An Embarrassing Healthcare System

A challenge from inception. What we have had since independence is an embarrassing healthcare system with myriads of problems ranging from incessant doctors strike to disharmony among health workers but billions of naira is spent year in year out on the health sector besides the health status of individuals and population have not improved significantly.

It’s the state of the healthcare system in Nigeria coming to the front burner again. That makes the incessant doctor’s strike and disharmony among healthcare professionals an issue that has been left unaddressed for many decades; rather we come up with a short term solution and keep postponing the evil day.

This is why the problem persists. Over the last 53 years, health ministers come and go but the healthcare system is still faced with the same challenges. Employing the services of health systems experts is capable of addressing the problems facing the Nigerian health sector.

Health systems experts are capable of devising tools policy makers and health actor can use or apply in addressing the challenges, weakness, deficiency and deterioration of the Nigerian health system.

The way out of the crises in the health sector is for all health workers and professionals to come together as one and work with health systems experts in order to save the health sector from imminent collapse and improve the health status of individuals and population in Nigeria.

Most healthcare professionals do not see the need to employ the services of health systems expert as a way out but the stark reality is that the situation in the health sector will not change if we do not look towards collaborating with people who understand the various components of an health system and how they can work together to improve the health of populations. Truth is—this is a sure avenue to solve most of our health problems as well as the health sector crises.

I stand to be corrected but that is my view in relation to the strike embarked upon by the Nigerian Medical Association and the many problems in the health sector. There have been numerous studies on health systems in both developed and developing countries by experts in this field. They all provide evidence that countries with strong and high performing health systems hardly experience most of the problems that have bedevilled the Nigerian health sector for many years now.

The leaders and policy makers of these countries’ health system have been able to come up with appropriate strategies, solutions and innovations in order to avoid unnecessary crises. But in the history of the Nigerian healthcare system, we have not confronted these problems and that is the reason they persist.

Now is the time for the medical community and health workers to seek ways by which the problems in the health sector is holistically addressed rather than fight over supremacy of one health profession over the other.

The disharmony and discord among the different health workers over the years have deepened the problem in the health sector. Patients have to die unnecessarily or seek alternative medical care when health workers go on strike as a result of dispute over which health professional is superior to the other. This battle for supremacy and persistent demand has led to a situation where healthcare services are delivered by health workers not as a team but rather as rivals.

Another issue that is rocking the health sector is salaries, compensations and condition of service. Other health workers have described the doctor’s agitations over this issue as selfish, unethical and illegal.

There conclusion may not be out of place considering the fact that doctors alone do not make up the medical team. Other health professionals also have concerns and demands but it will not augur well if all health workers destroy the healthcare system due to their grievances and annoyance over the state of the health system, the policy makers and leaders of government.

‘We cannot wait until the health system becomes paralyzed before something drastic is done; hence, there is a state of emergency in the health sector’. This was my summation in an article titled ‘The incessant doctors strike in Nigeria’ and which was written over three years ago.

Of all the roadblocks that exist in the Nigerian healthcare system, disharmony and rivalry among health professionals is the biggest challenge. Doctors care more about remuneration than healthcare reforms and health systems strengthening. But there is light at the end of the tunnel if we can adopt this approach.

Every healthcare worker should respect one another’s’ profession and stop thinking less of other people’s profession in the healthcare industry. This will help build a sense of belonging and encourage team work. Studies have shown that teamwork and harmony among health workers is capable of improving healthcare service delivery and avoids medical errors.

The habit of employing healthcare professionals who are not trained and experienced healthcare managers or administrators into position of authority, leadership and decision making in the health sector has also been the bane of the crises. Evidence suggests that there is a strong correlation between the quality of healthcare systems manager and the performance of health systems. This is actually true in Nigeria where trained, qualified and experienced healthcare system managers or administrators hardly get the opportunity to manage health facilities, departments and ministries. The consequence is a weak and non-performing health system but every healthcare professional is key and strategic in the management of the Nigerian healthcare system, ensuring peace and harmony among all health workers and working towards meeting the different health goals—with a view to reducing the level of poverty and improving the lives of disadvantaged population.

The major problem affecting the healthcare sector is that there are no square pegs in square holes when it comes to leadership and management. Individuals who are qualified, trained and experienced in health professions other than healthcare management and leadership often occupy position of authority, leadership and decision making in the health sector.

Thinking in this direction as well as adopting this approach is capable of addressing most of the issues that have resulted into an embarrassing healthcare system.

Written by
Bolaji Aregbeshola
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