BY CLIFFORD NDUJIHE
SENATOR Hope Uzodimma has described as incredible and treasonable, Governor Murtala Nyako’s letter to 18 northern governors claiming that President Jonathan, being an Easterner, was using the excuse of Boko Haram to kill innocent Northerners.
Senator Uzodimma said it was sad that a man who swore on oath to protect the interest of all Nigerians irrespective of tribe or religion could descend so low to incite other ethnic groups against Ndigbo and Easterners, adding that it appeared the Adamawa State governor “is preparing the grounds for another progrom against Ndigbo.”
He said while delivering a lecture titled “Healthcare Delivery in Nigeria: Challenges and Prospects,” last Thursday:“Let me, therefore, seize this opportunity to warn that Ndigbo and indeed Easterners will hold Governor Nyako responsible for whatever happens to them in the North henceforth. Be this as it may, I advise Governor Nyako to immediately apologize to Ndigbo and the Federal Government over his unguarded utterances or take full responsibility for the fate of Ndigbo in the North henceforth,”
Senator Uzodimma condemned the murderous activities of Boko Haram, saying that the essence of good health is to preserve our God-given life, adding: “You must, therefore, appreciate why I was jolted to read of the letter written by Adamawa State Governor, Murtala Nyako to his colleague 18 State governors asserting that President Jonathan being an Easterner is using the excuse of Boko Haram to kill innocent Northerners. The governor said Boko Haram is a phantom organization and that President Jonathan is only replicating the killing of Northern Political elites of 15, January, 1966, which he said was done by Easterners.”
Looking at the healthcare situation in Nigeria, which he dubbed “the health of Nigeria and Nigerians,” Uzodimma said there is need to boost healthcare delivery because “a healthy nation is undoubtedly a wealthy nation. It takes a healthy populace to be productive and it takes productivity to create wealth. A nation populated by healthy people will therefore have, in abundance, a productive citizenry that will create wealth for their nation.”
Defining healthcare as: “The totality of the provision of medical services to a people; the process and facilities for the diagnosis, treatment and prevention of any form of disease or illness as well as other human physical and mental impairments; the work carried out by medical practitioners in the actualization of the treatment and prevention of diseases,” he decried the parlous state of healthcare in the country in spite of the efforts of the three tiers of government. Despite having 34,173 health facilities across the country made up of 30,098 primary healthcare facilities located in the rural areas; 3, 992 secondary facilities and 83 tertiary facilities with the government owning 22,850 of these facilities while the rest 11,323 are privately owned, the senator said the facilities are grossly inadequate. How? Matched against a population of 150 million people, the availability of the facilities is at the ratio of 3750 people to one.
Although, Nigeria has one of the largest pools of human resources for health in Africa comparable only to Egypt and South Africa with about 66,162 medical doctors; 148,343 nurses; 101, 709 midwives; 1,400 medical Radiographers and 15, 911 pharmacists, Uzodimma lamented that the status of healthcare delivery in Nigeria offers little to cheer about. His words: “The 2011 MO Ibrahim African Government index rates Nigeria as 51 out of 53 countries in Africa. This implies that Nigeria has one of the worst healthcare delivery systems in Africa. Indeed our rating in the West African sub-region confirms this. Nigeria is ranked 13 out of 16 West African countries in healthcare. Ghana came first in the sub-region and seventh in Africa.
“It is instructive that one of the factors that informed this disastrous rating of our health service provision is the alarming number of Nigerians seeking for medical treatment abroad, particularly India. A recent survey revealed that 20 per cent of foreigners seeking medical attention in India were Nigerians. What a shame! The medical treatment exodus is not restricted to India. Indeed many Nigerians are known to also seek medical attention in the United Kingdom, United States, France, Italy, South Africa, Egypt and even our next door neighbour, Ghana.
High disease burden
This suggests that Nigerians have already passed a vote of no confidence on their healthcare system. It is also a statement of fact that Nigeria is said to shoulder 10 per cent of the global disease profile due to high disease burden in the country and our relative large population.
“National Demographic Health Survey puts the life expectancy of Nigerians at 47 years. The least Developed Countries (LDC) average life expectancy age is 57. This means that the life expectancy of Nigeria is 10 years below that of the least developed countries. Also, Nigeria’s life expectancy at birth is lower than that of most countries with either lower or higher human development index (HDI).”
Implications of healthcare delivery indices for Nigeria: Asserting that the Nigerian healthcare delivery system is not as robust and effective as it should be because a lot of preventable diseases still kill many Nigerians, maternal and child mortality is still high and malaria remains the highest killer of our citizens, the lawmaker said ordinarily Nigeria has all it takes to do better than it is currently doing. He identified poor funding as one of the factors militating against healthcare in Nigeria as household Out of Pocket Expenditure (OOPE) has remained, by far, the largest source of health expenditure in Nigeria. Quoting the Federal Ministry of Health, he said OOPE in Nigeria was N489.79b in 2003 N656.55 b in 2005, and now accounts for about 70 per cent of total health expenditure in the country.
“Technically speaking, this will mean that the health of Nigerians is in their hands and not in the hands of their government. This assertion is made even more lurid by the following figures from the FMOH. It revealed that the estimated health expenditure of private firms grew from N20.32billion in 2003 to N29.67billion in 2005. Contributions from the development partners to health sector stood at N48.02b in 2003 and increased to N78.78billion in 2005.
“Quite startling are the contributions from the different tiers of government within the same period. Federal government contributed just 12 per cent of the total expenditure, state governments 7.6% and local governments 4.5 per cent. This will mean that all the governments combined contributed just about 24 per cent of the total expenditure. It is crystal clear therefore that it is Nigerians who practically fund their health expenses. It is even clearer that the Nigerian governments have not been able to meet with the recommendation of the World Health Organization that a minimum of $40 should be spent per head on health in a given population. I am sure that at this point you will agree with me that the different tiers of government have truly not injected enough funds into the health sector to ensure effective and efficient healthcare delivery system in the land. This explains the huge economic burden of healthcare expenditure on households in the country. Sadly, majority of these households are the poor helpless Nigerians.”
Prospect for healthcare in Nigeria: He noted that the Federal Government has done and is doing a lot to improve on the system especially through the Subsidy Reinvestment and Empowerment Programme (Sure-P). He has recruited 3, 960 healthcare workers to provide quality antenatal, skilled birth delivery at birth and post-natal services for previously underserved rural, poor women ;enhanced access to maternal, neonatal and child health services in 500 SURE-P supported primary healthcare (PHC) centres across the 36 states and FCT and initiated the supply of essential drugs, health commodities and medical equipments to all 625 SURE-P supported primary and secondary health facilities, got all state governors and the FCTA Minister to sign a declaration to improve health outcomes in Nigeria. He hoped that state governments would take a cue from the Federal Government.