By Sola Ogundipe

The troubles confronting  health care delivery in Nigeria are legion. Even as he gets set to carry on with the mantle of leadership at the federal level of government, President Goodluck Jonathan already has his work cut out. Presumably, he is under no illusion about the Herculean nature of the task ahead.

Mr. President probably appreciates, already, that all but few public health institutions of national standing  can boast of a robust health care delivery. To be exact, he needs to admit, first and foremost, that the hallmark of healthcare in Nigeria today consists of unhealthy doses of insincerity, inadequacy, inefficiency, ineptitude, and shocking inconsistencies.

Although the nation’s health system has been undergoing reorganisation since the Bamako Initiative of 1987 with the promotion of community-based methods to increase accessibility of basic health care services, drugs and sundry matters, the erosion of confidence in the health sector, has, unfortunately, continued.

From decaying or decayed infrastructure, obsolete equipment and facilities, proliferation of quackery, the fake drug syndrome, shortage of doctors, nurses, laboratory technicians and other skilled personnel (the brain drain factor), the current state of the nation’s health care system is more than enough to give anyone, not to talk of Mr. President, sleepless nights.

With one of the highest child and maternal mortality rates in the world, coupled with one of the lowest life expectancy rates, the very fabric of existence of the Nigerian is constantly under threat.

Wasteful allocation of funds, poor planning and implementation of policies has been the hallmark of the health sector over the past decade. For instance in 2010, $1.0bn was proposed in the federal health care budget, but it is questionable exactly what percentage of this was actually disbursed on improving outcomes within the sector.

Indeed, over the last decade, it is questionable what percentage of the federal health budgets was actually spent on improving the quality of health of Nigerians.

Without a vibrant healthcare sector, the sustainability and viability of the nation’s economic and social growth will remain in jeopardy. In the absence of an adequate healthcare system, it is no surprise there is no steady economic growth.

However, the heavy disease burden, poor health indicators, exemplified by high maternal and child mortality rates is unacceptable.

One wish that every Nigerian cherishes so much is not to die of treatable and preventable disorders, simply because there is no comprehensive health plan put in place to guarantee access to affordable and comprehensive healthcare services that would ultimately improve their lives.

Today, access to quality healthcare is either limited or non-existent, or, where available, comes with enormous financial burden. This could justify agitations that the structure of the National Health Insurance Scheme (NHIS) may require looking into to extend its potential benefits to the Nigerian masses.

If the President hopes to guarantee access to affordable health care, the way to go about it is by restoring harmony among the healthcare providers while ensuring better legislation to preserve the national health care system through a realistic policy drive.

There is no doubt in the minds of the teeming millions of the Nigerian populace that President Jonathan would do better, this second time around, if he is focused on structurally addressing challenges facing the health system through restructuring, rather than focus primarily on addressing symptoms such as health workers’ strikes over agitations for better remuneration and working conditions and the like.

In addition, the issue of promoting medical and scientific research cannot be overstated at this point in time. The President must appreciate that, to a large extent, addressing the challenges of the Nigerian health sector must necessarily begin with the creation of an enabling environment.

What Nigerians expect of the administration in the new dispensation, is to strengthen existing national health intiatives and programme, making them more structurally and fundamentally viable. Strengthening the weak mechanisms on which the system currently operates is non-negotiable.

Everyone knows that one of the key elements of a sustainable and efficient healthcare delivery system is provision of regular power supply. Therefore, Mr. President must endeavour to resolve, once and for all, the electricity power crisis that has remained the albatross of the nation’s industrial sector over the years.

Nigerians are urging the President to critically look into the introduction of new policies that will decentralise the generation, transmission and distribution of power in the country with total deregulation, to make life easier for Nigerians. A good example is the private-public participation, PPP, initiative could be better harnessed to drive the transformation process within the health care market.

The take home for Mr President, here, is that anything short of a patient- oriented healthcare system would be inappropriate and unacceptable. It would gladden the hearts of many if a national and health system with provision for incentives and flexible structures for local and foreign investment is built up.

The competitive demand for a patient-motivated healthcare delivery system with the sole purpose of attaining acceptable recommendations for patient satisfaction is stronger now in the nation’s history more than ever.

It’s up to President Jonathan to leave a legacy of good health to all Nigerians, or go the way of his fore- bearers. Good luck, Mr. President.


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