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Healthcare is a basic amenity needed by everyone irrespective of status in society. While it is the responsibility of government at all levels to provide the needed primary, secondary, and tertiary healthcare infrastructure, funding, and manpower, well-meaning individuals and corporate bodies need to complement the government’s effort.
In this article, we will take a deep dive into the challenges bedeviling the healthcare sector since the early 2000s, and proffer solutions that can be adopted by relevant bodies, going forward.
Healthcare delivery in Nigeria has retrogressed largely due to unwillingness on the part of successive governments to effectively solve several problems that have long existed in the sector for decades. Some of these problems exist in the areas of:
As of the early 2000s, primary healthcare was largely provided through approximately 4,000 health clinics. In that same period, there were about 700 health centers and 1,650 maternity centers available for secondary healthcare delivery. In the area of tertiary care, only 12 university teaching hospitals with about 6,500 beds were available for a population of about 140 million.
While the hospital beds increased to about 160,000 hospital beds in 2015, the country still suffers from a very low bed per thousand population of 0.9 (less than one) in comparison to other developing countries like South Africa, with a bed per thousand population of 2.29. This low statistic has been a trend down through the years.
Another worrisome trend is that not only is there a lack of physical infrastructure required to adequately cater to the population, but existing structures are packed with outdated equipment. This has significantly limited the capacity of healthcare institutions in keeping up with the trends and developments in the profession. The ultimate implication of this is a limitation in increasing internally generated revenue within the institutions despite the rising demand for services.
With the global calls for governments around the world to provide health insurance coverage for the governed, the Nigerian government launched the National Health Insurance Scheme (NHIS) in 2005 to provide subsidized healthcare for government employees and private firms entering contracts with private health care providers. However, only a few people fall within these categories, as reflected in the existing data, which shows that less than 3 percent of Nigerians have health insurance coverage.
While there is increasing private sector participation in the Scheme with over 40 Health Management Organizations (HMOs) licensed by NHIS, more needs to be done by the government and private partners, as data on life expectancy, infant mortality rate, maternal mortality, malaria, and HIV/AIDS shows that Nigeria is still one of the worst-performing countries in terms of healthcare.
As of 1999, there were an estimated 0.2 doctors to 1,000 people. Currently, the situation has worsened, with about 1 doctor to 6,000 patients, which is a far cry from the 1 doctor to 600 people, as recommended by WHO. The reason for this manpower deficit can be traced to the “brain drain” being experienced in the healthcare industry.
Nigeria is one of the several major health-staff-exporting countries in Africa. For Instance, according to the Medical and Dental Council of Nigeria (MDCN), only about 500 medical professionals legally emigrated to the United Kingdom in 2002, but currently, there are about 72,000 registered Nigerian doctors, with only about 35,000 practicing in-country. Beyond the gloomy picture this data paints, what is more, frightening is that there seems to be little to no concerns from the relevant authorities, as reflected in the statement made by then minister of health, Prof. Isaac Folorunso Adewole, saying “it might sound selfish, but we can’t all be specialists. We can’t. Some will be farmers; some will be politicians. The man who sews my gown is a doctor. He makes the best gown. And some will be specialists, some will be GPs, some will be farmers.”
In April 2001, the member nations of the African Union (AU) met in Abuja, Nigeria, and resolved that at least 15 percent of their yearly budget will be earmarked to improve the health sector.
However, a perusal of the 2001 to 2021 budget reveals that Nigeria has never met that target. In fact, it does not seem Nigeria will even make attempts to meet the target, as a breakdown of the 2021 budget revealed that the nation allocated only 4.5 percent (about N592.166 billion) of the N13.082 trillion budget, despite the prevalence of the COVID-19 pandemic. A further breakdown of the budget showed that only N2,960 was allocated for the medical care of every Nigerian for one year (12 months).
Despite the existing challenges plaguing the Nigerian healthcare sector, several developmental strides have been witnessed down through the years. One of such worth mentioning is the development of telemedicine in the country. While a sizable number of Nigerians became aware of telemedicine during the heat of the COVID-19 pandemic, it dates back to 2007, when the Federal Ministry of Health (FMoH) partnered with the National Space Research and Development Agency (NASRDA) to inaugurate the pilot telemedicine project in two teaching hospitals and six Federal Medical Centres across the nation. Since then, the development of telemedicine has been spearheaded by private players.
One of the key players in the telemedicine industry in Nigeria is HealthConnect 24×7. With a fusion of next-generation telemedicine, telemonitoring, and home health technologies, HealthConnect 24×7 provides patients with unlimited access to highly trained and experienced doctors and wellness experts. The On-site Virtual Clinic Booth, Wellness Program, 24×7 Doctor Control Program, Health Analytics, Hospital at Home® Program, and Integrated Mobile Application of HealthConnect 24×7 can be used by individuals, employers of labour, HMOs, and governments at all levels.