Experts have identified poor regulation, poverty, and cultural beliefs as leading factors that make quackery thrive in the healthcare system.
They say unqualified and fraudulent practitioners operate freely amid widespread poverty, which makes people more likely to seek out low-cost healthcare options, even if they are risky.
Biodun Ogungbo, a brain and spine specialist, said many turn to quacks because they come cheap for the poor and serve as an alternative to those who lack trust in orthodox health professionals in the country.
According to a report by the World Health Organization (WHO) on countries that are at high risk of quackery, Nigeria is one of the most vulnerable on a list that includes India, Pakistan, Kenya, Ghana, and Tanzania.
Apart from poverty, the cultural beliefs that promote the use of traditional or alternative medicine, which can sometimes be harmful, also play a role.
Ogunbo said quacks have infiltrated both rural and urban centres such as in “local chemist where many go to for treatment of malaria and typhoid”.
He added: “Patients go to chemists to avoid paying for consultations. They feel that the prescribed drugs are often like what the chemists sell to them anyway.
“These quacks understand the local economy, the purse of the client and they may also take goods for barter. They are cheap and sometimes treatment is given on credit. They forget it might cost more in the long run as you end up losing your life.”
A public health administrator who didn’t want to be mentioned told BusinessDay that many Nigerians still chose local birth attendants over hospital delivery due to the perception that they are safer and spend less.
Tajudeen Salau, former chairman, Lagos chapter of the Nigerian Medical Association, said Nigeria’s brain drain crisis has also created an opportunity for quacks to thrive as many health professionals have migrated to even African countries.
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He said the current shortfall in health funding needs to be addressed to ensure health delivery is improved at local levels.
In the beginning, the first one would be the recommended amount of funding that should go to health, recommended by WHO.
“If that is done, we may be in a better place where we have the equipment, better remuneration, and reverse the brain drain,” he said. “There is a need for a strong drive for that to happen.”
Although Nigeria has pledged to commit 15 percent of its annual budget to the health sector, analysis of the Federal Ministry of Health (FMoH) and its agencies between 2001 and 2021 reveals otherwise.
The average budgetary allocation to the FMoH in 20 years stands at 4.69 percent, far below the 15 percent Abuja Declaration commitment and a 10.3 percent shortfall of the threshold.
In contrast, Rwanda, Swaziland, Ethiopia, Malawi, the Central African Republic, and Togo have since kept to the promise of the Abuja declaration.
Similarly, capital expenditure, which is expected to lead to increased investment in the health sector, lags behind.
For example, over a 20-year period, recurring costs account for 78 percent of overall health expenditure, while capital costs account for only 22 percent.
Nigeria’s recurrent health expenditure as a percentage of overall government expenditure, according to the World Health Organization, was 63.7 percent in 2001. This percentage decreased to 48.8 percent in 2002 and further decreased to 37.8 percent in 2003.
