Dearth of personnel, amenities, NHIS face health minister

As the nation awaits the screening and confirmation of the ministerial nominees of President Muhammadu Buhari, analysts say the eventually appointed health minister would have to contend with the dearth of medical professionals and hospital amenities bedeviling the sector.

Also, the integration of the National Health Insurance Scheme (NHIS)  scheme, drug counterfeiting, mass departure of Nigerians to other countries for medical tourism, are among the challenges that will face the incoming health minister.

Analysts further say that increasing budget allocations to health would ensure that more skilled health workers are employed, trained and adequately motivated to attend to citizens accessing their services.

From a recent analysis conducted by Development Communications (DevComs) Network,  in the last 15 years, Nigeria has witnessed the development of several plans, policies and strategies that have not been achieved.

One of such plans is the National Strategic Health Development Plan 2010-2015 (NSHDP) which was developed in the year 2010 to last till 2015, with the over-arching goal of improving the health status of Nigerians through the development of a strengthened and sustainable health care delivery system.

The national plan had targeted a maternal mortality ratio of 273 per 100, 000 live births in 2013 and 136 per 100, 000 live births in 2015, which will amount to a one-third reduction in maternal mortality ratio between 2010 and 2015. Similarly, the percentage of federal, state and local government budget allocated to the health sector was anticipated to increase from 5% in 2011 to 15% by 2015.

However, a number of the targets in the NSHDP were not met, as the most recent figure given by the Nigeria Demographic and  Health Survey (NDHS) 2013 showed 576 per 100, 000 live births, while the government ’s spending on health has varied from 4% to 9% between 2001 and 2013.

Also, the health budget had declined from 6.07% in 2012 to 5.61% in 2013 and rose slightly to 5.67% in 2014. The consequence of these failed promises is a weak health system which has encouraged the preference of several pregnant women and communities for antenatal care and delivery at homes, religious places and traditional birth attendants’(TBA) places.

The chapter II (article) 17(3)(d)) of the 1999 constitution of the Federal Republic of Nigeria which refers to the fundamental objectives and directive principles of state policy, requires all organs of government, authorities and persons exercising legislative, executive or judicial powers to ensure adequate medical and health facilities for all persons in Nigeria, but  which analysts say have not been achieved.

According to Mustapha Danesi, Professor of Neurology, College of Medicine, University of Lagos, “Nigeria’s health governance since independence remains the same.  Government provides ‘free’ or subsidised healthcare in competition with private providers who ‘charge money’ for healthcare.  There is no ‘Integrated Healthcare System’ that is all embracing, where government and private providers work in synergy, as is done in many developed and developing countries.”

“In view of this, many experts have likened the right to health to fundamental human rights, which are said to be justiciable rights and guaranteed by the constitution of Nigeria. The right to quality health (including maternal health) is also an important obligation of the government of the Federal Republic of Nigeria because the country has ratified international laws and instruments such as the Universal Declaration of Human Rights, The Convention of the Elimination of all Forms of Discrimination Against Women (CEDAW), The Convention on the Rights of the Child, and other regional treaties like The African Charter on Human and Peoples’ Rights,” he concludes.

Still on desired change and expectation from the incoming minister of Health, health professionals have said that a crucial change desired in the health sector is eradication of drug counterfeiting.

About 100,000 deaths a year in Africa are linked to the counterfeit drug trade, according to the World Health Organization (WHO).

There has been an influx of counterfeit malaria drugs (among others) and though, according to NAFDAC, there has been improvement in curbing counterfeiting because they recently revealed that production of phoney anti malaria drugs has reduced from 19.6 per cent to 3.6 per cent in Nigeria, a lot more needs to be done.

Kemi Ajumobi