Ngozi Eze lost her unborn baby in June 2023. She was struck by an illness during the eight month of her pregnancy.
Unfortunately, she had nowhere to run to, for solutions. Her community at Ndiukwa in Izzi Local Government Area of Ebonyi State neither had a hospital nor a primary health centre. Due to lack of medical attention, she had a miscarriage.
“I almost lost my life because for three hours I could not get any medical help,” she told one of our reporters when he visited there recently.
It takes 22 metres to move from Ndiukwa to Iboko, the capital of Izzi, where she could have got some medical attention. Yet moving to Izzi would have required spending at least an hour on a bike. Even at that, it would have taken about an hour to find a bike man moving in that direction.
This captures the experience of several rural pregnant women in Africa’s most populous nation where 1,047 of them die (per 100,000) as a result of lack of proper medical attention, according to the World Health Organization (WHO).
Nigeria has the third-highest maternal mortality rate in Africa and is still far from the United Nations’ target of 70 deaths per 100,000 by 2030.
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Stunted by poor facilities
Several hospitals in Nigeria are jammed due to lack of sufficient facilities and bed spaces for patients.
At the Surgical Outpatient Department of Lagos State University Teaching Hospital (LASUTH) on June 25, the patients numbered above 100. Some stood due to the unavailability of seats, with only three hospital officials attending to their files.
“This place is always crowded, and standing for long every time is quite stressful,” a female patient, who did not want her name in print, said. “Once I am booked for an appointment, I arrive before the given time. I was once at this hospital at 9 am and I was not done until 4 pm,” she further said.
One patient, Quasim Lateef, called on the hospital and government to provide enough seats for patients and address the exposure of patients to rains.
Several public hospitals in Nigeria lack bed spaces. Nigeria’s bed capacity stands at 0.9 hospital beds per 1000 people. This is lower than the global average of 2.3 hospital beds per 1000 people, the WHO said.
The latest Joint Monitoring Programme report by the WHO and the United Nations Children’s Fund revealed that 32 percent of healthcare facilities in Nigeria had no basic sanitation services as of 2021.
Nigeria has 34,076 primary health centres (PHCs), but only a quarter are functioning, said a Market Study Report.
“Most of the PHCs lack the capacity to provide essential healthcare services, in addition to challenges of poor staffing, inadequate equipment, poor condition of infrastructure, and a lack of essential drug supply,” the report said.
About 78,000 Nigerians died from cancer-related complications in 2020, with 120,000 new cases annually, says the National Institute for Cancer Research and Treatment. But the country has only 13 radiotherapy machines and fewer than five chemotherapy machines.
Doctors are leave in droves
Nigerian doctors are exiting to more advanced economies where they can be properly rewarded. Muhammad Pate, Nigeria’s health minister, said in March 2024 that about 16,000 doctors left the country in the last five years while about 17,000 have been transferred.
No fewer than 12,198 Nigerian doctors are in the UK, says the General Medical Council of the UK. Several others are in the US, Europe, Asia and other parts of the world.
“It is now hard to find specialists in various fields in Nigerian hospitals. We have fewer hematologists, anesthesiologists, gastroenterologists, and endocrinologists today than last year,” said Obinna Iheachonne, a Lagos-based cardiologist.
Due to the poor state of hospitals and lack of doctors, the rich are sending their children abroad when they are sick. Nigerians spent $40 billion on medical tourism and foreign education in 10 years, said Yemi Cardoso, Central Bank of Nigeria (CBN) governor, in 2023.
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Cost of drugs, operations are rising
Cost of essential drugs for diabetes, hypertension and other diseases have jumped by over 100 percent in one year.
Kwara State-based Emmanuel Kolawole,, who has been suffering from diabetes since 2018, said he has to go traditional due to the cost of drugs.
Essential drugs are scarce due to foreign exchange crunch, which has strangled the nation since 2016.
Also, private hospitals are shutting down due to high energy costs. Those still operating transfer costs to the patients.
“In the hospital setting, energy rationing only brings worse results. Yet, somebody must bear the burden of the rising cost. Most times, the same impoverished citizens bear the burden. It can be so saddening when some patients tell you after knowing the cost of a procedure that it is better to go home and die. It makes the doctor feel very bad. He cannot sustain the practice of free services,” Kay Adesola, president of the Association of Nigeria Private Medical Practitioners (ANPMP), told BusinessDay.
Diseases ravaging the nation
Cholera is tormenting Nigeria but the country does not have enough vaccines to tackle it, said Jide Idris, director-general of the Nigeria Centre for Disease Control and Prevention (NCDC). It has killed 4,364 Nigerians in four years.
Malaria is a major public health concern, with an estimated 68 million cases and 194 000 deaths in Nigeria, says the WHO.
The West African nation is one of the highest-burden on tuberculosis (TB), with incidence in Nigeria standing at 467,000 in 2021. That year, 125,000 Nigerians died of malaria, according to the US Agency for International Development.
Nigeria has a high burden of communicable and non-communicable disease (NCDs), with the latter making up 27 percent of deaths around 2019, says the WHO.
Health budgets are insufficient
Only five states allocated 15 percent of their budgets to healthcare in 2024. These states are: Kaduna, Yobe, Kano, Bauchi, and Abia. Others allocated between three and 12 percent. At the federal government level, only 4.6 percent of the 2024 budget was allotted to the health sector. From 2008 to 2021, the health allocations were less than five percent of total budgets in Africa’s most populous nation.
Government is confronting the snags
Amid these challenges, the Nigerian government is not keeping quiet.
In June, President Bola Tinubu introduced an executive order to suspend import duties and value-added tax on essential medical supplies imported into the country, including major inputs.
The policy is expected to boost the production of raw materials, intermediaries, or finished goods, according to Sam Ohuabunwa, immediate past president of the Pharmaceutical Society of Nigeria (PSN).
Chinyere Almona, director-general at Lagos Chamber of Commerce and Industry, said by significantly reducing production costs, this initiative will enhance the competitiveness of local manufacturers.
“The recent exit of some pharmaceutical firms has made drug availability difficult, leading to higher costs of medications. This policy intervention has come at a good time,” she added.
Secondly, prices of some medical products are moderating. At the exit of GSK from Nigeria in August 2023, the price of Ventolin used by asthmatic patients jumped from less than N5,000 to 53,000. However, the price now stands at N9,000. Analysts said speculators hiked the price as soon as GSK exited, but have lowered it owing to lower patronage and increased competition from imports.
Also, about N260 billion has been earmarked to revitalise the PHCs, said Ali Pate, health minister.
Partners in Nigeria’s health sector, including private sector partners, and international partners, have announced a $3 billion commitment to the sector.
“International investors have taken notice. We are seeing increasing interest from external investors who are willing to come and produce in Nigeria. Three entities are producing test kits and two more are coming, and every day we hear interests to come and produce due to policy shifts of Mr. President,” Minister Pate noted.
