Deficient health system amid rising population: Government must show convincing will

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The tales that the larger percentage of sectors in the Country, Nigeria, are to high degrees not in good condition, is apparently defensible with pointers of severe defecting characters which define the posture of the working patterns of these sectors. The health sector in Nigeria is one point of note in the discourse of sectoral profile of reckoning in the Country. The sector has largely been a prey to several deficiencies which largely have rendered it grappling with the syndrome of stunted growth. The surrounding purview of the sector reveals from all perceivable angles that rather than improvements to meet new demands, the sector is depreciating.

The fact that public health is one crucial aspect of societal life from which the Government cannot shy away from, speaks to the reason why more emphasis of demands have always been placed on the Government for provision of meaningful health services. As a result, the necessity for the demands of health services across nations, broadly fall within concurrent list of government jurisdiction with expectations from the Government being a forward player in driving the workings of the sector.

In Nigeria, the state of the health system appears too infantile to reasonably cater for the pressing needs of the Country. The state of the system has not in any way grown to suffice the demands of the geometric rise in population. The incommensurate capacity of health provisions to cater for myriads of health challenges, has brought a deficit that threatens the state of an healthy population. It is evident that shortfalls in both human and material provisions have positioned the health sector in the Country under intense pressure, which in turn have been reflecting syndromes of clustering deformities.

It is saddening that with the demands of a geometrically growing population, the facilities within the architecture of public health provisions from the primary to the secondary categorical classification, are inadequate in the eyes of many Nigerians. The shortfalls of both human and material capacities of the health institutions are inarguably signs of dangers against a healthy population. It is lamentable that majority of Nigerians who are unable to afford the luxury charges of accessing appealing private health facilities in the Country for medical attention, have been reduced without choice to suffering unwholesome conditions of the insufficient and poor capacity public health facilities.

The subject of the inhumane treatment ill people suffer, with their caring relatives looking after them, from health workers within public health facilities have been noted to be at critical point, so bad to make the sick lose hope of survival. Records of countless numbers of patients who have lost their lives for being left medically unattended to, remains disturbing. The case of insufficient bed and admission spaces  to accommodate patients have remained a character of the public health system.

The subject of the identified unwelcoming posture of health workers to patients remains another character of the system which is unethical to how an informed health system should work. However, the manifestations of these wings of troubles have been noted to be reactions arousing from defective strings in the system. In fact, the earlier mentioned unwelcoming posture of health workers to patients in public health facilities in the Country, have been attributed to, as reactions against the ill conditions under which they work. It is no new story that agonising complaints by health workers over their conditions of work, remuneration, and other benefits have been major subjects of acrimonies which have informed countless brands of industrial actions across the Federation.

The promise-and-fail posture of the Government to addressing these demands has been a major syndrome of distrust which has continued to spur the brain-drain phenomenon on the basis of which medical doctors in the Country have continued to flee to seek greener pastures abroad. The ready acquaintance of the knowledge of how humane health workers are treated under well organised system abroad, has brought into play the phenomenon where majority of Nigerian doctors at every slightest chance want to flee the Country to greener pastures where they would be treated honourably under serene conditions with appreciable benefits.

The undeveloping character of the health sector in Nigeria, particularly with the workings of the public health system, remains a source of disturbance the government is yet to come to terms with in the light of reasonable approach. The tradition of health tourism by the privileged few which government functionaries have categorised themselves among, may turn catastrophic at dangerous times. The syndrome of seeking refuge abroad for medical attention rather than working out parameters to fix the comatose state of health system in the Country, is too irrational for thought. The constraints of the COVID-19 lockdown which rendered the privileged incapacitated to embark on such voyage, led to some losses which otherwise would have been preventable. It is important to state that situations of such kind may still present themselves later in future. It is therefore, paramount for the Government to take decisive move beyond the recurring tradition of weak political syndrome demonstrated towards the state of the Nigerian health system over several administrations.

The deficits in human and material capacities are getting wider with multiplying population. It is saddening that the approach of the Government to the reality is rather taking the reactive syndrome of the defective posture of administration in the culture of Nigerian Government. The announcement by the Nigerian Medical Association (NMA) on Monday of the resignation of no less than 105 doctors in the service of Ondo last year, remains a topical issue of concern. The Chairman of the Association in the State, Dr. Stella Adegbehingbe and State Secretary, Dr. Olorunfemi Owa, had in a statement released in Akure, the State Capital, blamed the trend on irregular and percentage payment of salaries by the state government.

The statement had read partly: “Some Departments in the State-owned Teaching Hospital, which could hitherto boast of between 6 and 8 Doctors are now left with 1 or 2 Doctors. This makes it practically impossible for the hospital to function at a minimum acceptable level. Consequential vacancies in the medical officer cadre need to he urgently tilled. About 50 medical Doctors in this cadre have left the employment of the Hospital Management Board without replacement over the last few months. Yawning vacancies exist in the Resident Doctor and Consultant cadres at the Teaching Hospital. These have remained difficult to till due to the haphazard safety payments. We have it on good records that about 105 medical doctors have resigned their employment from the Teaching Hospital in the last year alone.

“Ondo State has not been able to engage requisite numbers of House officers since 2019. This has made our work almost impossible because this group of Doctors have a peculiar role in Health service delivery It is troubling to note that only three (3) house officers are left in the service of the Ondo State Government across the three senatorial zones. There is no gainsaying that the ongoing laudable efforts at having a Contributory Health Insurance Scheme in the state can only be successful if the urgent issue of manpower need is adequately addressed.”

The Minister of State for Health, Dr Olorunnimbe Mamora, had over the weekend during the commissioning of some health projects in Owo area of Ondo, said the Federal Government has renewed its efforts towards discouraging the outflow of Nigerian health workers from the Country, mentioning that the government was working assiduously to make migration of medical doctors from the Country unattractive.

He was quoted, “We are being faced with doctors leaving the Country but the Federal government has plans to fund hospitals across the Country and motivate our doctors and other health workers to make such migration unattractive. This is an issue of concerns for all of us and we are already looking at the factors which we know largely in terms of what is responsible. One of it is the renumeration and I want to repeat it here that no amount paid to any health worker will compensate adequately, looking at the health hazard they are exposed to.

“So, we are working on how to raise it a bit for our health workers, and you will recall that just a few days ago we had engagement with all the leaders of the unions in the health sector, working together on how to increase and put in place some kind of hazard allowance that will show we appreciate what they are doing. The Federal Government is also committed to building a healthy system that guarantees universal access to comprehensive, efficient, affordable, adequate, equitable, and quality healthcare for all Nigerians. It is not in the size of the structure but its functionality — the functionality and capacity to deliver the services that people need is the most important thing and to see that the services that people required are being provided. The whole concept of universal health coverage is accessibility — it must be accessible and it must also be affordable. It must be available, because it might be available and not be accessible. So, the first thing is availability, next is to be accessible and must be affordable.”

If the Federal Government as indicated by the Minister is really working towards the end of developing the health system to the height where it will be accessible to the masses as well as make brain drain unattractive, it is sacrosanct for the Government to display convincing political will towards this end by crafting and making known to Nigerians, the policy directions through which these have been aligned to take course with the timeline. Since  developing a robust health system sufficient to cater for the needs of a geometrically growing population, which is now estimated to be about 220 million, would require coordinated efforts from all levels of government  as well as private sector participation, it is imperative for the Federal Government to lead the course by defining the patterns to blend all resources with convincing posture.