Revamping the health sector

The recent report that over 75, 000 nurses and midwives left the country in the past five years due to poor wages and unconducive work environment has further underscored the rising brain drain in the nation’s health sector. This was disclosed in Abuja at the flag-off of this year’s International Nurses Day (IND) by the National President of the National Association of Nigeria Nurses and Midwives (NANNM), Michael Ekuma Nnachi. Besides, thousands of Nigerian medical doctors, pharmacists, consultants and other health professionals have migrated to foreign countries in search of greener pastures.

Therefore, it is laudable that President Bola Ahmed Tinubu has promised to invest the funds from fuel subsidy in health care, education, public infrastructure and job creation, among others. The nation’s corrupt and unsustainable subsidy regime has been a huge drain on the economy.  The immediate past Secretary to the Government of the Federation (SGF), Boss Mustapha, disclosed recently that subsidy payments from 2005-2021, a period of 16 years, cost the federal government a whopping N13 trillion. Mustapha, who relied on figures from the Nigerian Extractive Industries Transparency Initiative (NEITI), revealed that the figure was equivalent to total annual budget for health, education, agriculture and defence in the past five years and almost the capital expenditure for 10 years, 2011-2020.

It is expected that the health sector will be revamped if it is adequately funded and the health workers adequately remunerated. For years, the sector has been grappling under poor funding with annual health budget not exceeding five to six per cent. The federal budget for health from 2016 -2020 had never exceeded 4.93 per cent. Nigeria has not even reached allocating 15 per cent of its national budget to health as agreed by African leaders in Abuja some years ago despite being one of the signatories to the Abuja accord.

The extant health budget is grossly inadequate and cannot meet the ever-rising demands of the sector. Now that President Tinubu announced better investment in health care, let him start by allocating at least 15 of the nation’s annual budget to the beleaguered health sector. Apart from poor funding, obsolete equipment and dilapidated infrastructure, the health sector is threatened by mass exodus of Nigerian doctors, nurses and midwives and other health care professionals to United Kingdom (UK), United States (US), Saudi Arabia, Canada and others in search of better conditions of service.

The sector has also witnessed frequent strikes by doctors, nurses and other health workers over welfare issues. Another malaise facing the health sector is the growing medical tourism in the country, which is tacitly encouraged by our political leaders and other affluent Nigerians. As a president, Muhammadu Buhari spent several months in foreign hospitals, especially in the UK. Tinubu and others should not toe that path. There must be a departure from that ugly trend. Adequate training of our health care professionals and the provision of healthcare infrastructure will address the brain drain and medical tourism. This might explain why former Nigerian leader, Gen. Yakubu Gowon, recently made a case for improved training of our healthcare professionals and affordable healthcare in the country. The former head of state made the call at the 50th anniversary of the University of Benin Teaching Hospital (UBTH) in Benin City, Edo State. He believed that adequate investment in healthcare infrastructure would enable Nigerians have quality healthcare.

It has been estimated that Nigerians spend over $1 billion annually on medical tourism. Available statistics showed that Nigerians spent over $3 billion in medical tourism from 2020-2022. To retain our healthcare professionals, government must strive to improve their welfare and give them competitive wages. However, in revamping the health sector, there is need for the federal government to carry the state and local governments along. Let the government prioritise the primary health care, which accounts for over 70 per cent of the nation’s disease burden.

Government should revive some abandoned primary health care facilities across the country to quicken the access to affordable health care services. More emphasis should be placed in tackling malaria, typhoid, tuberculosis, hepatitis and other diseases that mostly affect Nigerians. The private sector should be part of the effort to resuscitate the ailing health sector. Since Nigeria accounts for 34 per cent of global maternal deaths, let the government put measures in place to address the challenge. The era of paying lip service to healthcare issues must be over. Let the government recognise the right to health as a fundamental human right for every Nigerian citizen.

The World Health Organisation (WHO) constitution acknowledges that ‘the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.’ The WHO further explains that ‘the right to health for all people means that everyone should have access to the health services they need, when and where they need them, without suffering financial hardship.’ Let the government ensure that all Nigerians enjoy the right to health and other basic human rights including access to safe drinking water and sanitation, nutritious foods, adequate housing, education and safe working conditions. The implementation of these rights will enable Nigeria achieve universal health coverage.