Inadequate funding, emigration affecting Nigeria’s healthcare services – Stakeholders

Stakeholders have attributed the poor state of healthcare services in Nigeria to inadequate funding by governments at all levels and the overwhelming emigration of experienced medical personnel.

Also, they recommended proper regulation of distribution channels to eliminate cases of fake and counterfeit drugs largely seen to be responsible for premature deaths of many Nigerians.

The stakeholders stated these in a survey conducted by the News Agency of Nigeria (NAN) in Osun, Ondo and Ekiti states on Tuesday.

They were unanimous that if the above-mentioned issues could be tackled headlong, cases of misdiagnosis, prescription error and other sad tales would become things of the past.

Chairman of Nigerian Medical Association (NMA) in Osun, Dr. Adeniyi Fasanu, said that the challenges facing the health sector today was basically due to shortage of manpower and lack of infrastructure in many public health institutions.

Fasanu, a consultant obstetrician and gynecologist, said that a large number of health workers, especially medical doctors, nurses and laboratory scientists, had left the country due to poor remuneration and insecurity.

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He said that due to shortage of manpower, the few doctors available were being overworked and stressed out.

According to him, quacks now dominate the health sector, with quite a number of them opening clinics and hospitals to treat unsuspecting patients.

“This is creating a lot of havoc in the health system.

“When you look at the recommendations of the World Health Organization in respect of ratio of doctor to patient, it is supposed to be like one doctor to 600 patients.

“But what we currently have in the country is one doctor serving as many as 2,500 patients,” he said.

Fasanu also said that many government hospitals lacked infrastructure and modern equipment for doctors to perform optimally.

“What we have in major government establishments now are obsolete equipment, and this affects the doctors because they are not able to operate and practice their trade effectively,” he said.

The consultant appealed to government to give priority to the health sector, particularly the welfare of medical personnel.

Also, Prof. John Okeniyi, the Chief Medical Director (CMD) of Obafemi Awolowo University Teaching Hospital Complex, (OAUTHC), called on the Federal Government to increase funding and make available modern equipment in the health sector.

Okeniyi said that the health sector had long suffered from insufficient funding, leading to lack of resources for upgrading equipment, purchasing new supplies and maintaining the existing infrastructure.

According to him, healthcare services need adequate supplies, proper infrastructure and an overhaul of the remuneration of health personnel to make it commensurate with global and contemporary best practices.

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The chief medical director also stressed the need for implementing mandatory continuous professional development programmes for healthcare workers to keep them updated with the latest medical knowledge and best practices.

He stated that strengthening of oversight and regulation, enhancing the regulatory framework by ensuring strict adherence to quality standards and regular inspections of healthcare facilities were also necessary.

On his own, Mr Adebayo Ajibola, Director of Pharmaceutical Services, Uniosun Teaching Hospital, said that the best way to tackle fake and expired drugs was by regulating the distribution channel.

Ajibola said that the open market operation for drug distribution and sales was highly unregulated, thus allowing for the proliferation of the markets with substandard and fake drugs.

He, however, commended National Agency for Food and Drugs Administration and Control (NAFDAC) for raiding markets where fake and expired drugs were being produced and distributed.

Ajibola said that as part of measures to tackle the menace of fake, expired and substandard drugs, pharmacists had been instructed to buy drugs directly from manufacturers.

“We equally advised people to buy drugs only from reputable and registered pharmacies,” he said.

However, the Permanent Secretary in Osun Ministry of Health, Dr. Isiaka Adekunle, said that the state had a well-structured disciplinary committee handling cases of unprofessional conducts among health workers.

Adekunle said that issues pertaining to wrongful diagnosis, wrong drug prescriptions and other professional errors were referred to the disciplinary committee for necessary action.

According to him, issues of wrong instructions to patients and prescription of wrong drugs are oftentimes due to negligence on the part of medical personnel.

Adekunle also said that the state government was working hard to replace obsolete equipment in all the hospitals across the state.

To Dr. Funmi Adesokan, a Consultant Paediatrician, Osun State University Teaching Hospital, pockets of mistakes in the health sector should not be used to define the country’s healthcare system.

Adesokan said that many of the equipment needed for diagnosis of patients were not readily available in the public hospital settings.

“This leads to delay in diagnosis or inability to make conclusive diagnosis.

“Public-private partnership may assist in getting the equipment to our hospitals, but improved health care funding by governments is essential,” she said.

On the rot in the health sector, Adesokan said that the brain drain syndrome had left many institutions under-staffed.

“To address this, the quality of training of healthcare professionals must be at the highest possible standard and this must be maintained.

“There should be no shortcuts in training. There should also a place for re-training of personnel and continuing education to improve skills and correct wrong practices.

“Proper funding and a conducive work environment may help reduce brain drain,” the medical expert said.

Also, Chairman of Nigerian Medical Association (NMA), Ondo State Chapter, Dr. Muyiwa Alonge, said that cases of misdiagnosis might occur, possibly much more than before, because of the dearth of qualified health personnel in many health institutions.

Alonge said that it was worrisome that the sector had been compromised due to the flight of qualified personnel.

“There are possibilities to have such dangers more because of the dearth of qualified personnel.

“Many private health institutions today are manned by quacks, unknown to the populace.

“The public health institutions are currently experiencing the backlash of the japa syndrome and this has put a lot of pressure on the few available personnel.

“The World Health Organization (WHO) recommended a doctor to 600 patient ratio but today in Ondo State, it is one doctor to 8,500,” he stated.

According to him, health workers are working under pressure and attending to more patients than they can cope with and are, therefore, more likely to make mistakes and misdiagnose.

The NMA chairman advised governments at all levels to improve conditions of services of healthcare professionals in order to attract and retain qualified personnel.

Alonge also said that there should be aggressive recruitment of more health workers, with constant training and re-training of the serving ones.

In his own submission, Mr. Okikiola Aremu, the Public Relations Officer (PRO) of National Association of Nigeria Nurses and Midwives (NANNM) in Ondo State, attributed the rot in the health sector to systemic failure caused by underfunding and resource constraints.

Aremu said that annually, less than 15 per cent was allocated to the sector from the country’s budget, thereby resulting in poor infrastructure, inadequate medical equipment and shortage of personnel.

According to him, without sufficient funding, most hospitals struggle to maintain modern equipment, procure essential medications and provide quality patients’ care.

“Corruption is another significant impediment to healthcare delivery in Nigeria. Funds allocated to health sector improvement are frequently mismanaged or embezzled, leading to shortage of essential services and equipment.

“Reports from Transparency International highlight the widespread nature of corruption within the sector, where inefficiencies and lack of accountability hinder proper utilization of resources.

“Also, inadequate monitoring and evaluation, coupled with deliberate oversights, allow lapses in healthcare delivery to persist.

“Worse incidents occur in general hospitals across the country, but often go unreported. Poor regulatory enforcement allows expired medications, substandard practices and deteriorating hospital conditions to persist unchecked,” he said.

Aremu urged governments to make regular training and re-training of healthcare professionals in the country a priority so as to give their best.

He also stated that poor conditions of service had forced many qualified personnel to leave the shores of the country in search of greener pasture.

Aremu called for strategic interventions in the sector, saying that the country could still significantly improve healthcare delivery and restore public confidence.

In his own reaction, the immediate past NMA Chairman in Ondo State, Dr. Omosehin Adeyemi-Osowe, said it was sad that health facilities in the state lacked modern equipment.

“However, the major problem that Nigeria is facing now is that our doctors are not ready to stay in the country.

“For instance, the recent recruitment in the sector, only 15 doctors applied while six of them came for interview; I am not even sure they will stay,” he said.

Adeyemi-Osowe said that the approval of 65 years as retirement age for medical doctors would not help the sector because those at that age might not be able to function as expected.

However, the Permanent Secretary of the Ondo State Primary Healthcare Development Agency, Dr. Francis Akanbiemu, debunked any allegation of inherent dangers in accessing healthcare in the state.

“Every system has its own regulations, standard operating procedures and guidelines which must be adhered to and I believe many health service managers have procedures to enforce adherence to standards.

“They will ensure that violations are dealt with according to the law and laid down procedures.

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“I do not have evidence of such infractions in our establishment or health facilities as you outlined in your perceived observations,” he said.

A resident of Oye-Ekiti, Mrs. Funmilayo Aina, said that she was delighted with the ongoing renovation of health centres by Gov. Biodun Oyebanji.

Aina said she was once a victim of wrong drug prescription by a community health officer, which caused her body pains and sleepless nights.

She appealed to the state government to employ more qualified and experienced medical healthcare personnel.

“I want to appeal to the state government to improve health care services by employing more qualified health professionals.

“It is inadequate health personnel that often cause problems for patients because too much workload can lead to wrong drug prescriptions,” she said.