Nigeria’s healthcare system has been lowly ranked on two major global healthcare surveys in the last 3 years. The World Health Organisation recently analysed the world’s health systems amongst the 191-member states. Nigeria ranked 187 out of 190 countries ahead of only the Democratic Republic of Congo, Central African Republic and Myanmar using performance indicators such as the overall level of health, health and financial distribution across the population.
Nigeria was also lowly ranked in the Healthcare Access and Quality Index. The study tracked each nation and its progress from the benchmark year of 1990 to 2015. Nigeria lagged behind other leading African nations ranking 140 out of the 195 countries accessed scoring 51 points on the Healthcare Access and Quality Index. The 32 diseases for which death rates were tracked included communicable diseases such as tuberculosis and measles and chronic diseases such as cancer and heart failure. Despite the high incidence of disease, Nigeria’s budgetary allocation for healthcare is less than 5% of the GDP. This is below the average expenditure for other developing countries in Africa and far below the 15% promised by the Nigerian government in the Abuja declaration.
The current challenge plaguing the Nigerian healthcare system is the state of the primary health system. The system suffers from lack of infrastructure and investment, negligence and greed on the part of the state, local and federal governments. Many citizens do not have access to affordable healthcare and so many do not seek treatment for curable minor diseases because of the financial setback. So, the death rates for curable diseases are extremely high. While the Nigerian healthcare system did enjoy success in its rapid and effective handling of the Ebola crisis, that was a one off. The high standard and effectiveness demonstrated during that period is now lacking. According to the WHO, the life expectancy for Nigerians is ranked amongst the bottom 5 in the world at 53 for males and 56 for females. The probability of dying between the ages of 15 and 60 is extremely high at 368/318 (male/female) per 1,000 population. (2015)
The government has tried to improve the state of the healthcare industry in the country through various initiatives which proved unsuccessful. The most recent of which was the Partnership for Transforming Health Systems II (PATHS2). “It was originally a six-year (2008-2014) development initiative aiming to ensure that Nigeria achieves important health-related millennium development goals.” The implementation of the program was extended to July 2016 for certain states, however in July 2018, many of the goals have yet to be achieved.
Another struggling initiative of the Nigerian government is the National Health Insurance Scheme (NHIS) which has been in operation of over ten years. The initiative has struggled to realise the objectives for which it was created, primarily affordable healthcare for every Nigerian citizen. Till date many Nigerians are paying out of pocket for their medical costs. There are many factors that contributed to the failure of these initiatives including: an inadequate legal framework, lack of political will, poor regulation and poor implementation of the initiative. With proper regulation and implementation, many of the programs attempted by the government could succeed.
Key improvements need to be made to the Nigerian health sector, especially in light of continued population growth and continued technological advancement. Will Nigerians continue to be subjected to subpar healthcare?