AGAINST the backdrop of poor access and the high cost of health services in Nigeria, stakeholders have made a case for political will to fully implement existing health policies like the National Policy on the Health and the National Health Act to ensure healthcare for all in the country.
Executive Secretary of the Nigerian Academy of Science, Dr Oladoyin Odubanjo, said the already inadequate human resources for health have become even more ineffective than they were, such that in a big city in the South-West, thought to be a medical epicentre, people are beginning to experience difficulty accessing healthcare from appropriate personnel.
He claimed that some high-profile cases of medical mismanagement in the news in the last year were all done by quacks.
“The already grossly inadequate human resources for health have become even more inadequate than they were before, such that even in the city centres in the south where we thought people could at least access healthcare, they are beginning to find it difficult even to access healthcare from appropriate personnel now.
However, he said reversing the situation in the health sector requires improving the operating environment to stop health workers’ emigrating, making local production of medical consumables and medicines easy and cheap, as well as a strong political will and purity of purpose to get the right things done.
President of the Medical and Dental Consultants Association of Nigeria (MDCAN), Professor Muhammad A. Mohammad, in reaction, said the cost of healthcare has gone up about five to seven times what it was before due to many factors, including the high cost of energy and medical consumables, inflation, and depreciation in the naira exchange rate.
“For example, the cost of electricity in the last year has increased by about five to seven times what it was before. Hospitals have high energy consumption. So, you can think of the cost of running every machine in a hospital. The hospital is a place where you will not want to have one minute of power failure because it can mean the life of someone.”
Professor Mohammad said although MDCAN, during a courtesy call to the president, had urged a special rebate on energy for hospitals and a 50 percent reduction on power costs to the hospitals, which was approved, it is yet to be implemented.
He said access across the three tiers of healthcare delivery is poor, infrastructural provisions at the facilities are not enough, the number of functional primary healthcare centres is not enough for the population, and the waiting time is making people look for other options like consulting at the pharmacy.
“The community members are discouraged from visiting these facilities. They feel that it is a waste of time to seek services at these places. It’s very strained and cumbersome to assess healthcare because there are a lot of bottlenecks and bureaucracies, and it’s quite expensive,” he added.
A public health physician with the University of Ilorin Teaching Hospital, Professor Tanimola Akande, said access to healthcare in Nigeria is low for various reasons, which include poor geographical access, particularly for those living in rural areas.
“Some cultures require permission from men to access healthcare, and there are various cultural beliefs that prevent men and women from accessing healthcare. Health insurance coverage is meant to reduce this challenge, but the coverage of Nigerians is very low.”
President of the University of Ibadan Students’ Union, Mr Damilola Aweda noted that access to healthcare services is non-negotiable and the right of everybody.
“UCH, Ibadan, the foremost healthcare provider in the country, was out of electricity for almost four weeks, and nothing was done. The same thing happened to many other tertiary providers. It is very bad.
“If that is happening in these foremost hospitals, you can imagine what is happening in the secondary and primary healthcare facilities. So, the government has to do a whole lot more in revamping the healthcare sector.”
In a reaction, the President of the Nigerian Medical Association (NMA), Professor Bala Audu, said despite Japa syndrome, quality of care is still high in the country, and there is no type of medical care that people require that is not available in Nigeria.
“We have a private sector-driven, highly-specialised service in Nigeria that can compete anywhere. It depends on whether you know where to access it or if you can afford to access it. Everything they use is imported, from medications, reagents for tests, to machinery,” he added.
Professor Audu claimed that healthcare services are extremely cheap in Nigeria and a high proportion of patients come in from other countries to seek treatment.
According to him, “the cost of healthcare is a value that is equated to the value of the naira as it exchanges these for foreign currency. Virtually everything you utilise within the health sector is an imported product. With one dollar, one cannot buy paracetamol in the US. But with one dollar, you can buy a packet of paracetamol in Nigeria.”
He said addressing access and cost of healthcare services will require a holistic approach given that health cannot be isolated from other sectors.
“No cost will go down so long as all the factors that determine cost and demand are going up. It will not spare the costs within the health sector.”
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