Addressing health challenges in Nigeria
by Simon Tumba
Nigeria faces tremendous health challenges.
The statistics paint a grim picture. An average of 20,000 Nigerians travel to India each year for medical assistance due to the absence of a solid healthcare system at home. Nigeria is responsible for a high amount under-five child deaths. UNICEF said in a recent report that “preventable or treatable infectious diseases such as malaria, pneumonia, diarrhea, measles and HIV/AIDS account for more than 70% of the estimated one million under-five deaths in Nigeria.”
Another report by the WHO says that nearly ten percent of newborn deaths in the world last year occurred in Nigeria. Furthermore, five countries accounted for half of all newborn deaths, with Nigeria third on the list. These are India (24%), Pakistan (10%), Nigeria (9%), the Democratic Republic of the Congo (4%) and Ethiopia (3%). Most newborn deaths occurred in two regions: Southern Asia (39%) and sub-Saharan Africa (38%).
While studies like the Global Burden of Disease show steady improvements in child survival rates, the persistent rate of avoidable deaths in Nigeria is deeply disturbing.
Now one may ask; is the problem lack of medical personnel? Certainly not. Because 77% of black doctors in the US are said to be Nigerians. Nigerians have achieved tremendous feats in American medicine. For example, Nigerian doctor Oluyinka Olutoye, based in Houston, made history this year by bringing out a fetus from a mother’s womb to remove a tumor, and then successfully restoring the unborn baby to the womb. There’s rarely any top medical institution in the US or Europe where you don’t find Nigerians managing at the top level. There’s a joke in my country that if all Nigerians withdrew their services from the health sector in the US, it would collapse.
So why is Nigeria’s health service in such a precarious state?
There is a toxic mix of problems including inaccessibility of quality health care, poor hygiene, corruption, malnutrition, lack of access to safe drinking water, poor health infrastructure, fake drugs, insufficient financial investment, and lack of sufficient health personnel. Government’s performance in the health sector has been abysmal. Investment in infrastructure has been poor, and meager remuneration for health workers has created a massive brain drain to the US and Europe. The annual budget of the government for the health sector is 4.17% of the total national budget, which is equivalent to only $5 per person per year!
Hardly a year passes without a major national strike by nurses, doctors, or health consultants. The major reasons for these strikes are poor salaries and lack of government investment in the health sector. Unfortunately, many Nigerians cannot afford private hospitals; they are simply too expensive.
Since financing is a major problem for patients, one would think that management of the National Health Scheme (NHS) through the Health Maintenance Organizations (HMOs) would help people secure better quality health care. But corruption has crushed this opportunity and made quality medical care inaccessible for people who contributed to the system.
The health sector – like other key sectors in the country – has failed largely due to inept leadership. It is such a shame that despite the huge talents of Nigerians, which are on display in health sectors all over the world, our own health system is failing. Donor countries and multilateral organizations are aware of these challenges, but there’s little they can do to improve the situation.
What is the solution? I believe that Nigeria’s policymakers and health professionals – including the Nigerian diaspora – need to come together and create a long-term blueprint for the sector. This should include a strategy for success in the next 25-35 years with timelines and key performance indicators. Creating this blueprint, and then making it a reality, is the only way to make meaningful improvements in the health of Nigerians.
Simon Tumba runs SY&T Communications, Minerva Strategies’ partner agency in Lagos, Nigeria.