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Equip hospitals, end medical tourism

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President Muhammadu Buhari’s recent travel to the United Kingdom for a medical check-up has again raised concern, appropriately, over the poor state of the country’s healthcare system.

The president returned to the country on Thursday, April 15, 2021, after spending two weeks abroad, and proceeded with business as usual, without any indication that anything was amiss with Nigeria’s health care. Yet, he was only a privileged Nigerian, out of 200 million, to be able to access good medical care abroad. It is a thing of shame for the country, with her huge resources and potential, to find herself in such ignoble health condition.

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Unfortunately, the Nigerian health sector is ‘plagued with various diseases’ ranging from poor rating in the continent to incessant strikes by health workers and loss of public confidence in the quality of service, leading to medical tourism which, according to a report, gulps over $2b yearly. Another Study ranks Nigeria 14th of African countries with the poor health system, while Buhari’s medical trip is viewed against a need to adequately equip the nation’s hospitals. Nigeria’s dismal rating in these regards is not surprising, given the appalling state of her healthcare delivery that has received nothing more than national lamentation for too long!

The new study ranked Nigeria 14th with a total of 41 scores out of 18 African countries surveyed in a first-of-its-kind Health System Sustainability index report. The country ranked last in maternal mortality, infant vaccination, and neonatal mortality. In addition, Nigeria also came 17th on births attended by skilled health staff and access to effective treatment for tuberculosis. Thus, this report reinforced what is already known, over which calls have been made for the government to make improvements.

The first global healthcare ranking, which was based on a qualification of personal access and quality for 195 countries and territories from 1990 to 2015 placed Nigeria at the 140th position. The Healthcare Access and Quality Index tracked progress in each country compared to the benchmark year of 1990. The 32 diseases for which death rates were tracked include tuberculosis and other respiratory infections; illnesses that can be prevented with vaccines (diphtheria, whooping cough, tetanus, and measles); several forms of treatable cancer and heart disease, and maternal and neonatal disorders.

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The result showed that virtually all countries improved over the period but many, especially, in Africa and Oceania fell further behind in providing basic care for their citizens. Nigeria lagged far behind most other African countries.

The need for the improved healthcare system in Nigeria, therefore, cannot be over-emphasised. Otherwise, every other critical ingredient of world-class medical care is available in the country. Nigeria is, indeed, blessed with some of the best medical doctors and health practitioners in the world.

Incidentally, many highly educated and talented Nigerian medical professionals are out in foreign countries excelling where the conditions and atmosphere are better. Nigeria’s poor healthcare infrastructure, in particular, coupled with poor remuneration and general insecurity are responsible for the mass migration of Nigeria’s best hands in health care.

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Without being prodded, the government ought to recognise that the country is in trouble if there is no adequate healthcare for its teeming population. There is a need for a re-calibration of the healthcare system for accessibility and efficiency in order to serve the population. This, of course, is a challenge to the nation’s leadership at all levels.

A former Minister of Health, the late Olikoye Ransome-Kuti, raised the nation’s healthcare delivery system to a historic world standard through his focus on primary healthcare programme that attracted international support and which he vigorously drove with personal commitment and integrity. Many international agencies supported the programme and funded it. UNICEF vehicles and personnel were found everywhere in the country, especially, in the rural areas implementing different aspects of the primary health care programme. Leadership was a critical variable in Ransome-Kuti’s success story. Sadly, the nation’s leaders now seem obsessed with jetting out of the country for health care at the slightest headache, leaving the poor masses to their fate in poorly equipped hospitals; a case of the ‘fish rotting from the head’.

It is a national embarrassment of intense proportion that wealthy Nigerians, who can afford it, continue to flock to foreign countries to seek medical help while the poor are left with no option other than to probably die. That is a sad testimonial for a country that is supposed to be a model and leading example in the Africa continent.

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To change this narrative, Nigeria has to be more pragmatic and improve accountability, reduce or eliminate corruption, promote good governance even within the health care system, jettison ethic racketeering, fight fake drugs, scale-up and ensure that all states buy into the National Health Insurance Scheme (NHIS) for a more organized health care system and also to improve the funding of health care. The NHIS will reduce out-of-pocket expenses on health.

Also, anti-corruption agencies should turn their searchlights to the health sector and ensure that the key performance indicators (KPIs) tied to the budgets at all levels of governance and other health finances are achieved; because despite huge budgets for drugs in most public hospitals, for instance, they are almost always out of stock.

Furthermore, as the nation is weak in curative health, it is important to change the paradigm and make health care more basic through preventive health using Sanitary Inspectors. There is a need for competitive federalism in the health sector. The Lagos State University Teaching Hospital (LASUTH) should be a model for other states to follow.

No doubt there is a need to raise the benchmark of funding of the health sector, and there is an urgent need to build the critical infrastructure as well as foist the right environment for a good healthcare delivery system in Nigeria. It is a worn phrase, but no improvement can be made on the saying that a healthy nation is a wealthy one.

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