Towards a revamped health care sector
In recent times, so much has happened within the Nigerian political and economic landscapes. From the hullabaloos over elections, to the slump in the prices of oil and the attendant effects on the value of the naira, Nigerians have had so much to witness and so much more to discuss.
However, in the health care sector, an atmosphere of worrisome stillness and stagnation prevails. Our problems remain colossal – high maternal mortality rates, poor access to medicines, unregulated drug distributorship network, encroaching malaria parasite drug resistance, inadequate access to finance, very low health insurance coverage, health labour force disputes and inter-professional wrangling, to name a few.The supporting industries that help to make health care accessible and affordable are underdeveloped and developing, the manpower limitations daunting and the need for fresh ideas will still be very much a critical requirement.
It is within the context of these present challenges that we affirm that the Nigerian government is auspiciously faced with an opportunity to create a modern day miracle. While we acknowledge that the numerous challenges besetting our health sector are not so easy to wipe away, we strongly believe that our capacities are correspondingly huge and adequate.We maintain the standpoint that if the Nigerian government dedicates a conservative 15 per cent of the nation’s budget to health care, it would create the much needed effective demand for care, which would in turn lead to a faster development in the level of private sector-led investment in health care. With judicious management, this should contribute significantly to a reversal in the brain drain suffered by the Nigerian health care industry.
It is important to note that the USA, with a population of about 350 million, has a practicing physician population of about 839,000 compared to Nigeria with less than 40,000 physicians serving a population of 170 million. The United Kingdom, on the other hand, has a population of less than 65 million individuals but boasts of a physician population of more than 200,000.Considering that Nigeria is projected to be the third largest nation by 2050 after India and China and that our locally-trained health care professionals contribute significantly to the health care team pool in developed nations, these figures become more significant and thought-provoking.Also noteworthy is that the USA, for instance, estimates that the demand for health care professionals in the years to come would outstrip the supply.
Another intervention that we expect of the government in revitalising the health care sector is the introduction of a drug pricing regime. The growth of the retail and hospital pharmacy industries has been severely hampered by the absence of this; the result of which is a price competition that helps no one, least of all expensively-trained health care professionals who are less competitive than the quacks who bear a lower operating and overhead costs.
With improved demand for care – created by a sound health financing policy, and proper legislations that create barriers-to-entry for quacks, the result would be a more investment-friendly health care sector which would not only result in a reversal in the brain drain syndrome, as earlier stated, but also strengthening of the local pharmaceutical industry which should continue to enjoy particular preferential treatment in the areas of access to finance and purchases by public organisation.
Another opportunity the government would do well to pursue is in a critical evaluation of the educational structures for health care personnel. The country certainly needs more health care professionals, who would stay and work in Nigeria. Not only is the health care brain drain an outright subsidisation of health care in developed nations but it should equally be noted that a sizeable volume of finances is expended by health care professionals on gaining postgraduate education.Should we aggregate this demand under a structure – say for example, the Nigerian–University College of London Health Care programme, which offers a variety of postgraduate health care courses, even at similar overseas costs, the result would be an education that is tailored to meet the unique challenges of Nigeria, led by dedicated scholars.
We believe that if implemented, this proposed programme, which should encompass the pharmaceutical and biotechnology industry with a management touch, would greatly help in sustaining the top-notch academic dialogue and knowledge development required to lead the necessary changes in the different aspects of our health care sector.
While some of the suggested initiatives may appear demanding in the light of prevailing circumstances, we believe that it is only with the desire to rethink the current system and a commitment to evaluating innovative ideas for feasibility that we can find practical solutions to the myriad crippling our health care sector.