A 21st Century Health Care Delivery System/Policy in Nigeria: Myth or Reality?

As the saying goes, Health is Wealth. Nigerians and indeed the international community were very pleased with the way Federal and state governments, indeed the good people of Nigeria, tamed the deadly Ebola Epidemic that recently and unfortunately claimed some lives in the country. The global community and Nigerians from all works of life sympathised with the deceased families and Federal Government   in partnership with international community work collaboratively to curb the disease. Today, Nigeria president Goodluck Jonathan administration has been commended by the international community for his sterling leadership qualities to bring about the control which, ultimately made Nigeria a free Ebola country by the World Health Organisation. Congratulations to the government and good people of Nigeria.

However, it is an acknowledged fact that before 1999, Nigeria’s Health sector was in a sorry state and Nigerians wonder why our past leaders failed woefully to give Nigerians good health care delivery system. Today, those who had ruled the country before now and had the opportunities, to holistically address challenges facing this important sector but let Nigerians and the nation down in their responsibilities, to invest in the health care sector and give Nigerians workable Health care policy ,are still be recycled and wanting to hang onto power to rule the country. Today, Nigeria demands a visionary leader/s that will bring about the needed reformation within the Health sector and, the country is in there need for a 21st century comprehensive Health care delivery system that will work not only for the few ruling rich elites but also, for the majority poor Nigerians in the country. Good, accessible and affordable health care delivery system is the right of every Nigerian and constitutionally, it’s the primary responsibilities of every Local, state and Federal Governments to provide these health services to the people, irrespective of class, ethnicities and religious beliefs.

While president Goodluck Jonathan administration is consolidating on the framework set up by the previous governments of Ex-president Olusegun Obasanjo and Ex-Late president Musa Yar-Adua [PDP] regimes, by reforming the health sector, more investment, effective and efficient co-ordination process , proper management and resounding result driven mechanisms are needed for a workable 21stcentury comprehensive Health care delivery policy for the country. Before 1999, in many places in Nigeria, our Hospitals, especially, primary Health centres are far away from where people live and some of these hospitals and care centres are dilapidated with corrugated roofs, structures and expired drugs.   Researches has shown that, in some tertiary and secondary health centres in the country, ordinary water supply are not available, patients and relatives have resorted to buying of water and health workers, have to wait endlessly for essential drugs and disposable gloves, most healthy centres and clinics faced with irregular power supply. To make matter worse, unprofessionally, some doctors and health officials, demands for money from patient before attending to them.

According to the 2003 and recent National Demographic Health survey, before now, our immunisation coverage was put at 13 % which gave some of the reasons why Nigeria as a nation recorded high death rate among children which could have been prevented. Today, under President Goodluck Jonathan administration, there has been a lot of improvements as government is now reforming the sector and to an extent, investing in the country’s health sector.

What are the challenges facing our health sector and what could government do to address these problems?

It is very unfortunate, considering the human and natural resources bestowed on Nigeria and Africa, to see that Africa and in particular, Nigeria is still struggling to come up with a comprehensive health care delivery system for the country. Why? due to some of the following reasons: [a] weak structures, lack of qualified personnel, mis-management of resources, low wages, lack of motivation, persistent shortages of basic medical supplies, poor working environment ,poor working conditions, dilapidated equipment, bad working practises and limited career opportunities/training to mention a few. Hence, the urgent need to address these problems.

There have been arguments from health experts, supported by this writer for the National Health bill to be revisited by the National Assembly. While Nigerians welcome the introduction of National Health insurance Scheme started by the previous PDP governments, the present Government should ensure functional structures, efficiently managed and result-oriented health care deliverables. Those assigned for this project should be professional, having the will, vigour, commitment and the right attitude to make this project successful. This writer urges our president to engage more Nigerian professionals in the diaspora to consolidate and enhanced his transformation agenda in the health sector and other areas of governance to develop the country.

This writer is of the view that the task of having a comprehensive 21st century health care delivery system should be an inclusive project. Government should come up with modern frame work and regulations and professionals within the sector equally should play their parts to ensure easy accessibility to health care services, ensuring confidentiality, prompt treatment and respect for patients and their relatives. As basic health care services are to some extent today, expensive for the vast majority of working class and vulnerable Nigerians, this writer is of the view that some categories of people in the society like children, pregnant women, the elderly and unemployed youths should be exempted from paying for medical services, to be funded for by the government be it local, state or at the federal levels.

Yes, some significant steps have been taking by the Government but experts and this writer are of the view that some of the below recommendations will go a long way in addressing the challenges facing the health sector in the country:

  • Building of more modern, well-staffed, well equipped hospitals and health care centres in the country.
  • Management of health care centres in the country should be decentralised starting with the village [local] state and Federal for health care deliverables.
  • There should be increased access to care services by making primary health care available to all Nigerians, irrespective of class, ethnicities and religious belief as obtained in developed countries and where applicable, engage the private sector to provide good medical services to the people.
  • As Nigerians and the nation deserves good and affordable health care services , be it public or private health care delivery system, government should put effective regulations and policing in place to ensure availability of safe and good quality essential drugs, through government agency like NAFDAC, confiscate and punish severely companies, importing or manufacturing fake drugs in and into the country.
  • The need for National Health information system should be looked into by the government, as obtained in western world to encouraging the facilitation of Health planning and management.
  • Disease prevention as professionally handled and addressed by the government as re: recent curtailment of Ebola epidemic in the country should be strengthened and enhanced.
  • Health education , promotions, research funded and investment in areas of Diabetic, HIVS/AIDS, STDS, Breast cancer, Ovarian cancer, infertility treatment, pregnant test for women and children immunizations treatments, should be given urgent attention and investment by the government, to save lives, produce well being and efficient work force for the country.

President Goodluck Jonathan [PDP] administration is putting Health, high among transformation developmental agenda of the government, various ministerial tasks and committee with wide range representations should be expanded. Their recommendations should be collated and further consolidated by the senate committee and inform the modern 21st century, articulated in government white paper-working document   and health policy for the country. The detailed 21st century Health policy document should incorporate views from all stakeholders and reflect the present day new reality and trends, including regional National Health situations, global initiatives [NEPAD] and the Millennium development goals [MDGS]. Also, The National Health reforms should carry forward the Health strategies of National Economic empowerment and development strategy [NEEDS] for a detailed and modern Health care policy for the country. Yes, Nigerians commend president Goodluck Jonathan in his health sector transformational reforms but more investment, qualified personnel, transparent process, accountability, easy access, affordability, motivation, good working conditions, re-training of health workers and effective government regulations as highlighted above   are needed to bring about a 21st century comprehensive health care delivery system/ policy for Nigeria. T his will prevent professionals leaving the country, being   brain drain for Nigeria / Africa and brain gain, positively, for the developed countries.

God bless Nigeria.

Written by
Benjamin Ogbebulu
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