ANALYSIS: Three years under Buhari, Nigeria’s health sector faces familiar problems

President Muhammadu Buhari-led federal government unilaterally -- without required consultation with states and the national assembly-- tampered with the NLNG funds.

The health sector under the present administration has attracted media attention mostly due to unpleasant events reflecting the true state of healthcare delivery in Nigeria. PREMIUM TIMES takes a look at some of these issues, three years into the Buhari administration.

Poor primary healthcare services/facilities

In the past three years, the nation has been hit by various diseases outbreaks that claimed the lives of over 2,000 Nigerians.

This has revealed the weakness and poor state of the primary healthcare centres in the country.

The high casualty recorded from the diseases’ outbreak was as a result of late diagnosis, lack of medical expertise to handling disease emergencies and low disease surveillance rate in the country.

This was evident in that some of the diseases, when they broke were not quickly detected and reported to the appropriate authorities until it nearly reached epidemic alert thresholds.

The poor facilities, poor staffing, lack of equipment, low disease surveillance rate among others were identified as part reasons why most of the diseases were not quickly curtailed.

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All these challenges were meant to have been effectively tackled if the government had delivered on its promise to bring healthcare delivery closer to the people.

This was meant to be achieved with the revitalisation of 10,000 primary health care centres across the country.

The minister of health, Isaac Adewole, a professor of medicine, had emphasised that revitalisation of the primary healthcare was one of the top priorities of the government.

This, the government believed was the bedrock of healthcare provision in the country. It said, would ensure that the poor have access to qualitative and affordable healthcare services.

However, much improvement is yet to be seen.

Many primary healthcare centres across the country are still in dilapidated states, low staffed, poorly equipped, lack electricity, water, and cannot effectively cater for the people in the rural areas.

Most pregnant women still seek the services of traditional birth attendants for delivery. Many children in the rural areas also miss out on routine immunisation which is meant to be one of the responsibilities of an effective PHC.

According to a 2016 Survey by the National Primary Health Care Development Agency, only 33 in 100 children got immunised around the country. About 4.3 million children have never been immunised in the last two years.

Shortage of vaccine and low immunisation

The country still records shortage of vaccines to combat deadly diseases.

Most of the deadly diseases such as Meningitis, Yellow Fever, Measles, Cholera, which ravaged the country in the last three years are vaccine preventable.

President Muhammadu Buhari during his campaign had promised to revive the local production of vaccines in Nigeria as a means of reducing dependence on international donors. This was also very necessary as Nigeria was tipped to graduate from the GAVI intervention list.

Though the government has made effort towards achieving this, by signing a MoU with May and Baker, the first batch of vaccines are yet to be produced.

Nigeria is still dependent on international agencies and donors for most of its health activities especially vaccinations.

Most large vaccine intervention in the country to curb the spread of Meningitis, Cholera and Yellow Fever outbreaks were championed by international donors.

The government has also asked for an extension from graduating from the GAVI vaccine intervention because it still need to put in place the necessary mechanism to fund vaccine procurement for the country.

Low response to public health emergencies

Response to public health emergencies in the country was put to test by the outbreak of different diseases.

The epidemic outbreak of Meningitis C and Lassa Fever revealed that there is a low state response to public health emergencies across the country.

Though there has been an improvement in the response rate as compared to what was obtainable last year during the meningitis outbreak, the country still needs to do more in terms of preparedness, surveillance, response.

Mr Adewole also laid the blame of low public health response on the state government. He said most of them wait for the Federal Government’s intervention to disease outbreak before taking steps.

Incessant strike by doctors and health workers

As if the challenges facing the health sector are not enough, the staff too have been putting a strain on public healthcare delivery in the country.

Currently, there is an ongoing strike by members of the Joint Health Sector Workers. This has crippled health delivery across secondary and tertiary health institutions for 41 days.

In the last three years, health workers had been on strike for about 57 days and their demands have largely been the same.

Medical doctors have also not been left out in the strike. In the last three years, doctors under Nigeria Medical Association and National Association of Resident Doctors have embarked on nationwide strikes which crippled the health sector. In 2015 and 2016, two strikes were called to press home their demands from the government.

In 2017, the government attended to their demands after 14 days strike. Since then, they are yet to embark on national strike. However, there has been series of doctors’ strikes across the states.

Mass migration of doctors and health professionals from the country

There has been a consistent mass migration of doctors and health professionals from the country. This is in relation to the incessant strikes and poor working conditions and environment at the healthcare delivery centres.

This is has led to an acute shortage of staff across the three levels of healthcare delivery in the country.

War on drug abuse

The Federal Government, as part of its war on illegal use of pharmaceutical prescribed drugs banned the importation and production of codeine-related drugs in the country. This is to curb the menace of drug abuse in the country. The war is yet to be won however.

Inclusion of the one per cent basic health fund in the budget

The Federal Government, through the National Assembly successfully included the one percent consolidated revenue fund into the 2018 budget for basic healthcare provision. This was achieved after 10 years of considering the National Health Act.

About N 57.15 billion was earmarked for the basic healthcare provision fund as mandated by the National Health Act, a law passed in 2014 but which has not been fully implemented.

For many, these and many other challenges stand in the way of President Buhari achieving his agenda in the health sector.

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