Independence: NMA seeks improved funding, retention of health workers
As Nigeria marks its 66th independence anniversary, medical professionals have called for increased health financing, functional facilities and improved workforce retention.
They made the remarks in separate interviews with newsmen in Ibadan.
The National Publicity Secretary of the Nigerian Medical Association (NMA), Prof. Olayinka Atilola, spoke on the health sector reforms.
He said the fuel subsidy removal, Naira devaluation, inflation and high interest rates created a sustained healthcare shock.
According to him, the overall cost of healthcare access has risen astronomically under the present administration.
He listed higher costs of medicines, medical equipment and energy to run healthcare infrastructure.
He also cited higher personnel costs, health insurance premiums and transportation costs to hospitals.
He said the negative impact had not translated into proportionately higher health spending by government.
This, he said, had led to major strain on public secondary and tertiary hospitals.
He added that purchasing power of healthcare workforce had been severely eroded relative to international peers.
He said this had led to mass exodus of critical manpower in the sector.
“Though there has been some feeble attempt to improve remuneration, the comparative wage-gap between Nigerian doctors and their counterparts in other countries, including some African countries, is still atrocious,” he said.
On the way forward, he said government must focus on financial protection as immediate priority.
“This means rapidly expanding publicly financed health insurance for poor and vulnerable households rather than relying predominantly on people to enrol and pay themselves,” he said.
He said government must stop treating human-resource crisis in the health sector as a recruitment problem but as a retention problem.
“Experienced health-workers will continue to leave, creating critical shortages, as long as wages are not equitable,” he said.
He urged government to increase budgetary allocation to health sector to at least 7.5 per cent of the total budget in the next year.
He said it should increase by 20 per cent annually for the next five years.
Also, Chairman NMA Oyo State Branch, Dr Olufemi Aworinde, said PHCs must become truly functional and not merely renovated buildings.
Aworinde is also a Consultant Obstetrician and Gynaecologist at the LAUTECH Teaching Hospital, Ogbomoso.
He said they require adequate personnel, essential medicines and diagnostic capacity.
He added they needed electricity, water, functional referral systems and emergency transportation.
He urged government to address health-worker retention urgently, stressing that infrastructure without skilled manpower cannot deliver healthcare.
“Remuneration, working conditions, career progression, security, training opportunities, welfare of doctors and other health professionals must receive sustained attention,” he said.
Aworinde said increasing workload on remaining professionals required deliberate action to prevent burnout.
He called for strengthening maternal and child healthcare and emergency medical services, disease prevention, health promotion and investment in reliable health information systems.
He said policies should be driven by credible data and measurable outcomes.
The consultant also called for stronger collaboration among federal, state and local governments, professional associations, private sector and communities.
“The direction of some reforms is encouraging, but the task before us remains enormous.
“Our ultimate objective should be a health system in which the quality of care available to a Nigerian is determined by his or her health need and not by the size of his or her pocket.
“That, in my view, should remain the standard by which we measure progress in the Nigerian health sector.
“FG has tried but their effort is not being felt by the common man,” Aworinde said.
President, Association of Resident Doctors, UCH Ibadan, Dr Uthman Adedeji, noted that Abuja Declaration commits AU members to 15 per cent health budget, but Nigeria’s remains below 5 to 6 per cent.
Adedeji said the last three years under President Bola Tinubu witnessed structured reforms anchored on Nigeria Health Sector Renewal Investment Initiative launched Dec. 12, 2023.
He said the initiative was driven by Sector-Wide Approach, SWAp, and had led to revitalisation of nearly 3,000 Primary Healthcare Centres under IMPACT programme.
Through Maternal and Neonatal Mortality Reduction Innovation Initiative and Free Emergency Obstetric Care, he said thousands of women benefited from free Caesarean Sections and VVF repairs.
Adedeji said this contributed to reducing maternal mortality, while immunisation coverage had scaled up with Measles-Rubella for children and HPV for girls.
On infrastructure, he listed Bola Tinubu Complex at FMC Abuja, Trauma Centre and Quality Control Laboratory at ABUTH Zaria, Infertility/ART Centre at ATBUTH Bauchi and Mental Health Complex at UMTH.
Others are Administrative Complex at UNTH Enugu, Laboratory Complex at UUTH Uyo, three world-class cancer centres and State Emergency Operations Centres in Kano, Sokoto and Katsina.
He also mentioned Lagos Vaccine Hub and NEMSAS fleet of 145 tricycle ambulances, six boat ambulances and 79 ambulances.
Socially, he said the reforms restored public trust in some quarters, as free CS and VVF repairs reduced catastrophic out-of-pocket spending for women.
On way forward, Adedeji advised government to sustain financing, ensure states strive to meet 15 per cent Abuja benchmark and ensure transparent, performance-based disbursement of Basic Health Care Provision Fund.
He called for retention through competitive remuneration, rural incentives and structured career progression to curb Japa syndrome.
He urged government to accelerate Presidential Initiative for Unlocking Pharmaceutical Value Chain to bring drug costs down.
The UCH ARD President also called for institutionalisation of Joint Annual Reviews and publication of annual state health scorecards to enable citizens track progress.
“Overall, the foundation for a resilient health system needs to be laid with commitment, consolidation and sustainability,” he said.