In what was termed the Abuja Declaration, African Union countries in April 2001 met and pledged to set a target of allocating at least 15 per cent of their annual budget to improve the health sector. Sadly, 19 year after that pledge was made Nigeria has failed to meet the AU allocation target. The result is poor health infrastructure, lack of equipment and drugs in hospitals, strikes and inadequate personnel, leading to very frightening low doctor-patient ratio.
To say that Nigeria is facing health management crisis is to say the least in the mildest way. Most of our hospitals have been turned to mere consulting clinics due to negligence by successive administrations.
Head, Human Resources for Health in the federal ministry of Health, Shakuri Kadiri, highlighted this much recently when he said that Nigeria has one doctor to 2,753 patients. At the launch of the Nigeria Health Work Force Country Profile and handover of the Nigeria Health Workforce Registry by the ministry in collaboration with the World Health Organisation (WHO) and other partners in Abuja, Kadiri noted that the profile put the number of medical doctors registered with the Medical and Dental Council of Nigeria at 74,543. This implies that there are 36.3 medical doctors per 100,000 population.
Similarly, the National Universities Commission (NUC) recently said that Nigeria needs about 300,000 medical doctors to meet the doctor-patient ratio of 1: 600 recommended by the World Health Organisation. Speaking at the maiden matriculation of the Bayelsa Medical University, Amarata, Yenagoa, executive secretary of NUC, Prof Abubakar Rasheed, said the current doctor-patient ratio in the country stands at 1:3, 500.
Rasheed pointed out that this was among the several challenges bedeviling the nation’s health sector. He added that the 3,000 doctors produced yearly by the nation’s medical schools are not enough to meet the WHO standards to deliver on health care services.
Also, the Nigeria Medical Association (NMA) has not relented in raising the alarm over the low ratio of medical doctors to patients in the country. A former President of NMA, Prof Mike Ogirima, once expressed concern when he was in charge of the professional body. He said that it was ironical that Nigeria, with such a poor ratio, could not afford to absorb products from her medical schools. He expressed dismay that many medical doctors have been left without jobs, while many others go to seek succour in other countries.
There is also the disconcerting report that no fewer than 5,405 Nigerian –trained doctors and nurses are currently working with the British National Health Service (NHS) in the United Kingdom. The figure released by the British government means Nigerian medics constitute 3.9 per cent of the 137,000 foreign staff of 202 nationalities working alongside British doctors and nurses.
It is feared that many more Nigerian doctors would join their colleagues soon because the UK is in dire need of medics from Commonwealth countries since some doctors in the European Union (EU) are already leaving because of Brexit.
Nigerian doctors and nurses are leaving for the UK and elsewhere because of better conditions of service. The migration has further worsened the physician-patient ratio in Nigeria resulting in longer waiting time at hospitals, rise in fatal disease outcomes, and more frequent medical errors by overworked doctors. According to WHO, countries with low physician-patient ratio have worse disease outcomes and life expectancy.
The mass exodus of Nigerian doctors has been blamed on poor remuneration for medical doctors, poor working environment and inadequate medical equipment and infrastructure. It is sad that Nigeria is using her resources to train doctors and professionals that will leave to work in foreign countries. The question is: what are those things attracting these doctors outside? Can we duplicate them here? Yes, we can!
As a newspaper, we believe that government can nip the situation in the bud by providing adequate remuneration for doctors and other medical personnel. We are not saying they should be paid so much, but they should be paid for the job they are doing as and when due.
The situation, in our view, could be reversed if the federal government makes the National Insurance Scheme (NHIS) compulsory for all citizens. This will provide enough funds to improve the conditions of service and working environment for health professionals. Government at all levels must as a matter of necessity make working conditions attractive for medical doctors.
A situation where a doctor comes to work and is scheduled to conduct a surgery but there is no electricity is unacceptable. Government needs to be more drastic in reorganising the way health service is funded. There should be compulsory NHIS that will attract adequate funds.
There is urgent need for huge investment in health care services by all stakeholders to mitigate the acute shortage of manpower and services in the sector. Federal and state governments must work to meet the allocation target set by the Abuja Declaration, even as they ensure that remuneration for doctors is such that they will not be tempted to leave in search of greener pastures abroad. They should prioritise the welfare of doctors and provision of medical infrastructure needed to reposition health services in the country.