Transforming Nigeria’s Health Sector

Where does one start analysing the recent claim by the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, that Nigeria is becoming a hub for quality health care and a destination choice for patients from the West African subregion and other parts of the world? Is it from the fact that as at the time he was making the statement on Tuesday, the number one citizen of the country, President Bola Tinubu was almost ready for a private visit, (believed by many to be health check related) to Paris, France the following day? Or, that the minister did not explain what he meant by “quality healthcare” nor did he tell the State House correspondents the number of patients that come to Nigeria from the USA and the UK for treatment and why.
Are they Nigerians in the diaspora visiting Nigeria and receiving treatment? Do the so-called people from all over the world come to Nigeria for medical treatment because Nigeria offers the best medical care better than anywhere in the world? No doubt, there may be some people who visit hospitals in Nigeria, maybe for fertility treatment due to certain restrictions in the countries they reside, who come to consult some particular health experts or those that find the treatment of certain ailments cheaper in Nigeria. There also exist some specialised hospitals in the country, particularly in Lagos and Abuja, who do attract patients from neighbouring West African countries for treatments in such areas as organ transplants, cardiology, fertility treatments, and advanced surgeries. But on a global scale, can Nigeria be regarded as a top destination for medical tourism? How did the minister arrive at that
And talking of quality healthcare, as earlier stated, it would have been nice if the Minister had given us the indices he used to arrive at his assertion and his own meaning of quality healthcare. Experts have defined quality healthcare as medical services that are effective, safe, timely, patient-centred, equitable, and efficient. It ensures that patients receive the right care at the right time, leading to better health outcomes. This means that, for healthcare to be considered quality, the treatments and interventions should be based on scientific evidence and best practices to improve patient health; it should minimise risks, errors, and harm to patients; patients should receive care without unnecessary delays; it should respect and respond to individual patient needs, values, and preferences; it should be accessible to all, regardless of socio-economic status, race, gender, or geographic location.
Above all, it should be efficient – resources should be used wisely to avoid waste and keep healthcare costs manageable. Are these the case in Nigeria? It is no hidden fact that many hospitals and clinics in the country, especially the public hospitals lack basic amenities like clean water, stable electricity, and modern medical equipment.  Rural areas suffer from a lack of healthcare facilities, forcing patients to travel long distances for medical attention. Many doctors, nurses, and other medical workers migrate abroad (japa syndrome) due to low wages and poor working conditions. The doctor-to-patient ratio is far below the WHO recommendation. Not once have we seen a doctor dozing off while consulting patients due to fatigue and heavy workload. All the doctors’ strike actions for these reasons have not brought about a significant change.
How easily do patients receive medical attention in our hospitals and clinics? In most government hospitals, patients spend almost a full day or more to see a doctor. When the doctor is a consultant, the waiting period will definitely be longer.  And how affordable are the treatments and the drugs? The National Health Insurance Scheme (NHIS) was established in 1999 in response to increased out-of-pocket payments and the call for a movement towards Universal Health Coverage (UHC). Since the scheme started its operations in 2005, how many people have enrolled in the programme? The current Minister for Education, Dr. Tunji Alausa, while serving as the Minister of State for Health in May 2024 said that the government had allocated dedicated funds and initiated collaborations to enhance primary healthcare services and expand health insurance coverage and that the president had mandated them to increase coverage from about seven million then to about 50 million people.
Today, records show that only a small percentage of the citizens are still covered by the scheme. According to a report by the Journal of Global Health Economic and Policy, less than 5 percent of Nigerians are enrolled in NHIS, while 70 percent still rely on out-of-pocket payments, making healthcare unaffordable for the poor The challenge of poor drug regulation, counterfeit medicine, inadequate funding, poor emergency response, inconsistent government policies and corruption, poor sanitation and hygiene are yet to be dealt with. How then do we have quality healthcare in Nigeria? What about the careless and nasty attitude of healthcare providers towards the patients. Many Nigerians are left with permanent scars and disabilities due to the negligence of so-called healthcare experts who treated them.
Sure, medical negligence is not peculiar to Nigeria but it has become a constant occurrence in our health facilities and must be looked into by the Medical and Dental  Council of Nigeria, the Nigeria Medical Association and other relevant authorities. To take the nation’s healthcare system to the desired eldorado, a combination of policy reforms, increased funding, infrastructure development, workforce enhancement, attitudinal change among the healthcare providers and reduction of corruption in the health sector is necessary. Pate on Tuesday revealed that federal government has approved the sum of N12 billion for Magnetic Resonance Imaging, an advanced diagnostic equipment, across six tertiary health institutions in addition to Nigeria’s ratification of the African Medicines Agency (AMA) Treaty, which aims to harmonise medical regulatory standards across the continent.
That is a commendable step by the government if only the government will ensure that the money when released will be used for the stated aim and the right equipment purchased and regularly maintained. It is also important that the government allocates at least 15 percent of the national budget to health, as recommended by the Abuja Declaration. They should explore public-private partnerships (PPPs) to attract investments in healthcare infrastructure. There is also the need to upgrade and equip existing hospitals with modern medical technology, establish more primary healthcare centers (PHCs), especially in rural areas and invest in digital health solutions such as telemedicine to improve access. The issue of shortage of healthcare workers must be addressed through improved salaries, benefits, and working conditions.
Incentives (such as scholarships, housing, and career growth opportunities) should be regularly offered to retain healthcare professionals. Other important measures to be taken include expansion of the NHIS to cover more citizens, including the informal sector; introduce community-based health insurance programmes to increase access to affordable healthcare; the government, both federal and states, should subsidise low-income families to reduce out-of-pocket expenses.The authorities should strengthen immunisation programmes to prevent disease outbreaks and promote health education campaigns on sanitation, hygiene and healthy lifestyles. The National Agency for Food and Drug Administration and Control (NAFDAC) should be empowered to monitor and regulate pharmaceutical products more effectively, while the law enforcement agencies should do more in the area of enforcing stricter penalties for drug counterfeiters.
Implement technology-driven tracking systems to detect and remove fake drugs from circulation.The government should also increase funding for medical research and encourage local drug production. Partnership with universities and research institutions to develop innovative health solutions will certainly be productive. Government should also consider supporting the development of traditional medicine through scientific validation. As Africans, many Nigerians in the diaspora believe in the potency of herbs. A story was recently told of how some Nigerians make money by sending herbal medicine to Nigerians abroad. So, developing and properly regulating this sector might be the major attracter of patients. To have people come from all over the world to Nigeria, with the assurance that they will get the best of medical care here is the wish of many Nigerians.
Maybe that will reduce the president’s trip to France and save the nation some money. But achieving that goes beyond rhetorics or making political statements. Let there be more actions than words

Calista Ezeaku