ria Health Watch shows that 80% of Nige­rian doc­tors are search­ing for jobs abroad. Out of 72,000 med­i­cal doc­tors regis­tered with the Med­i­cal and Den­tal Coun­cil of Nige­ria, only about 35,000 are cur­rently prac­tis­ing in the coun­try. The re­port also says the sit­u­a­tion could get worse if noth­ing is done to stem the ris­ing em­i­gra­tion of health­care prac­ti­tion­ers, in­clud­ing physi­cians, nurses, phar­ma­cists, lab­o­ra­tory sci­en­tists, etc.

Nige­ria cur­rently has one of the worst doc­tor-pa­tient ra­tios in the world. The coun­try has ap­prox­i­mately one doc­tor to 5,000 pa­tients. The World Health Or­gan­i­sa­tion's rec­om­mended doc­tor­pa­tient ratio is 600 pa­tients to one doc­tor. Ex­perts say Nige­ria needs 237,000 doc­tors to meet the WHO stan­dard. The coun­try would need to pro­duce over 20,000 doc­tors ev­ery year over the next 10 years to be able to close the gap. How­ever, Nige­rian uni­ver­si­ties cur­rently pro­duce less than 3,000 doc­tors an­nu­ally, and many of them em­i­grate to mostly the United States and Bri­tain.

The health­care sec­tor suf­fers from in­suf­fi­cient fund­ing, poor re­mu­ner­a­tion for the med­i­cal work­force and lack of med­i­cal fa­cil­i­ties. Inces­sant strikes by doc­tors have not led to in­creased in­vest­ment or a new health pol­icy. One week after Pres­i­dent Buhari re­sumed work after spend­ing 103 days on his lat­est round of med­i­cal tourism in the UK, the Nige­rian Health Sec­tor Re­form Coali­tion (HSRC), through its #MakeNai­jaStronger cam­paign, wrote an open let­ter to the pres­i­dent seek­ing an in­crease in health fund­ing. The group, com­pris­ing of the Nige­ria Med­i­cal As­so­ci­a­tion and Phar­ma­ceu­ti­cal So­ci­ety of Nige­ria, amongst oth­ers, wants bud­getary al­lo­ca­tion to health care in the 2018 bud­get to reach 7.5% of to­tal na­tional bud­get.

If Buhari would heed this ad­vo­cacy, his ad­min­is­tra­tion would take the fed­eral bud­getary al­lo­ca­tion for health in 2018 to mid-way of the 15% an­nual bud­get bench­mark rec­om­mended by the Abuja Dec­la­ra­tion, which was writ­ten by African Heads of States to im­prove the coun­tries' heath sec­tor. 15 years after African Union coun­tries made the pledge to in­crease the pro­por­tion of gov­ern­ment health spend­ing in April 2001, Nige­ria's 2016 health­care spend­ing was 380 bil­lion (or 5.1% of the na­tional bud­get of N7.44 tril­lion).

The HSRC group told the pres­i­dent that health­care is the foun­da­tion of na­tional se­cu­rity, eco­nomic growth and re­cov­ery. It may be a cliché, but it is true: “a healthy na­tion is a wealthy na­tion.”

It is def­i­nitely in­com­pat­i­ble with the gov­ern­ment's top pri­or­ity of eco­nomic re­cov­ery for the coun­try to con­tinue to lose $1 bil­lion in med­i­cal tourism ev­ery year. Build­ing a world-class hos­pi­tal in Nige­ria, strength­en­ing the ca­pac­ity of pub­lic hos­pi­tals, and ad­dress­ing the wel­fare of the med­i­cal work­force will not only re­duce the cap­i­tal flight; it will also save lives that are lost un­nec­es­sar­ily due to a dis­mal health­care de­liv­ery sys­tem.

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