Nigeria’s health sector is still in the woods three years after President Muhammadu Buhari assumed office

By Samuel Ibezim

The Joint Health Sector Unions, JOHESU, was on strike when Muhammadu Buhari celebrated three years in office as Nigerian president and also the 19^th year of uninterrupted democracy in the country on Tuesday, May 29. Indeed, it was their 42^nd day of observing strike when the president was giving his democracy speech.

The symbolism of the JOHESU strike, which was later called off, is reflected in the rot in the health sector not just in the last three years but since the country gained its independence in 1960. But it appears that the situation has worsened in the last three years. JOHESU, mother union of health bodies in Nigeria gave the federal government 21 day notice on February 5, before embarking on the strike on midnight of Tuesday, April 17. To the disappointments of Nigerians, the government did little to ensure that it didn’t hold as the ministry of labour and employment claimed that it had met almost all the demands of the unions on issues of payment of promotion arrears and salary shortfalls among other things.

The lackadaisical attitude of government to the health sector is attested to the fact that President Buhari did not say anything about the JOHESU strike in his speech. JOHESU represents just a part of the health challenges confronting the country as corruption and misappropriation of funds budgeted for the sector has become worrisome.

For instance, in October 2017, Aisha Buhari, president’s wife, lamented the rate of corruption being perpetrated by the management of Aso Rock Clinic and called for them to be probed. She said that she was advised to join her husband in London for treatment after she called the clinic only to find out that the X-Ray machine was not working despite receiving a budget of N3billion. She questioned the essence of state of the art buildings at the clinic without equipment for treatment and wondered how other state clinics in the country would look like.

Earlier, Zahra Buhari, the president’s outspoken daughter, took to her Instagram page to criticize Jalal Arabi, State House permanent secretary, on his inability to provide paracetamol tablets to the clinic. Nigerians were touched by the bold steps taken by Buhari’s family to ensure that the corruption in the health sector is minimised. This is because their visits to Nigerian hospitals exposed the vices. However, the president was recuperating in an undisclosed London hospital when his wife and daughter raised alarm about the appalling health management in the country.

This notwithstanding, the climax of the rot in the health sector was when Buhari decided to go on medical treatment in London. The interpretation of his action is that he preferred to be treated abroad because he has no confidence in the capability of health institutions in the country and those running it.

Expectedly, his treatment abroad elicited criticism which was deflated by Isaac Adewole, health minister, who told Channels Television that Buhari’s choice of foreign medical treatment was not an indictment on the quality of the healthcare in the country. Absolving him of any wrongdoing as he was not the only Nigerian to travel abroad for medical care, the minister said that Buhari may have opted for foreign doctors in order to protect his privacy. Does this mean that Nigerian doctors cannot keep secrets which they are official sworn to keep?.

Suffice it to say that the president’s medical tourism abroad has weakened his change mantra which Nigerians expected will extend to all phases of our national life, especially in the health sector where Nigerian trained doctors are migrating to foreign lands where they are assured of adequate health facilities to save lives and better remuneration.

Figures from the Nigerian Medical Association, NMA

, showed that about 45,000 doctors are currently practicing in Nigeria. This means that 12 per cent of 45,000 Nigerian doctors, that is 5,405, are practicing in the U.K. and the country is now left with less than 40,000, excluding those practicing in the United States, South Africa, Saudi Arabia and others. These figures run contrary to the All Progressives Congress, APC, campaign promise of increasing the number of physicians from 19 per 1000 population to 50 per 1000.

The party while soliciting for votes in 2015 general election that brought Buhari to office, promised to reduce maternal mortality rate by more than 70 percent. As at 2017, Nigeria ranks second among countries with highest maternal mortality rate. The APC also promised to increase national health expenditure per person per annum to about N50, 000. It also promised to reduce HIV/AIDs infection rate by 50 percent and other infectious disease by 75 percent.

But since the inception of the administration of Buhari, budgetary allocation to the sector has not met the African Union benchmark expenditure for health which is 15 percent of the annual budget of the country.

A look at the budget for health showed that only N221billion was mapped out for health in 2016, while N304billion and N340billion was for 2017 and 2018, respectively. The 2017 budget on health represented a meagre 4.17 percent of the national budget of N7.298 trillion. This allocation is grossly insufficient for the health which is critical to ensure a healthy populace who can plan for security, development or economic advancement of the country.

Also, The World Health Organisation, WHO, says for Nigeria to be seen to prioritise healthcare, it must at the least spend a minimum of N6,908 per person in a year, which when multiplied by 180 million people will amount to N1.2 trillion.

This means that if N1.2 trillion is budgeted and spent on healthcare for a year, as against the current N304 billion being allocated to healthcare for 2017, it will go a long way in solving significant health issues in the country.

The WHO’s analysis therefore shows that with only about 25 per cent of the supposed allocation given to healthcare for 2017 in Nigeria, it means on the average, about 75 per cent of healthcare services for each Nigerian will be funded from out-of-pocket, with majority of Nigerians obviously unable to afford it.

In a bid to to close the huge health funding gap by governments to its citizens, especially in developing and underdeveloped countries,WHO in its wisdom recommended that countries should allocate at least 13 per cent of their annual budget to the health sector for effective funding.

However, hopes may not be lost in fixing the health sector as Buhari has promised to increase investment to halt the migration of Nigerian doctors to foreign countries. He made the pledge when he received the executive members of Medical and Dental Consultants Association of Nigeria, MDCAN, at State House, Abuja, on December 2017. He appreciated the concern expressed by the association on the state of the health sector in the country and promised to implement the association’s recommendations to boost healthcare system in the country. “We will do our best to work on your recommendations, and increase investment in the health sector,’’ he added.

– Jun 7, 2018 @ 19:43 GMT |