Why Nigerian teaching hospitals are not doing well – Minister

Obafemi Awolowo Teaching Hospital (OAUTHC)
Obafemi Awolowo Teaching Hospital (OAUTHC)

Nigerian teaching hospitals will not function optimally until adequate attention is given to primary and secondary healthcare facilities, Health Minister, Isaac Adewole, has said.

The minister said the challenges facing the teaching hospitals and other tertiary health institutions flow from the inability of the primary and secondary healthcare facilities to meet people’s needs.

Mr Adewole spoke while appearing before the Senate plenary on Tuesday.

The senators, last week, invited the minister to appear before them over the poor condition of teaching hospitals across the country.

Speaking to the senators on Tuesday, Mr Adewole emphasised the importance of a functioning primary and secondary health care system.

“The teaching hospitals by design constitute the apex of healthcare in any country and for us in Nigeria, they represent the topmost and by design, they are expected to receive referrals and manage complicated cases.

“For them to function, they depend on primary healthcare centres and functional secondary healthcare centres. When these two levels of care are functioning, about 90 per cent of ailments can be taken care of at primary and secondary healthcare centres. Only 10 per cent of Nigerians who require care will need to go to a tertiary institution. The PHCs 70 per cent, the secondary 20 per cent.

“However, over the last couple of years, we have a major challenge, the healthcare system can be described as a pyramid. The primary health care centre at the base, secondary at the middle and tertiary at the top.

“The problem we have is that the foundation is bad (primary healthcare), the wall is weak (secondary) and we are only concerned about the roof (tertiary).”

He said Nigeria currently has 22 teaching hospitals, 20 federal medical centres and 17 specialist hospitals.


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The minister noted that the current administration is making efforts to restructure the pyramid. He said Nigerians go to tertiary health care centres because the primary and secondary have collapsed.

Mr Adewole said the tertiary institutions are suffering from various challenges, chief of which is overcrowding.


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Other challenges include power supply, water supply, capacity building of personnel and the states’ neglect of other levels of health care.

“The states have literally abandoned healthcare such that everything is handled by federal. We cannot succeed with this. Governors need to invest in secondary health care. If we don’t solve this, we’ll just be scratching the problem on the head with regards to tertiary. The tertiary cannot expand beyond this, we have limitation with resources.”

“The states need to partner with us so that the secondary hospitals are working, so that our tertiary institutions can go back to being referral hospitals.”

Mr Adewole also cautioned states and local government from proliferation of structures in the name of building health care centres.

He said Nigeria currently has 30, 000 PHCs spread across the country but few are functioning.

“All we want to do is to make 10, 000 work to reach one in each ward and 100, 000 across the country,” he said.

To further seek solutions, he said the Ministry of Health has engaged consultants to visit the all tertiary institutions in Nigeria and come up with recommendations as to what needs to be done to revive the tertiary health care institutions.


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