What is the way forward for Nigeria, post-COVID-19? (IV): Think beyond Nigeria’s health crisis
A common saying, which is an English proverb is, ‘health is wealth’. We understand this ‘an individual and or collective health and wellbeing is the greatest wealth one has. It is not about money or your account balance. Good health matters. We consider the COVID-19 pandemic a global plague, which is currently afflicting the health of nation-states including the citizens. Nigeria is not exempted at all.
With the current health challenge and its negative implications, one cannot but think and engage in the importance of the health systems in Nigeria.
As we were planning to write this fourth piece in the series, the importance of primary healthcare as critical to the wellbeing of our nation, post-COVID-19 comes to mind. It is this species that we want to address in this piece.
What is the state of our nation’s healthcare system, especially in the current COVID-19 pandemic? What systems are put in place for efficient surveillance to track and monitor the outbreak of communicable and non-communicable diseases in the country? What is the state of health of an average Nigerian? What access to primary health care specifically does an average Nigerian have? How many primary healthcare facilities are accessible in each of the 774 local governments in Nigeria? These are some of the questions we want you to think about as you read this piece. Our intention is to bring to the fore these questions even as we argue that essential to a post-COVID-19 Nigeria is the need to prioritize building our healthcare systems and infrastructure, especially the primary healthcare system across all the local government areas in Nigeria. This will include having a long-term, strategic plan that is sustainable with the ease of monitoring over time.
Article 25 of the Universal Declaration on Human Rights noted that “everyone has the right to a standard of living adequate for the health and wellbeing of himself and of his family, including food, clothing, housing and medical care and necessary social services […]”. In agreement with this, the World Health Organisation (WHO) emphasised the importance of primary health care. WHO characterised primary healthcare as ‘meeting people’s health needs through comprehensive promotive, protective, preventive, curative, rehabilitative, and palliative care throughout the life course, strategically prioritizing key health care services aimed at individuals and families through primary care and the population through public health functions as the central elements of integrated health services’. The value of human life is what primary healthcare is about, right from the grassroots of society. Of importance is for every citizen to have access to reliable community health right from the grassroots in Nigeria.
Evidence from peer-reviewed literature shows that ‘the present state of Primary Health Care (PHC) system in Nigeria is alarming, with only about 20% out of the 30,000 PHC facilities relatively distributed throughout the 774 Local Government Areas (LGAs) across Nigeria working partially’ (Oserei & Uddin, 2019). As of 2017, the current health expenditure (% of GDP) of Nigeria, South Africa, Egypt, Arab Rep. was 3.76, 8.11 and 5.29 respectively. Of the three countries, Nigeria had the lowest spending in percentage of GDP (The World Bank). The data indicates an exigent need to address the state of our health systems and infrastructure in Nigeria. The need to take seriously the health sector in Nigeria and provide effective and efficient primary healthcare is key to the future of the nation.
The current situation presents enormous opportunities not just for the government across the three levels: local, state and national. It presents an opportunity to think of a data-driven health sector. Post-COVID-19, governance cannot be business as usual especially with the slump in the earnings from oil price in the global market. This is the time to think of not just leaving the health sector to the government. The private sector, especially through the health maintenance organizations (HMOs), can come up with innovative solutions in partnership with the government. While we engage the government to increase the spending on health care as a percentage of GDP, this is time for the private sector to become more involved as well. In every crisis are pockets of opportunities if the mindset and attitude are right. We personally believe that within the crisis in our health system, this is the time to think differently and search for new, innovative ways to find solutions to our health sector in Nigeria.