Nigeria: the pathway for a healthy people

 Today, 7th April is recognized by the World Health Organization as the World health day. This year, the WHO has coined a theme which is in line with the global advocacy for actualization of SDG 3 (Good health and well being). This article, written for the SDGs ACT Lagos Chapter is focused on the Nigerian Health sector as part of our social responsibility to advocate for the actualization of a greater Nigeria through the SDG platform and also as part of activities to commemorate the World health day. Nigeria  being the home base of the author and the organization. All views expressed are solely for the author. Enjoy your reading fellow compatriots.

Nigeria is a country with an estimated 180 million population and rapidly explosive population expansion due to high natality rates and immigration. The country’s national budget for the health sector unfortunately continues to decline in relation to the overall budget size. In 2018, a meagre 4% of the proposed appropriation bill was allocated to health compared to 5.97% in 2012. Considering the status quo in which only about 30% of allocation to the health sector is allotted for capital projects and about 70% for recurrent expenditure largely involving payment of salaries and office running costs coupled with poor budget implementation over the years, making quality healthcare available for everyone looks increasingly impossible.

By all available indices, it is no longer news that health delivery in Nigeria has been and is still very poor. The country continues to battle with a rapidly explosive population growth. She also struggles to cope with the emerging dynamics and advances of global health. These challenges are so many and remain difficult to resolve especially in the face of dwindling revenues.

The health sector in Nigeria is faced with massive infrastructural deficit and in places of availability, they are often obsolete or overstretched. I had an encounter with a fresh graduate of one of Nigeria’s highly glorified medical colleges and the result left my mouth wide agape!. The lady was so sincere to admit that she had never observed or gotten involved in a live dialysis session before except of course, in theoretical terms during her coursework. This, she said was due to the collapse of the dialysis equipment in the dialysis room. These equipment had been left unattended for years!. We can only afford to produce doctors who are not fully equipped with the skills to face the modern day health challenges. With advancing technological inputs in global health, we remain lagging behind in terms of basic human capital. What a pity!

In a recent survey conducted on social media, with all respondents being Nigerians, it became quite clear that a majority of Nigerians believe that we should prioritize issues relating to human capital development even ahead of building infrastructure. Little do we know that both go hand in hand. The adequate infrastructure will enhance the rate of absorption and further increase the quality of personnel. On Facebook, 56% of respondents favored enhancing medical education as a priority area ahead of building more hospitals. Similarly on twitter, 71% of respondents voted in favour of enhancing medical education as against 29% in favour of building more hospitals.
In view of the discussion, it is worthy to note that the WHO classifies Nigeria among the 44% of nations that have less than 1% doctors per 1,000 population. Human resource problems being so high in the country that we have only 7 states having specialist care for  cancer. Can you imagine?

What can we do?

The Federal and state governments in Nigeria need to work vehemently to increase their IGR as a way of increasing available means. Governments across all sectors need to display transparency and accountability in governance through citizen engagement, granting access to budget documents, giving regular budget implementation reports e.t.c. The public will gain more confidence in the system and will be ready to do even more to support the government especially when the government calls for private collaboration and investments in the health sector.

Government must make it easy to register and run businesses related to healthcare services especially for NGOs. Registration should not be a herculean task and also the government should attract investments within the sector while formulating reasonable policies to maintain community health.
Government should commit more funds to healthcare especially in areas of nutrition deficiency, infectious diseases control, maternal and reproductive health. A higher percentage of this funds should be channeled into capital projects within the sector especially with building of more community health centers and equipping of all health delivery facilities with adequate equipment to function optimally. Our tertiary colleges should not be left behind in this process.

The curriculum for medical colleges should be revised regularly to accommodate changes, invention and advances on the global stage. This will go a long way to improve human capital as our medical personnel will be equipped with adequate skills to cope with emerging health advances and challenges especially in relation to health emergency response and infectious disease control.
Government should also engage skilled doctors and other caregivers to train individuals (volunteers) in the local communities as health extension workers, caregivers, first aiders e.t.c. This will increase healthcare reach and definitely we can have qualitative healthcare, for everyone, everywhere.

AbdulBasith Sijuade Akinyemi-Eshilokun is a Community health educator and advocate. He is a volunteer for the SDGs ACT Lagos who is passionate about good governance in Nigeria.
amb AbdulBasit Sijuade Akinyemi-Eshilokun holding the goal 3 flashcard to demonstrate and sensitize people at the beach, during the organization World Water Day 2018 project.
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