NMA’s five-year plan for health sector
Nigeria’s health-care delivery sector, sadly, has one unmistakable signature: decay. Indeed, the nation’s health-care system is an embarrassment of monumental proportions in spite of the billions of naira expended on some tertiary hospitals during the era of former President Olusegun Obasanjo. This is totally unacceptable and must change. Against this background, the Nigeria Medical Association’s recently unveiled five-year plan for the health sector is a soothing breath of fresh air. It is hoped that governments at all levels would join hands with the doctors to implement the plan.
Although some strategic departments in some tertiary hospitals were once equipped in the Olusegun Obasanjo administration scheme, 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, high morbidity and mortality rates, poor attitude of health workers and neglect of patients by medical personnel, are all responsible for the poor health care delivery system.
Other factors include obsolete equipment, and the brain drain that begun since 1985, leaving the country with just a few practising physicians and specialists attending to 180 million Nigerians. This is against the World Health Organisation, WHO’s design that for any country to claim to have enough doctors for its population, it should have one doctor for every 600 persons. This means that Nigeria needs about 300, 000 medical doctors, but has about 35,000 working in the country today. Even these few working medical officials do not have a conducive operational environment. The consequence of this is grave!
Though, there are no firm statistics on mortality and morbidity, recent reports show that avoidable deaths are being recorded even as a result of rivalry among health-care professionals and indifference in hospitals, not to talk of death from the burden of diseases such as Lassa fever, meningitis and other diseases. While meningitis is on the prowl, there is a reported outbreak of leprosy. To show that these problems are not recent, sometime in the past, a Minister of Health was quoted as saying that “the reality is that we are losing too many loved ones and I share in these pains. However, the truth is that these meningitis outbreaks are just a symptom of a bigger problem that had been there for years. For too long, we have abandoned the Primary Health Care system, which would have taken care of major disease treatment and management at the lower levels. For too long, we had concentrated on general and specialists’ hospitals to the detriment of the PHCs, which would have helped us carry out routine immunisations and disease management at the villages.”
Realising that the health sector is now in a shambles the Nigerian Medical Association (NMA) has reached out to all the other professional organisations and, together, launched a five-year strategic plan bringing together civil society organisations (CSOs) and other healthcare professions for the first time to improve the health sector.
The NMA, CSOs, other medical professions, development partners and organised private sector then finalised the NMA Strategic Plan 2017-2022. The Plan, which is structured after the National Strategic Health Development Plan developed by the Federal Ministry of Health in 2009 is up for a review.
The plan includes areas of health care where doctors can play direct roles, including operationalising the National Health Act, clinical governance, medical education and research, and improving health care delivery nationwide. The National Health Act is a framework for regulation, development and management of National Health systems. It sets standards for rendering health services, achieving universal health coverage, elimination of quacks from the profession, provision of health care insurance to certain class of people who are actually deprived, cut down on medical tourism and other related matters. The Act also provides that the NHIS would provide health coverage for pregnant women, children who are under five years, the elderly and the physically challenged persons.
This move by the NMA’s is commendable.
Instead of resorting to industrial action all the time, NMA is demonstrating good leadership by championing a repositioning of the health sector! Leadership, indeed, is a critical variable in dealing with the crises in the sector. It is hoped that as the professional groups within the sector have come together harnessing their skills and competencies and engaging themselves transparently in search for solutions, the nation will have an improved health care system. Repositioning the health sector requires government support.
As such, governments at all levels should support this initiative, procure more equipment in different areas of health care delivery, especially modern hi-tech equipment and machines that could enhance the quality of service delivery; provide physical space; and employ more personnel to reduce the waiting time of patients. Some very critical areas such as laboratories; ophthalmology departments, radiotheraphy, cardio-thoracic, paediatric and renal units should be well equipped with state-of- the-art equipment to reduce cases of wrong diagnosis. Furthermore, hospital pharmacies should be well stocked with drugs. There should be capacity building for health workers to address their poor attitude and further hone their skills. Nothing, indeed, should be left undone and no cost should be spared to make the health-care delivery system in Nigeria first class.