FG and another health sector plan?

Leaders at all levels in Nigeria should realise that citizens of this country should be tired of empty and unsustainable human development goals. There are no good hospitals in the country and education quality is embarrassing. So, any news item of another national health plan cannot thrill anyone in the country. How many national health plans should a nation launch before it can have a good healthcare delivery system?

Realising that the health sector is at the moment in a shambles, the Federal Executive Council (FEC) the other day approved a new five-year National Health Strategic Plan 2, which is to gulp a whopping N6.07 trillion; and will involve the 36 states of the federation including the Federal Capital Territory.The previous Plan 1 covered 2010 to 2015; while the new Plan 2 would cover 2018 to 2022. This five-year plan if funded and implemented faithfully, would achieve a 31 per cent reduction in maternal mortality; 33 per cent reduction in horizontal mortality; and under five mortality reduction of 29 per cent. This development is in tandem with the advocacy over the years for a national health plan.

Accordingly, the new Plan 2 would be structured to cater for the failings of the Plan 1, which was only able to achieve about two of its 52 targets. The new plan essentially has five strategic pillars and 15 priority areas – enabling environment for the attainment of health sector good, increased utilisation of essential package of health services, strengthening our health systems and protection from health emergencies as well as health financing.

Lofty as this Plan 2 may seem, throwing money at the sector may not be the Midas touch against the backdrop of the billions of naira expended on some tertiary hospitals during the era of former President Olusegun Obasanjo, which yielded little or no fruit. Reason: The nation’s health-care system is still an embarrassment of monumental proportions and the sector, sadly, has one unmistakable signature: decay.

Therefore, that the health sector requires attention is no news because for decades, it has been characterised by a disturbing degree of deterioration due to neglect by successive administrations. Indeed, the sector is now near a total collapse.There is little or nothing to write home about the so-called apex hospital, National Hospital, Abuja. Even State House Clinic established to take care of the President, Vice-President, their families as well as members of staff of the office of the president in Abuja has reportedly joined the league of hospitals that cannot deliver quality healthcare services. This came to the public glare when wife of the president, Mrs. Aisha Buhari took ill in 2017 and was advised to travel abroad because of the poor state of the clinic.

However, she opted to go to a private hospital owned by foreigners in Abuja when she was told that the x-ray machine in the State House Clinic was not functional.Indeed, that the nation’s health sector is nothing to write home about is evident on so many other fronts. Citizens who can afford medical treatment abroad often travel as far as India, United Arabs Emirate (UAE) and Egypt for cheap medical care. The wealthier ones travel to Europe and North America.

The most telling example in recent time has been the treatment of our president abroad for about a quarter of a year and the various ‘routine’ health checks; not discounting medical tourism time of most of the governors of Nigeria’s 36 states. They too always slip out of the country for medical examination. Also, a former Vice-President, Dr. Alex Ekwueme recently died abroad while seeking healthcare. Before then, these examples have been embarrassing indictments on the nation’s healthcare system managers and leaders at all levels, a shame on those in office, and a reproach that should be removed.

Besides, our president going abroad for treatment has been curious because contrary to his promise while campaigning to stop medical tourism, he has been the one showing the way. Why has the President taken the citizens for granted? Also, why can’t other public office holders use Nigerian hospitals to demonstrate to us that they ‘enjoy’ the quality of healthcare services that they are giving to the electorate who employed them three years ago?

What is responsible for this shameful health sector?Although some strategic departments in some tertiary hospitals were once equipped in an aforementioned regime in this democracy, some of the equipment installed have since been tampered with and cannibalised with the result that the supposed centres of excellence are not much better than consulting clinics. Again, inadequacy of medical facilities, high cost of drugs, sub-standard drugs, wrong diagnosis, poor attitude of health workers and neglect of patients by medical personnel, are all responsible for the poor health care delivery system.

So, the new deal of health sector plan will be useless if it does not change the effects of other critical factors, which include obsolete equipment, and the braindrain that began since 1985, leaving the country with just a few practising physicians and specialists attending to 180 million Nigerians. Even these few working medical officials do not have a conducive operating environment. The consequence of this is grave – high morbidity and mortality rates in the country.

Also, for too long, we have abandoned the Primary Health Care (PHC) system, which includes clinics, maternity homes, dispensaries and other professionally manned health centres established and managed by churches and mosques in the early days of our beloved country, that would have taken care of major disease treatment and management at the lower levels. We have concentrated on general and specialists’ hospitals to the detriment of the PHCs, which would have helped uscarry out routine immunisations and disease management at the villages.

Matching the five-year national health plan against the five pillars will be a soothing breath of fresh air into the health sector. However, for synergic outcomes, the public and private sectors should collaborate. Furthermore, governments at all levels should commit themselves to implementing the plan.

This is doable and government at all levels in Nigeria should work in synergy towards improving access to quality health care services. After all, former governors Emmanuel Uduaghan of Delta State, Babatunde Fashola of Lagos State and Olusegun Mimiko of Ondo State are some state executives that built and equipped mother and child (MCC) hospitals aimed at reducing maternal and child death while in office. The MCC hospitals were meant to address the lack of access to health care services including pre-natal and post-natal care, obstetric services and family planning information, particularly in rural areas.

Therefore, as the country has shown the political will to reposition the health sector with Plan 2, we should develop plans on how to retain trained medics. This situation can be reversed by making the National Insurance Scheme (NHIS) compulsory for all citizens, which is hoped, will provide enough funds to improve the conditions of service and working environment for health professionals. At the moment, NHIS is working, but limited to the civil and public service. However, it works well in some other jurisdiction because people including those in the informal sector pay their taxes, subscription fees or premium on insurance policies.

So, it is not enough to talk about health sector plan without political will to implement the plan. It is also not helpful to keep repeating promises of robust investment in the health sector, all the time without adequate budget and implementation strategy. It will, on the whole be another tragedy if Buhari who has been going on medical vacation in the United Kingdom leaves office in May 2019 without improving healthcare delivery system in the country he has had a second chance of running as an elected leader.