Nigeria @ 53: NMA Scores Health Sector Low

As Nigeria celebrates her 53rd Independence, the Nigeria Medical Association (NMA) assessment of the health sector  has said that the country's  health sector like other sectors of the country’s economy has had its good and bad times with uninspiring national health indices attributable to years of cumulative insults, lack of professional order and best practices, a weak private health sector, poorly developed social infrastructure, as well as policy inconsistency.
According to the President of the Association, Dr. Osahon Enabulele: "It is troubling that after 53 years of Nigeria’s independence, her health system is still struggling to deliver health dividends of democracy to her long suffering people.
"Nigerians had expected that following the Walter-Harkness Ten Year Development Plan as well as the enunciation of the first National Health Development Plan in 1960, Nigeria before half a century of her independence would have achieved Universal Health Coverage with all her citizens having access to quality and affordable healthcare.
"Sadly, many factors have continually conspired against the realization of this laudable objective, despite the current efforts of the Federal Government through the country’s Honourable Minister of Health, Prof. Onyebuchi C.O. Chukwu, to reposition the health sector," he said.
Highlighting factors that have conspired against the realization of the development plan, Enabulele said, there is poor governance at most levels of government; political instability, policy inconsistency and evident lack of political commitment to health by most state and local governments in Nigeria; monumental corruption and infrastructural decay; undue politicization of the health sector coupled with declining professionalism and non-adherence to best practices; poor constitutional and legal framework for health in Nigeria, particularly the absence of a National Health Act that clearly makes the health rights of the people justiciable; that defines the roles and responsibilities of healthcare professionals, as well as the roles and responsibilities of local, state and federal governments in the management of the three levels of healthcare
Other factors include poor co-ordination, integration and implementation of health policies, programs, projects and donor support; poor funding and budgetary provisions for health, far less than the stipulated 15 per cent of the national budget as prescribed by the World Health Organization (WHO) and affirmed by the 2001 Abuja declaration of African Heads of State; poor Health Human Resource (HHR) Development Plans and Reward System in the health sector, including poor remuneration, poor working conditions and poor motivation of the health workforce; as well as inadequate numbers and inequitable distribution of the health workforce; worsening poverty and low level of Health Coverage for all Nigerians; inadequate involvement of health professional associations and communities in the planning, implementation, monitoring and evaluation of health policies, programs and projects; as well as in budget monitoring.
Enabulele said other factors are: a weak private health sector coupled with inefficient utilization of healthcare resources; pervasive quackery in the health sector with poor enforcement of extant laws; poorly developed data base and Health Management Information System, coupled with poor use of Information Communication Technology, particularly e-Health in advancing access to healthcare.
Despite these challenges which have affected the life expectancy of Nigerians and blighted Nigeria’s progress in her health sector, Enabulele said, it is important to note that there have been some achievements recorded over the years in the health sector, particularly in the last decade.
"For instance, whereas most other public/government parastatals and banks have either collapsed or are at the verge of collapsing, the indigenous managements of most public and private hospitals in Nigeria have survived the travails and systemic decay of the Nigerian society.
"This is an achievement in itself, especially when one recalls that the International Hospital Group of British managers imported some time ago to run National Hospital, Abuja, could not contend with the suffocating environment under which the current Chief Medical Directors and Medical Directors of public hospitals operate. Of course, one cannot forget the tremendous milestones recorded in Nigeria’s health sector in the 80’s and early 90’s with general improvements in Primary Health Care, as well as noticeable improvements in institutional and human resource development."
He said there seems to be hope that with respect for professionalism and best practices in the health sector on account of some development initiatives by the current Federal Minister of Health, Prof. Onyebuchi C.O. Chukwu, backed by renewed commitment to health and good governance by some state governments, in addition to the contributions and constructive support of other stakeholders in the Nigerian project.
"This hope is further strengthened by some improvements recorded in Nigeria’s health indices, as reflected in the results of some recent health surveys. These include improvements in the Maternal Mortality Ratio from its 2003 figure of 800/100, 000 live births to the 2010 figure of 545/100,000 live births, and now below 400/100, 000 live births in 2013 (according to the National Bureau of Statistics).
"Similarly, the Infant Mortality Rate is said to have improved from its 2003 figure of 100/1000 live births to 75/1000 live births, while Under-five Mortality Rate is said to have improved from its 2003 figure of 201/1000 live births to 157/1000 live births," he added.