Nigeria’s healthcare system presents a stark paradox: pockets of advanced medical practice exist, offering a beacon of hope, while the majority of the population struggles with access to even basic healthcare services.
The recent narrative of “reverse medical tourism,” championed by Vice President Kashim Shettima, highlights a promising, albeit limited, trend. Foreign patients, including those from the US, are reportedly seeking specialised treatments like kidney transplants at Nigerian facilities such as the Zenith Medical and Kidney Centre Abuja. This influx suggests a burgeoning potential for medical excellence within the country and offers a glimpse of what could be achieved with broader systemic improvements.
However, this positive narrative masks a far more pervasive and troubling reality. A recent US Embassy report paints a sobering picture of Nigeria’s healthcare infrastructure and the systemic challenges that plague it. The report details crumbling facilities, widespread insecurity hindering access to care, and critical shortages of essential medicines. The proliferation of counterfeit pharmaceuticals, coupled with unreliable emergency services and the common demand for upfront cash payments, further exacerbates the crisis. These issues are compounded by weaknesses in essential infrastructure like water supply, road networks, and public transportation, all of which indirectly and directly impact healthcare delivery. For example, poor road networks can delay or prevent patients from reaching healthcare facilities, while unreliable water supplies can compromise hygiene and infection control.
Adding to these concerns is Nigeria’s ranking as the 140th least corrupt nation out of 180 countries, according to Transparency International’s 2024 Corruption Perceptions Index. This underscores the urgent need for improved governance and accountability.
So, how can Nigeria navigate this complex landscape and build a healthier, more prosperous future for its citizens?
The healthcare challenges are multifaceted and demand a comprehensive, multi-pronged approach. A piecemeal approach will not suffice. Experts emphasise the following key strategies as crucial for meaningful progress:
1. Strategic Investment and Resource Allocation: A significant and sustained increase in funding is crucial, but it is not simply about pouring money into the system. Investment must be strategically allocated based on thorough needs assessments and transparently managed to maximise its impact and minimise waste. This includes upgrading dilapidated healthcare infrastructure, ensuring a reliable supply of essential medicines and equipment, and investing in comprehensive medical training programmes for healthcare professionals. Beyond traditional budget allocations, innovative financing mechanisms must be explored. For example, the National Health Act (2014) provides a framework for healthcare financing in Nigeria, though its full implementation and impact are still being debated. Further research on successful healthcare financing models in similar contexts, such as those used in Rwanda or Ghana, could be beneficial. Transparency in budgeting and expenditure is paramount to ensure accountability and prevent corruption.
2. Strengthening Governance and Combating Corruption: Corruption within the healthcare sector erodes trust and undermines progress at every level, diverting vital resources and hindering effective service delivery. Robust measures are needed to strengthen institutional capacity, promote accountability and transparency in procurement and financial management, and ensure that those found guilty of corruption are swiftly and decisively brought to justice. This requires fostering a culture of ethical conduct and good governance within the health sector. Transparency International’s reports on corruption in Nigeria’s health sector provide valuable insights into the scope of the problem. Learning from and adapting successful anti-corruption initiatives in other countries, tailored to the Nigerian context, is essential.
3. Forging Strategic Partnerships: Collaboration is essential for leveraging expertise and resources. Public-private partnerships (PPPs) can bring private sector innovation and efficiency to bear on healthcare delivery, while international collaborations can provide valuable technical assistance, access to global best practices, and supplemental funding for critical programmes. These partnerships must be carefully structured to ensure mutual benefit and avoid exploitation. Clear guidelines and regulatory frameworks are needed to govern PPPs in the healthcare sector, ensuring quality of care and affordability. Examples of successful PPPs in healthcare in other developing countries, such as those in India or Brazil, could offer valuable lessons.
4. Prioritising and Investing in Primary Healthcare: A strong primary healthcare system forms the bedrock of a healthy nation. Strengthening primary care through increased investment in infrastructure, human resources, and essential medicines will improve access to preventative care, maternal and child health services, and timely treatment for common illnesses. This will prevent these illnesses from escalating into more complex and costly conditions, reducing the burden on secondary and tertiary care facilities and ultimately improving population health outcomes. This also includes a focus on community health outreach and education, empowering individuals to take control of their health. The National Primary Health Care Development Agency (NPHCDA) in Nigeria is a key authority here, and their strategic plans and reports should be closely followed and evaluated. The Alma-Ata Declaration (1978) and its reaffirmation in the Astana Declaration (2018) emphasise the importance of primary healthcare as the foundation of a strong health system.
5. Focus on Human Resources for Health: Addressing the shortage and maldistribution of healthcare professionals is critical. This includes not only increasing the number of trained doctors, nurses, and other healthcare workers, but also improving their working conditions, providing opportunities for continuing professional development, and implementing strategies to retain them in underserved areas. Investing in local training institutions and creating incentives for rural postings are essential. Furthermore, addressing issues of brain drain, where healthcare professionals leave Nigeria for better opportunities abroad, is crucial.
6. Data-Driven Decision Making: Implementing a robust health information system is crucial for collecting, analysing, and using data to inform policy decisions, resource allocation, and programme evaluation. This data should be used to track progress towards health goals, identify gaps in service delivery, and adapt interventions as needed. The National Health Management Information System (NHMIS) of Nigeria is relevant here, but its effectiveness needs to be strengthened. Examples of successful health information systems in other countries, such as those in Kenya or South Africa, could offer valuable lessons.
Strengthening primary care will address basic healthcare needs, improve access to preventative care, maternal and child health services, and provide timely treatment for common illnesses, preventing them from escalating into more complex and costly conditions.
The upcoming elections present a crucial opportunity for Nigerians to demand accountability from their leaders. Citizens must engage actively in the democratic process, scrutinising the manifestos of aspiring leaders and demanding concrete, actionable plans for improving healthcare, infrastructure, and governance. The health and well-being of the nation should be a central focus of political discourse. Nigeria can draw inspiration from other low- and middle-income countries that have successfully implemented social and financial risk protection schemes, ensuring access to healthcare as a human right for even the most vulnerable populations. As emphasised in recent reports on healthcare in Nigeria, this is an achievable goal. By prioritising the health of its citizens, Nigeria can unlock its full potential and build a more equitable and prosperous future. The time for decisive action is now.
By: Shu’aibu Usman Leman
(Former National Secretary,
Nigeria Union of Journalists)
shuaibuusmanleman@yahoo.com
