“Nigeria is the only nation to have never eradicated polio”-USAID

Nigeria officials and their families travel overseas for their medical care, same nations that depend on Nigerian trained physicians and nurses work force to run their health systems. On close observation of The Federal Ministry of Health, we interestingly discovered practical and actionable policies often designed with the assistance of WHO and other international health agencies. The problems we identified are largely on implementation and poor co-ordination between all the departments of the ministry and poor collaborative initiatives between ministries. For example, there is no policy level collaboration between the ministry and ministry of education which we consider a great opportunity missed.

The NHIS, National Health Insurance Scheme, is a laudable idea and that’s been what it is, and idea. Since it’s creation in 1999 it has only been able to care for less than 10% of the population. How could the program claim to provide accessible and quality healthcare to subscribers when the nation does not have accessible and quality infrastructures?

Let’s look at this by addressing the 3 key components that must interact in healthcare system delivery:
For the NHIS to achieve measurable goals such as reducing maternal mortality and child mortality rate, combating HIV/AIDS and tuberculosis, improving national life expectancy etc, we must increase the number of health facilities and equip them with functional and practical equipments and trained personnel.

Linking a really nice water pump to a drive well is what we did with the NHIS. Most Nigerians avoid government hospitals if they can, rightly so because of poor service from half committed staff, decayed infrastructures and lack of medications. What use is a medical insurance when you will have to bring your own hand gloves and syringes to be treated?

The States and Federal Ministry of Health lack the ability to collect data on the hospitals and clinics. Without accurate data collection, it becomes difficult to monitor and regulate this sector and this has exposed the NHIS to fraudulent claims. The states and local governments should be made to periodically collect data on every health facility under their care. This will include operators, annual censor inspection reports and mortality rates. This information must be promptly updated in the national data base

Fraudulent NHIS claims due to States and Local Governments officials negligence should attract fines on both the operators and the responsible authorities.
The Nigeria Medical Association will be charged with:
  • Constituting a task force to design preventive care guidelines and diseases screening schedules based on scientific evidence.
    • Producing guidelines for evidence based and cost effective diagnostic and treatment methods on the nations common admission diagnoses.
    • Encourage data collection and reporting among members.

  • Work with the The Federal Ministry of Health to form epidemiology intelligence agency that is deployable at a very short notice to an area of outbreak or suspected outbreak. This agency will have the capability of field testing and information gathering and recommending measure to control outbreaks.
Through persistent health education campaigns, citizens will learn practices that can prevent sickness and hospital visits. Education and outreach programs are the only ways to discourage those cultural practices that may lead to serious health problems.

Malaria costs the sub-sahara Africa an estimated $12 billion/year and millions precious young lives, it kills upward of a million Nigerian children before age five. It can be eradicated by supplementing current efforts with smart grass root health education. Same with preventable diseases as polio. Without outreach programs and education, people may decline immunization for cultural or religious reasons.

A standard patient bill of rights in all local dialects will be designed by the Federal Ministry of Health and made available on their website for downloads. It will be an enforced standard procedure nationwide for every patient to be provided with a copy at the point of healthcare delivery. Signs asking patients to demand for bill of rights must be conspicuously displayed at multiple areas in every healthcare facility.

These are just few of the measures that we believe put responsibilities into the hands of the people and also hold all the players accountable. In such a system, implementation of policies occur as a matter of cause. Imagine a system where a patient looks at his bill of right and knows how he should be treated and where to turn to with complaints.

Once again, Nigeria has a robust and practical healthcare policy but needed smart implementation and addressing infrastructures simultaneously.

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