For a country working towards achieving the Sustainable Development Goals (SDGs), the state of public health facilities is a cause of deep concern. Both at state and federal levels, public health facilities face an existential challenge.
Public officials, sometimes at the expense of national security, often jet out of the country to get medical help whenever they face a crisis. This is tantamount to passing a vote of no confidence in our healthcare system. Infectious diseases, control of vectors, maternal and infant mortality as well as poor hygiene, disease surveillance and road traffic injuries are still major challenges.
The 2019 WHO Global Status Report on non-communicable diseases listed Nigeria and other developing countries as the worst hit with deaths. Cardiovascular disease, tuberculosis, hepatitis, cancer, diabetes, chronic respiratory diseases, sickle cell disease, malaria, asthma, coronary heart disease, obesity, stroke, hypertension, road traffic injuries and mental disorders are on the increase. Life expectancy at birth, as of 2021, hovers around 59 years for male and 63 years for female.
In addition, inter-sectoral cooperation and collaboration between the different health-related ministries remain a major issue. This is a critical issue affecting public health care delivery in Nigeria despite the collaborative efforts of the government, donor agencies and NGOs.
The problems have been attributed to irrational appointments, inadequate payment of medical workers’ salaries, poor quality of care, and inequitable healthcare services for even the sector’s workers among others.
There are also the issues of uncompleted agenda on the containment of infectious disease as well as the emergence of non-communicable diseases. There is shortage of health workers as a result of economic and social brain drain.
It has been estimated that there are only about 27 physicians per 100,000 people in Nigeria as against the WHO’s recommendation one to 600. These multifaceted challenges are compounded by poor economic policies, socio-political factors in the country’s history and limited institutional capacity to provide efficient responses at the population.
To address these problems the government should collaborate with other international health institutions to do the needful to achieve an efficient and effective system.
Construction of additional medical facilities is urgently required across the nation, with remote areas given priority. Existing health centres should also be rehabilitated and upgraded. Recruitment of more medical practitioners and provision of a conducive working condition for them will also go a long way in resolving the health crisis in the country.
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On mental health the government should continue to promote the ideals of International Health Regulations (IHR) while working with relevant agencies to curtail drug abuse incidences as well as curb the spread of fake or expired drugs and their subsequent abuses.
There is also the critical issue of how Nigerian public officials manage their health. By now the Freedom of Information Act of 2011 ought to have removed the aura of mystery and exclusion with which most public officers conduct public affairs. There remains a shroud of secrecy on the health status of most public officials. This is akin to the secrecy that obtained in the colonial era Official Secret Act (OSA) of 1911.
Public officials hardly ever declare their health statuses before and when in office. This should stop. Nigerians deserve the right to know how healthy the persons who lead or who aspire to leadership positions are. The health challenges of incumbent President Muhammadu Buhari has caused the nation a great deal. All these must change if Nigeria is to overcome the crises she faces at the level of public health.
We therefore call for the enactment of a law that compels all public officer to declare their health statuses and how they are managed. Management must be by designated public health institutions. In the 1970s, the First Lady of the nation, Mrs. Victoria Gowon, gave birth at LUTH.
The Teaching Hospital at Ibadan attracted persons from the Commonwealth. Candidates seeking public office in the 2023 general elections should give evidence of good health. This, as part of the social contract between the officials and the electors, will compel state officials to improve health services in the country.
Nothing describes conflict of interest and sabotage more than public officials using private health facilities both at home and abroad.
