Despite having 29,362 public health facilities in the country, many poor health-seeking Nigerians die as a result of poor facilities and absence of specialists in the facilities.
According to the Nigeria health facility registry by the Federal Ministry of Health, there are 40,017 operational hospitals and clinics in Nigeria and 29,362 of these facilities are owned by the government while 10,655 are private.
The data shows that there are 28,036 public primary healthcare centres, 1,226 secondary health facilities and 100 tertiary health facilities in the country, totalling 29, 362 government-owned health facilities across the country.
Katsina, Niger and Benue states have the highest numbers of primary healthcare centres at 1,837, 1,338 and 1,236 respectively.
Delta, Akwa Ibom and Oyo have the highest numbers of secondary health facilities at 74, 59 and 53 respectively while Kaduna, Bauchi and Oyo have the highest numbers of tertiary health institutions at 12, 5 and 5 respectively.
However, Nigeria is ranked 187 out of 190 countries in the health index according to the World Health Organisation (WHO).
Also, the country loses about $2 billion in foreign exchange annually to medical tourism, according to the minister of health, Dr. Osagie Ehanire.
This is not surprising as LEADERSHIP Friday learnt that there are inadequate specialists on ground to handle some medical conditions, even as lack of ambulances to convey patients in emergency conditions and poor attitude of health workers in public health facilities contribute in forcing Nigerians to look for alternative health solutions.
Accident victims and other patients requiring urgent attention are often denied attention in the hospitals due to lack of bed space.
Relatives of these patients sometimes have to take them from one hospital to another in search of a bed, and some end up dying on the way.
Even pregnant women referred to secondary health facilities from primary health care centres are usually rejected for lack of bed space.
In the rural areas, lack of amenities like power and water remains a huge burden, especially at PHCs, which often compel people to take their loved ones in need of medical care to secondary and tertiary health facilities, despite distance and transportation challenges.
According to federal government’s statistics, there are 74,543 medical doctors in Nigeria registered with the Medical and Dental Council of Nigeria (MDCN) as of 2018. This equates to 36.3 per cent of medical doctors per 100,000 population (doctor to population ratio of 1: 2753) whereas the World Health Organisation’s recommendation is one doctor to 600 population (1:600).
However, available statistics revealed that only about 35,000 doctors are practising in the county.
This existing problem of inadequate physicians to cater for the country’s rapidly growing population is further fueled by the trend of emigration among healthcare professionals as the number of doctors living in the country increased from 656 in 2014 to 1,551 in 2018.
Meanwhile, experts have blamed increasing brain drain leading to manpower shortage in the sector on poor remuneration, welfare, poor working environment and population explosion.
Former National Medical Association (NMA) president, Prof. Mike Ogirima, told our correspondent that the country’s healthcare system was bedeviled by inadequacy of specialists and facilities.
He said, “How many specialists are they producing; all in all, we have about 72,000, but half of these are outside the country and the recommendation is that you should have at least one doctor to about 600 population. How many are we having? The facilities are not there; even if they are there, they are obsolete. That is the problem: inadequacy of facilities.”
Ogirima lamented that the secondary health facilities have been abandoned by state governments except for states like Lagos, Rivers and a few others.
“All the secondary health facilities, what has happened to them? Before you will now talk about primary healthcare, do they have enough staff? Where are they located? Far from the populace. Some are overgrown by bushes.”
According to him, it is these primary healthcare centres that should take care of common ailments like malaria, respiratory infections, antenatal care and immunization, but the centres are not equipped and are not properly staffed, adding that the PHCs are supposed to have a doctor to attend to the populace to attract patronage from the populace.
He blamed the collapse of the primary and secondary health facilities on medical tourism, saying those that can afford to travel abroad for medical care will have no choice but to go.
On the way out, he said there is an urgent need for the government to take healthcare seriously, like business, and to motivate health workers so that they do not run away.
Collaborating Ogirima’s position, the immediate past NMA president, Dr Francis Faduyile, identified the disparity in the facilities in terms of location as well as access to these places as a problem.
He also said that the total number of bed spaces for the tertiary institutions in Lagos State are, probably, just for about 2,000 people.
Lagos is one of the most populous states in Nigeria with an estimated population of about 14 million residents.
He said, “I think we also need to know the location of these hospitals. In Lagos, we have about three teaching hospitals, that is, Lagos State University Teaching Hospital, Lagos University Teaching Hospital; sometimes you may have to add the Federal Medical Centre. The total number of bed spaces for these tertiary institutions are maybe a total of 2000 people.
“The problem we have, when you look at the totality of the hospitals, there are some hospitals that are in rural areas – you hardly see anybody going there, and in the densely populated area, you have a lot of issues about bed spaces in the urban areas.
“For instance, I stay in Lagos, you have somebody who stays in maybe Abule Egba, the access to FMC, Ebute Metta, will not be easy because of the distance, so he would want to look at areas around him or her. So when you don’t get space, you will have to move around that radius and you hear them talking about bed spaces. This is the reason why I think we have the issue of bed spaces.”
Dr Faduyile also identified lack of integrated health system in the country as a problem, saying many private facilities have many unused bed spaces while the public hospitals are oversubscribed.
“If there has been an integration of the health system, some of these bed spaces can be utilised in these facilities to ease out some of these bed-space issues that we are talking about,” he said.
On manpower shortage, he said the doctors who are working in Nigeria are not happy with the situation, and apart from not being appreciated, the pay is abysmal when compared with some other countries.
“Even in West Africa, you have a lot of our doctors going to work there, and that is really sad,” he added.
The NMA had reported in 2020 that out of 75,000 doctors officially registered in Nigeria, over 33,000 had left the country in search of greener pastures.
Earlier this year, within a space of 100 days between June 10, 2021 and September 20, 2021 during which the National Association of Resident Doctors (NARD) were on strike, 353 doctors were reported to have left Nigeria for the UK alone. That is not to count those going to Saudi Arabia, Qutar and other parts of Europe, Asia and America.
The way out, according to him, is for the government to ensure a good working environment and availability of basic amenities.
“When you are talking about health, you cannot find the way out really in health. We have to ensure that we have good road network, security and make sure that water and all other necessary things that make life worth living are in place, otherwise you will still see people not happy,” he said.