Public Health in Nigeria, the need to move into the future.
Growing up, my sole ambition was to become a medical doctor, to wear white clinical coats and work in a nice hospital just like my role models on TV, this gradually developed into a genuine desire to help people in need, especially in the medical field. But as I grew older, I realized that the problem with the health system in this country wasn’t, still isn’t a scarcity or lack of qualified doctors or medical professionals, but rather a total lack of an effective management system.
The Present Situation.
The public healthcare delivery system in Nigeria has recorded little development in the last 2 decades, and is in fact ranked 187th among the 191 member states of the world health assembly. It doesn’t make it more encouraging that life expectancy of the average Nigerian is at an all time low of 47 years. The international community has very little regard for this system and the feeling is mirrored by Nigerian citizens (including our presidents and very senior elected government official) who would rather seek medical counsel or treatment outside the country. Foreign nationals are warned about the dangers of prolonged visits to Nigeria in case of medical emergencies.
It is very sad to see many people die in this country simply because the system has nothing in place to cater to their needs. These people are of course the vast majority who cannot afford private or foreign medical care, or emergency cases that are not accorded the level of priority that they deserve. Our system effectively has no health insurance scheme, no emergency response/disaster management unit, no system of accountability and very few equipped hospitals. There is also the troubling fact that the government does not view health financing as a priority, the sector has what I call “budgetary irrelevance” as less than 4% of the annual budget goes to health. This is an irony considering that Nigeria is a signatory to, and actually hosted the AFRICA PUBLIC HEALTH 15% PLUS campaign 2001 where member states of the African union agreed to allocate at least 15% of their annual budgets to health. It therefore comes as no surprise that there is a general lack of confidence in our public health system.
The Possible Future Situation.
Emergency medical services in Nigeria will not just save countless lives, it will provide thousands of jobs for university graduates in the colleges of health sciences, graduates of Human Anatomy, Human Physiology, Medical Laboratory sciences etc, will become gainfully employed in the system without leaving their primary discipline. Health insurance is practiced all over the world because of the great cost of medical care for certain conditions. Dialysis for kidney disease, chemotherapy and radiotherapy for cancer and most forms of surgery are usually too expensive, even for the middle class and are thus reasons for such a scheme. In Nigeria, such illnesses are usually death sentences for a vast majority of the citizenry. It is relatively common for patients to be taken to hospitals only to be turned away because of scarcity of hospital equipments, making people wonder if there was no audit and approval for the opening of that hospital for health care. Doctors leave their duty posts for private businesses and no one is held accountable for the loss of patients.
The Solution and Way to the Future.
Nigeria needs a change, but not just an ordinary change, we need an overhaul of the healthcare delivery and management sector. We need accountability, passion and the zeal to protect the dignity of our fellow man, realizing that medical care can be needed anytime and by anyone. In the face of deep rooted corruption and poverty, this change can only be effected by people with genuine passion and commitment to public health, people who will be dedicated to developing a country where excellent healthcare is viewed as a necessity and not a luxury and is thus accessible to all, a country where the system values the world’s most prized possession, LIFE.
