By Emmanuel Urhiofe – There is no doubt that the Nigeria health care system is at a crossroad. Bedeviled by lack of constant electricity and necessary infrastructure for its sustenance, the Nigeria system cannot account for the monumental budgetary expenditure in the health system.
What, with the prevalence of many infectious disease that have continued to abound, with no hope of abatement, the health care challenges has reached such a historic proportion that it would need urgent and radical reforms for its to be on a good level footing. The giant of Africa still suffers from inadequate medical equipments, poorly managed health centres, lack of coordination of health policies inadequate and decaying infrastructure, inequity in resource distribution and deplorable health delivery system. Most importantly is lack of clarity in the policy in the policy making machinery of government towards the health care sector.
One of the notable efforts of the Nigerian government in the revitalisation of the state of health in Nigeria was the introduction of the Nigerian Health Insurance Scheme (NHIS) that was established in 2005 by Decree 35 of 1999. This was a bill that was first proposed in 1962 by the then Minister of health, but lack of foresight and focus prevented its full introduction for another 53 years. But ten years has elapsed since its introduction. Is it working? Are Nigerians having access to quality health services? We can check if it is working by looking at the aims and objectives of the scheme. These include to ensure that every Nigerian has access to good health care services; protect Nigerians from the financial burden of medical bills; limit the rise in the cost of health care services; ensure efficiency in health care services; ensure equitable distribution of health care costs among different income groups; ensure equitable patronage of all levels of health care and maintain high standard of health care delivery services within the scheme. Others aims include to improve and harness private sector participation in the provision of health care services, ensure adequate distribution of health facilities within the Federation and to ensure the availability of funds to the health sector for improved service. There is abundant evidence that these aims and objectives have remained Olympian and elusive. To make matters worse, government budgetary allocation to the health sector has reduced compared to that of information. How do we compare propaganda to an important sector like the health sector?
Perhaps it was based on these inadequacies that, Nigeria health care professionals in the US were quoted as saying that they would like to return to Nigeria to help build the health sector. But they were quick to add a caveat. The government would have to grant their request for putting certain conditions in place. Among these conditions is the provision of a housing loan, the provision of sophisticated equipment of hospitals in Nigeria and the approval for a much enhanced salary scale for them. While this news may not be a true reflection of the entire medical doctors in the US, it is an eye opener to the gross disparity between the health system in the US and that of Nigeria, which in normal clime has no basis of comparism. There are more than 30,000 Nigeria health professionals (including Doctors, nurses, physiotherapists and home care specialists). There is no doubt that that if half if these professionals are allowed to return home to Nigeria with all the demands being met, there is expectedly going to be a change.
Lets come back home to the UK where there are more than 15,000 Nigeria health professionals providing frontline services to the UK population. How can this number of professionals be of use to Nigeria? It is first important to note what these health professionals are doing in the UK. Like in the US, they are contributing immensely to the care industry in the UK as well as to the NHS or private practice. They have wealth of experience in diverse fields ranging from sophisticated surgery, patient care, diagnosis, paediatrics, to care for various kinds of diseases. This is not to insinuate that Nigerian doctors are not skilled but Diaspora doctors and professionals have got the exposure and added skills which the Nigerian Doctors in Nigeria do not have. Many UK doctors have performed some of the amazing surgeries you can ever think of in the civilised world.
Collaboration
One of the ways to achieve this is through collaboration. UK professionals can collaborate through partnership with government hospitals or health care management in either the Federal or State levels. Legal requirements of such partnership deals can be drafted by legal draftsmen in the UK or in Nigeria. The terms of such partnership deals should be continuously monitored by the legally embodied organisations in both countries. Collaboration can also go beyond partnership. UK doctors and professionals can also be encouraged to invest in health infrastructures such as buildings, equipments and other government sponsored initiatives. Such Diaspora sponsored initiatives have been very useful in some other countries where government have recognised the noble role professionals can play in the development of their home country. Such role will compliment the efforts of Diaspora organisations in meeting the Millennium Development Goals especially in areas such as the reduction of child mortality and the improvement of maternal health environmental sustainability. There is still a plethora of infectious diseases that need urgent eradication. Diaspora professionals can also help the system by the introduction of appraisals and revalidation which makes it mandatory for professionals to embark on professional development and feedback
Nigeria must replicate the health system that is obtainable in the United Kingdom, Germany and the United States where creativity and technology has been used to revamp the system. The world Bank Economic Forum says it will take 300 years for developing countries with the existing infrastructure to achieve the same doctor to patient ratio that exist in many western countries. This means that developing countries like Nigeria would need to wait for the next 300 years to sort out the health system to be at par with that of the UK. Are we going to wait for 300 years?
There is need for urgent attention to the eradication of poverty, inequality and ignorance in the Nigerian system. This should go in tandem with improvement in educational attainment and women empowerment.
We believe that health care professionals in the UK can make a difference in these areas. The government need to pursue a creative agenda for development. We believe that the Buhari’s government will find these suggestions useful.
