It’s time for Health for All

It’s World Health Day 2023!!!

The year’s theme is “Health for All”. This aims to broaden the conversations and enhance actions that will birth universal healthcare, a situation where everyone is able to access healthcare regardless of their ages, gender, colour, race, physical or mental ability, religion and socio-economic status. While I dream of a brighter future for the health sector in Nigeria, Africa and the globe, I had to reflect on the points of concern and worry first as a Nigerian, then, as an African and finally as a global citizen knowing how well global travel, interconnectivity and global economics can affect the health of individuals, families and communities.

The exodus of doctors from the shores of Nigeria in droves continues without end and on a daily basis. This contributes to massive understaffing, poor motivation and brain drain in the medical field and as a result, poor health outcomes. Doctors who remain are fatigued, overworked, poorly renumerated and left to work with obsolete equipment due to poor investment in healthcare. Wealthier, more advanced countries continue to poach Africa for medical professionals who will seemingly be paid lower wages compared to their counterparts but deliver at the best of their abilities. The economic disparities across continents makes this a very easy “Apple” to sell in the Nigerian market as medical professionals look out for more improved economic realities and have recently topped the list of the “Japa” crooners. 

The Primary Healthcare System today looks largely underutilized as they are poorly staffed and over 90% of PHCs in Nigeria work averagely 6-8 hours daily, on weekdays only. One is left to wonder if ailments will wait for weekdays to happen or rather, only happen when the PHCs are opened within the hours that they work. This situation has led to a massive distrust in the services of PHCs and an overflooding of secondary and tertiary facilities with patients who should ordinarily have been attended to at the PHC level. 

Poor investment in healthcare across various levels of government continues to narrow the path to “health for all”. In April 2019, the President of the Nigerian Medical Association, Dr Francis Faduyile confirmed in an interview with the Punch Newspapers that Nigeria had only 8 radiotherapy centers where Cancer treatment could be done and of the 8, only 4 were functional. He also confirmed that there were only 143 kidney dialysis centers across Nigeria in both public and private hospitals. It is worthy of note that in 2021, the Federal Government of Nigeria approved 12 new chemotherapy centers where Cancer treatment can be done. This is however a far cry as Nigeria’s over 180 Million estimated population will need at least 200 cancer treatment centers. Also, there is little or no coverage for cancer with the National Health Insurance Scheme and as well, most Health Management Organizations (HMOs) even as the mortality rate from cancer cannot be ignored. Asides cancer, similar is the issue for various other deadly diseases.

Today, out-of-pocket expenses represent about 70% of total expenditure on healthcare in Nigeria. This is sad considering the large number of people who live below the poverty line and are unable to afford secondary and tertiary healthcare expenses. The National Health Insurance Scheme continues to expand its scope and coverage but there is need to overhaul the country to get as many people as possible into the scheme especially for Primary Healthcare Services. 

Even with increasing awareness, emergency preparedness and first-aid knowledge is not widespread. Many accidents result in preventable deaths simply because the people are largely unskilled or have no ready facilities to tackle emergencies in the public places and our homes. Community health workers are lacking in most communities and everyone looks to various sources in addressing their health challenges. The health seeking behaviors of Nigerians is anything but encouraging.

So, what must we do to turn the tides for #Healthforall ?  

1. Increase Investment in Healthcare: Governments across all levels must increase strategic investments in healthcare with the aim of providing/making available adequate infrastructure, technology, facilities, knowledge, pharmaceutical supplies and financial sustainability for healthcare professionals.
2. Overhaul the Medical Education curriculum: Ministries of Education must enhance the quality of education and training for medical students and professionals across all levels. This will massively upskill the medical workforce to provide quality healthcare for all.
3. Nurture Sustainable Partnerships: Partnerships between governments, NGOs, private sector entrepreneurs, funding organizations and logistics service providers in the health sector to ensure elimination of bottlenecks in the pharmaceutical distribution chain and promotion of various community-based health interventions.

There’s a lot more to be done and this list can never be exhaustive. The bottom line nevertheless is that all hands must be on deck to ensure health for all. 

You have a huge role to play, I have a huge role to play, we all have a huge role to play. Let’s all play for Universal healthcare. 

Happy World Health Day 2023!

Abdulbasith Sijuade Akinyemi-Eshilokun is the Executive Director at Health Volunteers Nigeria Initiative.