Sunday Vanguard spoke to the President of the Nigeria Medical Association, Professor Mike Ogirima, on how the country’s health sector has performed in the outgoing year. To him, the country’s health indices are far from getting better.
How do you assess the health sector in the last one year?
In the last one year, the health sector in Nigeria has witnessed some mixed kind of development. We have had issues with government not implementing certain programmes that would have improved the indices of the health of Nigerians, particularly the National Health Act, NHA, which was passed in 2014.
Again, we thought the 2018 budget will capture certain privileges for the vulnerable population: The pregnant women, children under 5 and road accident victims. One per cent of the consolidated revenue should have been set aside as basic health trust fund for such group of people. In the budget as presented, I have not seen whether that is realisable in 2018.
This is the third year since the law was enacted; so we need constant advocacy not only from health practitioners but also from the people in the media to remind government to do the needful because, even if you have three per cent of our population captured under the National Health Insurance Scheme as it is today, without extra funding, we cannot get it right.
We can now talk of Universal Health Coverage, UHC, which means every Nigerian should be able to access health, no matter how little, from the comfort of his room and get better.
Rehabilitation of 10,000 PHCs
Then, government healthcare programme in the past has not had clear cut direction. This government tried to say when they came in that they want to rehabilitate 10,000 primary healthcare centres. This is their third year; Nigerians should be able to ask: where are we on rehabilitation of the 10,000 health centres?
And we are talking about just rehabilitating the structures; we want them to be functional. We want the personnel to be there and involved in the people’s health. We want basic antenatal care and we want immunization to be given at the primary healthcare centres. And when you look at the Teaching Hospitals, are they faring well? No, because most of them cannot render the services they are meant to render.
Doctors are supposed to be trained to become specialists. Over the years, that has suffered neglect due to lack of funding. We are not training doctors to become specialists and that is dangerous for our country.
I can go on and on and on, but the summary is, Nigeria is not moving. In 2001, Nigeria was part of the African declaration that at least 15 per cent of our annual budget should be put into health. Nigeria is still struggling between 3- 4 per cent. Meanwhile, some African countries are already going beyond 15 per cent and you cannot see the effect of that in their healthcare indices. Nigeria is still far behind.
Looking at it holistically, if you compare the 2018 budget with the 2017 budget, there is marginal increase in the amount of money budgeted for health. But go back to the 2017 budget, how much of that, that was budgeted was released? It is very small.
For capital budget, I am sure it is around 20 per cent. Of course, you could say that recurrent expenditure, staff emolument, government tried to pay but not all staff are receiving 100 per cent of their emolument at the end of the month. In 2018, the capital budget for health is N71billion; that is N20billion above what was budgeted last year but how much was released from the N51billion that was budgeted last year? Only 20 per cent.
Implication of the 2018 budget for health
Government must disburse the budget promptly no matter how small; that will go a long way to have some effect on what we are having now.
Quacks in practice
To make medical practice better and drastically reduce quackery, we have introduced what we call ‘doctor’s stamp’. As an association, the stamp is to identify who a real doctor is and that stamp is available to any doctor that has renewed his license and is practicing. So, as a patient, you have the right to demand for that stamp and a genuine doctor will show you.
We are planning to partner with the Nigerian Union of Journalists, NUJ, to sensitise Nigerians. We have done it on social media. If you Google, you will get the doctor’s stamp. The authorities and the regulatory bodies have cued into it that is one way of stemming quackery.
How do you assess state governors in terms of health projects?
I can mention some governors that we have praised. Governors of Yobe, Kano and Lagos states have blazed the trail in healthcare and that is why our members are giving them awards. I will not recognise any state that is under performing in health. They know themselves. There are states owing doctors, there are states that are paying 25 per cent of salary to workers. The people know the governors that are meeting their health needs.