In this report, LARA ADEJORO highlights the events that shaped the healthcare sector in 2022 as experts set the agenda for 2023

From a decline in COVID-19 cases to a resurgence of disease outbreaks, the enactment of the health insurance bill, and a massive brain drain, the healthcare industry has seen many ups and downs.

Nigeria went from reporting more than 5,000 COVID-19 cases weekly to reporting just 77 cases in two weeks from November 20, 2022. The death toll has also fallen. Since the outbreak began in 2020 until November 20, Nigeria has recorded 266,057 cases and 3,155 deaths so far.

More than 63 million of the total people eligible for the COVID-19 vaccination have been fully vaccinated, while more than 12 million of the total people eligible for the COVID-19 vaccination have been partially vaccinated so far.

Development partners, including the United States government, the United Nations Children’s Fund, and traditional and religious leaders, similarly praised the government’s progress on immunization rates.

US Ambassador to Nigeria Mary Beth Leonard said she is confident Nigeria has laid a solid foundation to minimize morbidity and mortality as a result of COVID-19.

“We congratulate the Nigerian government on the successful launch and implementation of the SCALES strategy, which resulted in the administration of more than 100 million doses of COVID-19 vaccines to eligible people in Nigeria. This is very uplifting and impressive,” he said.

Multiple disease outbreaks

However, re-emerging diseases have continued to expose gaps in the healthcare sector as the country battles multiple disease outbreaks.

Currently, there are 604 cases of monkeypox, 1,038 cases of Lassa fever, 18,545 cases of measles, 961 cases of meningitis, 23,550 suspected cases of cholera, and 1,601 suspected cases of yellow fever. All these diseases have killed no less than 1,078 people in the country in 2022.

According to NCDC Director General Dr. Ifedayo Adetifa, Nigeria recorded the highest number of cholera cases worldwide in 2021.

“This year seems to follow the same pattern. But perhaps it’s not surprising because if the circumstances that contributed to the number of cases last year have not been addressed, then we should have the same number of cases this year. So it tells us that the necessary interventions that needed to be put in place were not done at the desired scale to have an impact on cholera cases,” he said.

health insurance for all

The health sector underwent a dynamic change in May when the President, Major General Muhammadu Buhari (ret.), signed into law the National Health Insurance Authority Bill.

“As part of our healthcare reforms, I enacted the recently passed National Health Insurance Authority Act 2022, which repeals the National Health Insurance Scheme Act. We will ensure the full implementation of the new law to provide coverage to all Nigerians,” Buhari said.

In a statement by the Principal Special Assistant to the President on Media and Advertising, Garba Shehu noted that a fund will be established to ensure coverage for 83 million Nigerians who cannot afford premiums as recommended by the Nigerian Lancet Commission.

Fragile health centers

But all this could not guarantee that the sector was fully attended. Health facilities, health centers, staff and medical equipment are inadequate to care for the population.

In November, the Lagos State Health Commissioner, Prof. Akin Abayomi, said that at least 60 percent of primary health care centers in the state are not in a very desirable state.

However, Abayomi, who revealed this via his Instagram account @profakinabayomi, said the state government had invested time to conduct a needs assessment on PHC infrastructure to provide evidence-based information for improvement.

The commissioner confirmed that Lagos State has more than 325 PHCs, and at least 60 percent of them are not in a highly desirable state.

“Currently we have the plans that will serve as a framework to transform all the PHCs. Construction will start soon and we believe that in the next three to four years the PHCs will be transformed. #ForUnGranLagos,” he stated.

Bad health budget

To be sure, healthcare is capital intensive, but the government has not lived up to its 2001 Abuja Declaration commitment, which requires the nation to ensure that at least 15 percent of its annual budget allocation goes to health. .

A breakdown of the 2022 budget indicated that 724 billion naira (4.2%) was allocated for healthcare in the 36 federation states and the Federal Capital Territory.

Furthermore, of the total budget for 2023 of N21.82 trillion, only N1.23 trillion (5.64%) was allocated to the health sector.

Although the healthcare sector experienced calm as there was no national industry action in the healthcare sector in 2022, the University Teaching Hospitals amendment bill in the House of Representatives has continued to clash with stakeholders in the healthcare sector. the health of Nigeria with each other.

The bill is fraught with disputes over jurisdiction and administrative titles.

It intends to establish a permanent tenure in office for heads of tertiary hospitals; include health sciences students in tertiary hospital training programs; including hospitals established after the promulgation of the existing legal framework in the schedule and for other related matters; restructure the composition of the boards of directors of tertiary level hospitals of the federal government, among others.

By implication, any healthcare professional, including pharmacists, lab technicians, nurses, and others, can now run teaching and tertiary hospitals, as opposed to the current hierarchy held by physicians.

Brain drain

The healthcare sector is battling its worst brain drain this year with no fewer than 10,296 Nigerian-trained doctors practicing in the UK, according to the Nigerian Medical Association.

Furthermore, the Nigerian Association of Resident Physicians has said that the number of doctors in the country is decreasing on a daily basis, adding that there are only about 10,000 resident physicians left.

The association’s president, Dr. Emeka Orji, said about 100 resident doctors leave the country every month in search of greener pastures.

Insecurity, poor pay and poor working conditions, among others, have been identified as push factors for health workers in the country.

Tanimola Akande, a professor of public health at the University of Ilorin, said that despite the legislative achievements recorded by the sector, it still performs poorly compared to benchmarks in healthcare financing.

In addition to the brain drain, the health infrastructure, according to him, only experienced a facelift in a few university hospitals, but not entirely significant considering the various levels of health facilities.

Expectations for 2023

“Hopefully, one hopes for a better financed health sector in 2023,” Akande said.

Among the advances he expects is the completion of the task before the Health Sector Reform Committee.

The don also hopes the government will have the political will to implement the committee’s recommendations.

The NARD president noted that the government can do better with the right structures in place.

“The budget for the health sector is below six percent and is below the AU target,” he said.

Noting that the percentage is far less than optimal, Orji said the available fund will not be enough to address the challenges the sector is currently facing.

With proper funding, he said, Nigeria can set up some of the hospitals that politicians visit abroad for medical care.

“We have had interactions with many of them, and they will tell you that it is the same Nigerian doctors who treat them there. The difference is that those countries have invested in their health sector and we must do the same to keep our best brains,” he said.

“We’re not saying the government should ban medical tourism because it’s a free world and you can choose to seek medical care anywhere in the world, but it shouldn’t be done with taxpayer money.

“If there is a policy that civil servants cannot be sponsored for medical checkups, you will see them making efforts to develop the health sector in this country,” he said.

For his part, the president of the Lagos State chapter of the Nigerian National Association of Nurses and Midwives, Olurotimi Awojide, urged the government to improve the working conditions of health workers for better medical care.

“In other climates, you see that they have social services for their elderly and continue to care for them, but that is not the case in Nigeria and many people want to leave the country,” he said.

He lamented the wave of insecurity in the country and how nurses are victims.

“During the Owo massacre, we have a nurse who lost two lower limbs and there is nothing available to take care of her. Only those of us who are her colleagues are making efforts to rehabilitate her,” she said.

He also has expectations for the coming year, including making the work environment conducive and introducing different packages that will make Nigeria attractive to healthcare workers.