Premium Times takes a look at the challenges ahead.
Despite all odds, reports so far in the course of 2013 indicate that Nigeria fared slightly better in the health sector when compared with its abysmal and gloomy ratings in past years.
However, the sector was besieged by several industrial actions culminating in a warning strike by the Nigerian Medical Association just before Christmas. The doctors, on December 23, while suspending their five-day old strike, promised a graver showdown in 2014 if the government continued with what was described as ‘its insincerity’.
The year in polio and cholera
With health practitioners, who should help salvage the health sector, more out of hospitals over disagreements with the government, among other developmental drawbacks in the sector, 2014 seems already filled with various challenges.
The nation’s polio eradication programme, for instance, did not fare well as expected this year; it should be the government’s top priorities for next year. This year’s eradication efforts were further hampered by the insecurity caused by the Boko Haram insurgents. The National Primary Health Care Development Agency, NPHCDA, acknowledged that the gains earlier made by the country in the eradication programme, especially in some Northern states where the virus is endemic – Borno, Yobe, Bauchi, Plateau, Kano, Jigawa and Kaduna, were gradually being lost on account of the insecurity. Health officials rejected postings to the states troubled by Boko Haram following the killing of some of their colleagues in June.
Nigeria remains one of the most entrenched reservoirs of wild polio virus in the world. It is the only country with ongoing transmission of all three serotypes: wild poliovirus type 1, wild poliovirus type 3, and circulating vaccine-derived poliovirus type 2. As a result of the nation’s continued failure to eradicate the disease, India and Saudi-Arabia have now introduced a new policy targeting Nigeria. It would now be mandatory for all Nigerians, irrespective of age, coming into their country for whatever purpose to show evidence of having received the polio vaccine. And when in doubt, Nigerians would receive the vaccines at the customs/immigration screening point of these two countries before being granted entrance into their domains.
Attention would also have to be given to cholera as several parts of the country, towards the end of the year, were besieged by the disease primarily caused by poor hygiene. States such as Lagos were not spared. Meanwhile, Oyo which in 2008, 2009 and 2010 was well known for cholera outbreaks, did not report any incident in 2013.
The lows and highs
For sure, the Federal Government must work towards achieving the Millennium Development Goals, MDGs, in the health sector. 2015 is meant to be the deadline, hence, would want to ensure it is met.
The nation’s health indices, according to statistics from the Federal Ministry of Health seem to have indicated that maternal mortality ratio has also continued to reduce over the years; from 800 per 100,000 live births in 2003 to 545 per 100,000 live births in 2008. However, Nigeria still remains one of the countries with the highest maternal mortality in the world, contributing at least 10 per cent of the world’s maternal deaths.
Efforts still need to be deployed at reducing the mother/child mortality rates though the nation’s infant mortality rate has remained on the downward trend at 99 per 1000 live births, under-five mortality rate at 157 per 1000.
The abysmal cancer incidence in Nigeria took a sudden u-turn this year. Before now, there had been several challenges within the Nigerian health sector in the fight against cancer; insufficient medical personnel being one of them. As at September 8, 2011, there were only 15 Oncologists in the country but after the embarrassing discovery, contentious efforts were made to make the specialty attractive in the country. Subsequently, the next head count of Oncologists in the country this year showed that the number had increased to about 40.
Although still far from what it ought to be when compared with the rate at which the dreaded disease is spreading, it is still a source of hope that healthier days in the fight against cancer are ahead.
Notwithstanding the setbacks, the nation’s immunisation programme was however strengthened with the use of the MenAfric meningitis vaccine which replaced the now rested scarce polysaccharide vaccine. The MenAfric meningitis vaccine according to a pharmacist with the NPHCDA, Muhammad Adamu, is a more efficacious vaccine used for prevention of huge meningitis epidemics unlike the polysaccharide.
In 2013, no fewer than 79.5 million Nigerians between the ages of one and 29 years were innoculated with the MenaAfricVacine across 26 states which include the Federal Capital Territory.
With Nigerian doctors fleeing the country for greener pastures abroad, even to neighbouring African countries, the government has much work to do to wedge this tide.
Presently, the country has only 27,000 doctors (both general practitioners and specialists) to care for over 160 million Nigerians. Out of these, there are only 600 paediatricians to care for the nation’s 40 million children under age six; 120 urologists to manage reproductive health issues in over 50 million Nigerian men and not a single podiatrist to care for the feet of the nation’s growing diabetics.
No doubt, 2014 will be a very busy phase in the history of the nation’s health care delivery system. Nigerians do have every cause to anticipate healthier days next year if the ship is properly captained and in the right direction.