The Nigerian Medical Association (NMA) has raised the alarm once more over the worsening state of the nation’s health sector underscored by the relentless exodus of Nigerian doctors to overseas. The Chairman of the Lagos Branch of the NMA, Dr. Saliu Oseni, recently observed that the problem became worse in the last two years. Available records show that on the average about 50-60 doctors leave the service of the Lagos State government every six months. If this is the state of affairs in Lagos, which is regarded as the “Centre of Excellence,” the situation in other states is better imagined.
It is, indeed, lamentable that the health sector is deteriorating on a daily basis across the country, while the government is not doing much to revamp it. Sadly, most primary health care centres across the country are in dilapidated conditions. It is worrisome and even appalling that those in authority have allowed the decay in the health sector through inadequate funding. There is no doubt that the rot in the sector did not begin today. The inability of the government to implement pragmatic health policies might have contributed immensely to the rot in the sector
While the World Health Organisation (WHO) recommends 1:100 doctor-to-patient ratio, in Nigeria today, it is about 1:500. Nigerian doctors work for long hours these days. On the average, a doctor in Nigeria sees not less than 100 patients daily in the urban centres. Therefore, the working condition of Nigerian doctors can be frustrating. It must be pointed out that doctors are highly trained professionals who spend about six to eight years in the medical schools before they qualify to practice. The courses of study are usually very rigorous. As a result, it is very expensive to train a medical doctor. It is unfortunate that doctors now face all kinds of challenges securing job placements. Some of them do not find it easy getting places for specialisation.
The most frustrating part of the journey to self-actualisation and career fulfillment for the medical doctors is perhaps in his work environment. The physical infrastructure and tools to do the job are grossly inadequate. Nigerian doctors are among the least remunerated in the world. This can explain the mass exodus of Nigerian doctors to foreign land where the working conditions are favourable.
The federal and state governments must do something urgently to stem the ugly tide of doctors’ exodus. There is no way our health sector will be developed with the frequent migration of our doctors to Europe and America. First, government at all levels must proritise healthcare. It is a well-known fact that one of the best ways to develop the human capital of any country is to pay adequate attention to its health and education. But what do we find in Nigeria? Successive governments have paid less attention to these two key sectors with budgetary provisions declining to a dismal average of between four and six per cent of the total yearly. Bill Gates recently explained why governments in the country do not invest enough in health and education. He traced it to the poor GDP to National Revenue ratio, which is a paltry six per cent and one of the lowest in the African.
This should be enough cause for concern. The best way to redress this problem is for governments at both the national and sub-national levels to find the political will to change the sad narrative in the health sector. This can be done by substantially cutting the cost of governance and use the savings to resuscitate the health and education sectors. It is a given that government alone may not be able to revamp the health sector. This is the time therefore for all the stakeholders to find creative ways of enhancing the money allocated to the health sector. Specific and well-targeted special funds and taxes could be introduced to aid the sector.
The growing medical tourism is another problem undermining the funding of the nation’s health sector. The time has come to stop the flourishing medical tourism. If the nation’s centres of medical excellence are working effectively, many Nigerians that embark on medical tourism ought not to have done so. Above all, let the Federal government initiate good policies that will improve the nation’s healthcare delivery system. Government should pay urgent attention towards improving the remuneration of doctors and other workers in the health sector. Doing so will stem the current exodus of Nigerian doctors to foreign countries.
