Some solutions to nigeria’s healthcare problems, by Dr. Biodun Ogungbo

I could start this article by telling you the problems bedeviling the Nigerian healthcare sector.
However, I want to assume you know about it already.
If not, please kindly take yourself to the nearest hospital and spend an afternoon in the emergency care unit.
Better still, follow a truly sick patient to any of our primary healthcare centre, a general hospital or if you are in real deep trouble, a University Teaching Hospital.
I bet you will be able to write the beginning of this article yourself! So, let us assume we are both up to date! The majorhindrance in Nigeria’s healthcare sector is the lack of government commitment to healthcare.
There is poor leadership from the top and poor funding.
Successive Nigerian governments have paid lip service to the issues surrounding preparing to paper the cracks in the wall.
Naturally, the solution starts from the government.
Healthcare must be top of the political agenda and taken seriously.
After all, it affects both weak and the powerful! Government Healthcare,especially tertiary healthcare, is not cheap.
Government must fund massive infrastructural programs, purchase of equipment and manpower for any meaningful delivery of quality care.
The government must also stop employing or paying the salaries of healthcare workers in the hospitals.
Instead, encourage each facility to compete and generate income through creativity and delivery of much needed services locally.
Hospitals will then be accountable to its employees, employ only much needed manpower and weed out ghost workers, as are rampant in many facilities.
Incomes and outcomes can then be measured and remunerations will be based on actual patient activities and service delivery.
Primary healthcare is the cornerstone of true quality in Nigeria.
The focus must also be on delivering functional primary centres in all the nooks and crannies of Nigeria.
Health centres must be close to the people and accessible in terms of location and cost.
The government must also ensure the success of the National Health Insurance Scheme (NHIS).
The issues in the scheme relate to a conflation of the regulatory functions, payer, risk-bearer, and policymaker functions, the non-mandatory status of the Scheme, to the lack of awareness, and more recently, the inability of the Agency to provide quality data on the of its activities.
The NHIS must be cleaned up and made technologically fit for purpose.
It should be supported by employers of labor and all organisations should be mandated to key into the system.
The government could make it mandatory for every employer or company to register their staff on the scheme.
Similarly, the informal sector which is the largest uncovered population must be integrated into the scheme.
There should also be a defined way to collect funds from the informal sector whose population is a significant contribution, if added to the scheme.
The private hospitals in Nigeria must be supported to succeed and regulated better so they deliver quality .
Medical practitioners need to up their game and deliver better care.
Charlatans, herbalists and pastors must be discouraged and run out of business through strict regulations, enforcement and medico-legal instruments.
They do more harm than good and people should be encouraged to take them to court for redress.
Hundreds of Nigerian doctors working abroad are quite keen to come back home.
They should be encouraged.
The government and the banking industry can and should reduce the bureaucratic snafu that ensnarls investors in Nigeria.
Healthcare loans in single digits and a health care bank are ideas worth pursuing to increase the investments in health nationwide.
The rich Nobody can afford ill health.
This is why rich Nigerians must be encouraged to invest in healthcare, even if for themselves in the first instance.
They can do it for selfish reasons; to have a quality hospital to attend in case they fall sick.
Whatever they build locally will still make an impact on the whole nation.
Many already invest in the hotel and entertainment industry.
Finally, the people must be informed and educated about health issues.
We need serious health advocacy and information strategies to modify and change behavior plus health seeking attitudes of Nigerians.
This must be seen as a social responsibility and a must by both the government and all organisations.
The Association of Nigerian Practitioners in the Americas (ANPA), Medical Association of Nigerians Across Great Britain (MANSAG), Guild of Medical Directors and the Nigerian Medical Association are collaborating to carry health awareness messages across Nigeria.
This may be in the form of articles, features, short messages, videos and films on health issues.
This is what I have for now.
Please feel free to add your own ideas.

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