Nigeria: In 2021, Nigeria witnessed an “unprecedented exodus of health professionals”

... Holistic health sector reform is overdue

There is no doubt that the health sector has been turbulent throughout 2021. The COVID-19 pandemic in particular has disrupted all aspects of life and has also exposed huge gaps in Nigeria with its healthcare systems. relatively poor health.

As the end of the year nears, Good Health Weekly spoke with Dr. Casmier Ifeanyi, renowned health analyst and medical laboratory scientist and former National Publicity Secretary of the Association of Laboratory Scientists Medical of Nigeria, AMLSN.

In his assessment, Ifeanyi notes that 2021 is more of a postponement of years of many challenges that have long plagued the health sector. He regretted the widespread effect of the brain drain on the country even amid the COVID-19 pandemic and called for a comprehensive and systemic repositioning of the health sector. Excerpts:

The Nigerian healthcare sector in the year ending in 2021 has been relatively turbulent. This year 2021 is rather a year of postponement of the many challenges that have long plagued the health sector. The previous year, 2020, was the start of the global COVID-19 pandemic in Nigeria. This global public health challenge has left the country very ill-prepared to respond to and contain the pandemic.

Since then, the country’s health sector has been struggling. Of course, before the pandemic, our healthcare systems were pretty much in shambles and had been roundly deemed fragile and dysfunctional.

Our hospitals were in poor condition, dilapidated and the workforce unmotivated. Despite the situation of the country’s health sector, it has proven to be very resilient in the face of the challenge of the Covid-19 pandemic.

The Nigerian health sector has handled the response to COVID-19 commendably given our limited resources. Credit must be given to President Muhammadu Buhari who spared no resources to reactivate and revamp the health system, including the health infrastructure.

Unfortunately, despite all the colossal investments, little has changed in the sector until the end of the year. The sad tale is that much of the dilapidation and systemic decay remains.

How the healthcare sector fared in all aspects

The Nigerian health sector performed poorly during the year under review. Despite strengthened budgetary provisions, colossal sums allocated and released, it is regrettable that the health sector is not even better at serving the Nigerian people. There was the usual inglorious episodic industrial unrest and the strike, especially the National Association of Resident Doctors, NARD. The 2021 NARD strike was the longest in recent memory and has crippled hospitals across the country. The disputed issues that led to the strikes are not yet fully resolved. Again, imagine if the federal government released the sum of 1 billion naira each for almost all 36 states and the FCT, and another installment of about 950 million naira each was released to all hospitals federal tertiary as a special Covid-19 response fund, unfortunately there is little or nothing in most of these hospitals commensurate with such a huge investment in the health sector in 2021.

Over the past year, Nigeria has seen an unprecedented exodus of health professionals of all categories out of the country to other climes for greener pastures.

It was a matter of national embarrassment when Dubai and many other countries set up centers in hotels and many other undisclosed locations in Abuja and Lagos to massively recruit Nigerian medical professionals for their country. of origin.

Rather than addressing the root cause, the Nigerian government responded by cracking down on these centres. Even in December, young and dynamic Nigerian health professionals, the critical mass of health workers, are still leaving the country in droves.

You cannot mention any tangible infrastructural intervention in the health sector in 2021 to support the government’s much-vaunted interest in revamping the health sector and systems and upgrading it to meet the current health challenges facing the nation. and its people are confronted. battling.

Just recently, the Budget Minister visited Port Harcourt University Hospital for an on-site assessment of the use of his own N950 million Covid-19 response fund.

The minister could not hide his disappointment as he was not shown anything substantial and left threatening that the federal government would summon the anti-corruption agency to investigate how the fund was used. Nigerian health sector officials have yet to make the most of the lessons learned from the COVID-19 experience.

Frankly, the Nigerian health sector did not fare any better during the year under review. Health systems are not yet reorganized; health systems are not yet reformed. To help reposition the health sector, urgent holistic reforms are needed.

Effect of the pandemic on the medical laboratory sector

Under the leadership of President Muhammadu Buhari, there has been steady improvement in budget allocation to the health sector. Even though we have not yet reached the Abuja declaration of 15%, the country has hovered between 4 and 5% and this is commendable progress.

If increase on the annual allocation to the health sector. It is worrying that this budgetary improvement has not translated into improved delivery of medical laboratory services for the people of Nigeria.

To date, no medical laboratories in government hospitals in Nigeria have any form of “third party” accreditation for testing carried out in these hospitals. Many public medical laboratories are ill-equipped and ill-equipped to provide cutting-edge diagnostics.

Little has been done in the year under review to revolutionize medical laboratory services in Nigeria. A country’s ability to detect a disease is a function of the capacity of its medical laboratory structure and its workforce.

The deliberate underdevelopment of the medical laboratory sector in Nigeria has continued to worsen. Apart from the modest efforts of the leadership of the Nigeria Center for Disease Control, NCDC, the country’s ability to timely detect diseases, especially endemic diseases in our country, which have continued to wreak havoc in our country, has remained very rudimentary.

In Nigeria, medical laboratory diagnosis of diseases such as Lassa, fever, meningitis, cholera and other childhood killer diseases remains a huge challenge. Thus, a key area of ​​the Nigerian health sector needing and deserving attention is building the capacity of the medical laboratory sector. We need to strengthen our medical laboratories in tertiary health institutions, specialized hospitals and secondary health institutions.

Supportive medical laboratory systems for timely disease diagnoses and disease reporting systems are not in place in Nigeria.

Go forward

I want to call on President Muhammadu Buhari to consider a holistic reform of the Nigerian health sector by 2022, as it is long overdue.

The hegemonic structure of the sector is its main obstacle to the health system. The government should improve financing and monitor its investments to ensure value for money and fight corruption.

It is an effective intervention that we can help to mitigate medical tourism. The government must urgently put in place measures to mitigate the horrendous mass exodus of health professionals that is causing the brain drain.

Although this is not enough, the Nigerian President a few days ago ordered some interventions to quell the unrest in the health sector.

President Mohammadu Buhari recently ordered that the arrears of all withheld salaries of health workers who went on strike earlier, for whom the no work, no pay rule was mooted, be paid. In a similar vein, the National Commission on Income, Wages and Salaries released revised risk allowances approved for all categories of healthcare workers in December.

Although there are doubts about what has been approved, it is also commendable because something better than N5000 has been offered by the government. It is commendable.

The government must do more. One of the things I look forward to in the new year is to address the issues of pay disparity, parity and relativity in pay for Nigerian health care workers which will encourage retention and help mitigate leakage brains of health professionals.

The government should make it mandatory for Chief Medical Directors and Medical Directors of various Federal Tertiary Hospitals and Specialty Hospitals to holistically adopt the Quality Management System (QMS) and therefore pursue and obtain international accreditation such as JCI and ISO for the services they render.

This is the most effective way to straighten out our health system and reposition it to better serve the people of Nigeria. It’s not all about funding.

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