Martins Hile, Editor, Financial Nigeria magazine

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  • Social Development

Calling on President Buhari to reform healthcare 11 Sep 2017

The Nigerian healthcare system is teetering on the brink of collapse. Unlike policymakers who are accustomed to accessing healthcare outside the country, the reality of the worsening state of patient care in the country hits home every day for millions of Nigerians. While President Muhammadu Buhari was receiving world-class medical care in London, so many people died from preventable causes in Nigeria. One of such cases was my brother who died at the age of 27 on Sunday, July 30.          
When I left our home in Adikpo, Benue State, a few days earlier, Fabian was hale and hearty. The day before he died, he had severe headache and was admitted at a hospital at about 6pm. The doctor who examined him wrote down a prescription and left the hospital. Unfortunately, the medications were not available at any of the pharmacies that family members frantically visited that night. My brother's condition grew worse the following day, and without proper intervention by the hospital, he eventually died.

A few weeks after Fabian was buried, I was ill and went for a medical check-up at a reputable hospital in Ikeja, Lagos. After the medical examination, the doctor told me the test results were fine. But based on the symptoms I reported, she made a dubious diagnosis, suggesting that I “might have a bacterial infection.” Dissatisfied and disappointed, I went to see a cardiologist with whom I had previously consulted. Dr. Sam's (not his real name) diagnosis was that I was having panic attacks. It's anyone's guess what the previous doctor's erroneous diagnosis and treatment could have cost me.

My experience is hardly unique. There are countless cases of medical malpractice, resulting in death or injury to patients. The reasons for this are wide-ranging, from inadequate facilities to knowledge gap and sometime just negligence on the part of healthcare providers. For instance, the prescription the doctor in Adikpo had given was riddled with spelling errors. Indeed, when I showed it to Dr. Sam, his first observation was the wrong spellings. How a medical doctor would wrongly spell medications really bothered me, quite apart from the giving a prescription that was unavailable at the hospital dispensary or nearby pharmacies in treating a medical emergency.

If the life of every Nigerian means anything to the government, this is the time to reform the healthcare system. A new poll released last month by NOIPolls in collaboration with Nigeria Health Watch shows that 80% of Nigerian doctors are searching for jobs abroad. Out of 72,000 medical doctors registered with the Medical and Dental Council of Nigeria, only about 35,000 are currently practising in the country. The report also says the situation could get worse if nothing is done to stem the rising emigration of healthcare practitioners, including physicians, nurses, pharmacists, laboratory scientists, etc.

Nigeria currently has one of the worst doctor-patient ratios in the world. The country has approximately one doctor to 5,000 patients. The World Health Organisation's recommended doctor-patient ratio is 600 patients to one doctor. Experts say Nigeria needs 237,000 doctors to meet the WHO standard. The country would need to produce over 20,000 doctors every year over the next 10 years to be able to close the gap. However, Nigerian universities currently produce less than 3,000 doctors annually, and many of them emigrate to mostly the United States and Britain.  

The healthcare sector suffers from insufficient funding, poor remuneration for the medical workforce and lack of medical facilities. Incessant strikes by doctors have not led to increased investment or a new health policy. One week after President Buhari resumed work after spending 103 days on his latest round of medical tourism in the UK, the Nigerian Health Sector Reform Coalition (HSRC), through its #MakeNaijaStronger campaign, wrote an open letter to the president seeking an increase in health funding. The group, comprising of the Nigeria Medical Association and Pharmaceutical Society of Nigeria, amongst others, wants budgetary allocation to health care in the 2018 budget to reach 7.5% of total national budget.

If Buhari would heed this advocacy, his administration would take the federal budgetary allocation for health in 2018 to mid-way of the 15% annual budget benchmark recommended by the Abuja Declaration, which was written by African Heads of States to improve the countries' heath sector. 15 years after African Union countries made the pledge to increase the proportion of government health spending in April 2001, Nigeria's 2016 healthcare spending was 380 billion (or 5.1% of the national budget of N7.44 trillion).  

The HSRC group told the president that healthcare is the foundation of national security, economic growth and recovery. It may be a cliché, but it is true: “a healthy nation is a wealthy nation.”

It is definitely incompatible with the government's top priority of economic recovery for the country to continue to lose $1 billion in medical tourism every year. Building a world-class hospital in Nigeria, strengthening the capacity of public hospitals, and addressing the welfare of the medical workforce will not only reduce the capital flight; it will also save lives that are lost unnecessarily due to a dismal healthcare delivery system.