By Professor Friday E. Okonofua
The National Hospital was conceived as a specialized women and children hospital under the poverty alleviation project of then-wife of the military Head of State, Mrs. Maryam Sani Abacha. It was established under Decree 36 of 1999 (Act 36 of 1999) as the National Hospital for Women and Children, and formally opened on September 1, 1999.
I can remember with nostalgia how those of us obstetricians and gynecologists throughout the country welcomed the establishment of the specialized women hospital at the time, as we envisioned that it would provide a fulcrum for the improvement of all indicators of women and children’s health that still remain poor in the country till this day. Unfortunately our hope did not last very long as the name was soon changed to the ‘National Hospital’ on May 10, 2000, ostensibly to enable the hospital designed to offer more comprehensive specialist medical care that includes all components of health care delivery. The hospital was then placed under the supervisory function of the office of the Secretary to the Government of the Federation, possibly to strongly position the hospital to proffer services to officials of government.
The expansion of the hospital from a specialized women hospital to a comprehensive specialist public hospital also had a second rationale. Although not explicitly stated at the time, it was to cater for the health needs of high level public officials who were then relocating from all parts of the country to Abuja. At that time, Abuja had no public hospital of note. Therefore, government may have conjectured that, with the rapid influx of personnel from various parts of the country to Abuja, and not having a centralized public hospital, a National Hospital would be needed to fill the gap and provide comprehensive health care able to address the immediate health needs in the city at the time.
Given the passion for national recovery, especially within the context of the new democratic process, and with “the can do spirit” that permeated throughout the country at the time, it was possible that the new democratic government also wanted to create a national hospital of the type that will stem the proclivity for the use of overseas hospitals for medical care by public officials. Our hope at the time was that the Federal Government would develop the National Hospital to such a level that it would become a national reference hospital of the type that will compare with some of the very best in other parts of the world.
In this regard, it is appropriate to critically and objectively assess whether, indeed, some of the expected outcomes of the hospital have been achieved after 20 years, considering the magnitude of the human movement to Abuja from other parts of the country over the past years.
The reflections in this presentation have been structured in four major segments. In the first part of the presentation, I will present a strategic framework to enable the understanding of what a National Hospital of the type envisaged for Abuja ought to be, drawing from experiences from in other parts of the world. In the second part, I will try to describe, as best as possible, what I know of the current functioning of the National Hospital, especially to identify the areas of strengths and some weaknesses that need to be addressed. A specific question that will be answered in the second section of the paper is whether the National Hospital, Abuja has been able to meet the expectations of its founding fathers in staunching the use of overseas medical care by Nigerians, and in paving the pathway for reducing the burden of disease in the country.
In the third session of the presentation, I will discuss the leadership role that the National Hospital, as the flagship tertiary health institution, should fill in enabling the country to address some of the most daunting challenges in the delivery of composite health care. In the final section, I will make recommendations on ways to strongly position the hospital to take over the leadership role it deserves in moving this country’s health care delivery to a higher pedestal.
To continue next week