Health Sector Review in 2013: Divergence, Insufficiency Halt Growth

December 30, 2013 5:31 AM

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The health sector, just as in yester years has always been plagued by crisis. 2013 is not exempted as this sector went through upheavals occasioned by government’s lack of consistency in policy formulation and enforcement.

In 2011, the Federal Government allocated four per cent of the year's budget to the health sector, it was then increased to five per cent in 2012 and it was increased to 6.04 per cent of the budget in 2013 as against the 15 per cent of the total annual budget as recommended by the World Health Organization (WHO) and the 2001 Abuja declaration of African Heads of Government.


Visits to health facilities give a clear picture of the inadequate and inequitable distribution of medical doctors in the country. It is clear that Nigeria has not met the World Health Organisation (WHO) prescription of one doctor to 600 patients. Also, while it is easy to find specialised doctors in the urban areas, it is normal to get community health workers, nurse aids or perhaps, pharmacy assistants in the rural areas.

A report given by the Nigerian Medical Association (NMA) shows that, there are over 3,500 Nigerian trained physicians actively practicing in the United Kingdom. "Many more are in the United States of America and other nations of the world, and several are still leaving on a daily basis. This is partly due to the unavailability of functional equipment/tools in the workplace, unhealthy competition in the health sector as well as a not too conducive work environment."


It is distressing to note that major healthcare deliverers have downed their tools twice this year as the National Association of Resident Doctors downed their tools and shunned work for almost two months as a result of the fall out of the Integrated Personnel Payroll Information System (IPPIS) which was introduced to government owned hospitals.

The Nigerian Medical Association recently directed all doctors in government institutions to also embark on a nationwide strike starting Wednesday 18th December, 2013. They embarked on the strike to show their grievances towards the neglect of their requests bothering on workplace conditions and injustice meted out to doctors in their conditions of service and funding, infrastructure and equipment upgrade of the health sector, which have not received any significant attention from the government.

However, in a statement signed by the NMA president, Dr. Osahon Enabulele said, rising from its Emergency Delegates Meeting (EDM) at Minna on December 14, Nigerian doctors shall not hesitate to commence a full blown strike action from 8am on Monday, January 6, 2014, if the government does not satisfactorily resolve their demands- the cycle goes on.

National Health Bill

Following the 2000 UN ranking of the country as 187th among 191 countries due to poor health indices, there was a reawakening by government to immediately do something, thus the journey towards the birth of the National Health Bill.

In 2004, the first draft of the Bill went before the National Assembly and it suffered setbacks and backlash but, by 2011, it managed to scale the passage of the Assembly only to be nailed at the Presidency because President Goodluck Jonathan failed to assent his signature due to unclear reasons.

Now, the Bill which has been represented before the Seventh Section of the NASS has had its first public hearing and, from all indications, it appears another round of open attack may be brewing especially among stake holding operators on composition of Technical Committees and sundry issues.

The passage into law of the National Health bill has however been swept under the carpet. It would be recalled that groups and associations have spearheaded campaigns to pass the national health bill into law; the national health bill signifies an important and bold step to positively turn around the fortunes of the health sector.

Non-passage of this bill will mean that many ordinary Nigerians will be lacking in basic requirements necessary for good health. Experts have posited that a public private partnership will go a long way in turning around the story of the Nigerian health sector.


Just two years to the deadline for the MDGs, Nigeria lags behind in attaining the goals.

Stakeholders at the 56th National Council on Health meeting held in Lagos in August 2013, agree that a lot more still needs to be done for effective healthcare delivery especially in the attainment of the Millennium Development Goals (MDGs).

According to the Executive Secretary of the Health Reform Foundation of Nigeria, Dr. Mohammed Lecky, the health sector is very challenged with gross inadequacies and disparities of resources.

Lecky said, "for now our health sector is very challenged, clearly we don't have enough resources to do what we need to do, not just money, even adequacy of human resources and what we have are not deployed maximally, that is a problem and we are not performing well."

On the MDGs, he said, though, the MDG- 4 which aims to reduce child mortality has recorded some progress since 1990 till date but there are still some disparities from some states in the north-west and north-east.

“We are making progress but the overall performance falls short of the target. In these, there are disparities across the country. Southwest is actually on course to meeting MDG-4 and 5, but the general performance is not doing well.

Most of the deficits are coming from the northwest and northeast. Nigeria indeed has a vast abundance of health sector access, with over 34, 000 health facilities, but there are issues on the level of functionality, dilapidation, gross inadequacies, all leading to dire deficit and constraint to service delivery and confidence in the system.”

Lecky also said, Nigeria also has human resources worth of 39, 210 doctors and 124, 629 nurses but the issue of distribution still plagues their effectiveness, while life expectancy (47 years) is comparatively low compared with developed countries of the world.


Statistics show that Nigeria loses N78bn ($500m) annually to medical trips abroad.

Earlier this year, Enabulele said, “We lose at least $500m every year to patients travelling abroad for treatment. India makes $260m from Nigerian patients annually. It is estimated that this year alone, India would gain between $1bn and $2bn from medical tourism. Our patients are part of the people that make that sector boom. Something must be done; this figure should provoke some actions from our government.”


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