Improving the health sector in 2014
For the Nigerian health sector, the year 2013 ended on an ominous note with the five-day warning strike (December 18 to 22) embarked on by the Nigerian Medical Association (NMA) to press home some of its demands.
The association had threatened to commence an indefinite strike action from January 6, 2014, if the Federal Government (FG) failed to meet its demands, among which were: establishment of a Hospital Development and Intervention Fund for health infrastructure upgrade, appointment of a Surgeon General of the Federation, and expansion of the universal health coverage.
However, it was good to hear the news early in the year that the association had announced the suspension of its plan to embark on an indefinite strike, following the agreement between it and the government, and to allow for the implementation of the MoU reached with the FG. This is a good sign for the New Year.
Still, it must be emphasised that, to chart a new course for the health sector in 2014, ensuring industrial harmony is crucial. This is because the sector was bogged down last year by several industrial strike actions.
It must equally be emphasised that it is essential that the government accedes to the legitimate demands of the NMA. However, in doing this, the government must refrain from unwittingly creating more disharmony in the health sector by treating the issues raised by the NMA in isolation. The challenges facing the health sector, as a whole, must be tackled, with due consideration for health care professionals, other than the medical doctors. To do this, the government must involve all the health care professionals in its efforts to devise and implement strategies for progress.
The Nigerian government has a major role to play in helping to promote team spirit in the health sector. Already, the Nigerian Union of Allied Health Professionals (NUAHP), whose members comprise pharmacists, physiotherapists, radiographers, medical laboratory scientists, dietitians, occupational therapists, dental therapists, dental technologists, nurses, optometrists, health information officers, medical social workers, among others, is disputing the decision of President Goodluck Jonathan to appoint a Surgeon General of the Federation, who will be a medical practitioner.
The NUAHP, in a signed statement by its secretary and president, O. C. Ogbonna and F. Faniran, said it was wrong for the president to take such an important decision without a proper stakeholders’ conference, adding that the NMA constitutes just 10 per cent of the workforce in the health sector, while the NUAHP members constitute the remaining 90 per cent.
This contentious issue must be carefully addressed, to avoid inadvertently creating a new crisis in the health sector, while trying to solve another.
Nevertheless, aside from ensuring industrial harmony in the sector, there are also several other challenges facing the health sector that must be surmounted to make the sector better this year. The first is the nation’s polio eradication efforts. While we note that the efforts of government to rid the country of the epidemic were seriously hampered in 2013, as a result of insecurity in some northern states, the FG must devise a way to eradicate polio, in spite of this challenge. Nigeria remains the only country right now with on-going transmission of all 3 serotypes (wild polio virus type 1, wild poliovirus type 3, and circulating vaccine-derived poliovirus type 2) and our inability to eradicate polio has continued to give the nation a bad image globally.
Also, although recent statistics from the Federal Ministry of Health on maternal mortality indicated that maternal mortality ratio has reduced over the years, it is worrisome that the country is still one of the nations with the highest maternal mortality in the world.
To tackle this problem and also reduce the child mortality rate, the National Primary Health Care Development Agency (NPHCDA) must do more to revive and transform primary health care delivery system in the country. This first port of call in the health system must be strengthened to provide quality health care to millions of Nigerians at the grassroots.
Also, quite a lot must be done, in terms of preventive medicine. The outbreak of cholera late last year in some states of the federation and its attendant casualties in a 21st century Nigeria is a sad commentary for us. Cholera and some other diseases killing and maiming Nigerians can be prevented with proper education, enlightenment and immunisation.
It is our opinion that 2014 offers Nigeria a great opportunity to turn around the health sector for good, as it is the last year available to work on achieving the health components of the Millennium Development Goals (MDGs). Consequently, deploying resources and strengthening strategies to ensure these goals are met will be quite beneficial in transforming the Nigerian health sector this year. It is also the way to go to save Nigerians dying from many preventable and treatable health conditions.