22 May 2019

Nigeria: 80% Lack Access to Emergency Surgical Care - Surgeon

A Paediatric Surgeon, Emmanuel Ameh, said in Abuja on Tuesday that Nigeria's poorest citizens and those living outside major cities face the greatest challenge in accessing emergency and essential surgical care.

Mr Ameh spoke at the launching of two documents; "the Assessment Checklist for Federal Tertiary Hospitals" and "a National Surgical Obstetrics, Anaesthesia and Nursing Plan (NSOANP) for Nigeria".

Both documents, sponsored by the Federal Ministry of Health, are geared towards establishing health care standards for health institutions in the country.

The Assessment Checklist for Federal Tertiary Hospitals is meant to serve as a guide for the National Tertiary Health Institutions Standards Committee. This will help sanitise the tertiary health facilities and ensure comprehensive quality care for Nigerians.

Meanwhile, the National Surgical Obstetrics, Anaesthesia and Nursing Plan (NSOANP) for Nigeria is a plan meant to serve as a guide to strengthen emergency and essential surgical care and anaesthesia as a component of Universal healthcare in Nigeria.

National Health Act

The documents are some of the mandatory provisions of the National Health Act, 2014 (NHA) as captured in section 13 of the Act.

One of the mandates given to the minister under the NHA is for the minister to establish National Tertiary Health Institutions Standards Committee. The federal government is also meant to provide for persons living in Nigeria the best possible health services within the limits of available resources.

Also, it is set to protect, promote and fulfill the rights of the people of Nigeria to have access to healthcare services.

By this, Nigerians should have equal access to health services across all the geographical locations in the country. This includes access to emergency surgeries and procedures. Many Nigerians, however, have no access or financial capacity to access surgeries as at when needed.

Lack of surgeons

Giving an overview of the Surgical Obstetrics, Anaesthesia and Nursing Plan (NSOANP) for Nigeria, Mr Ameh said many health facilities in Nigeria do not have the expertise required to meet surgical needs of its citizens.

Mr Ameh, a professor of surgery, expressed his dissatisfaction with the current state of health in the country.

He said Nigeria has a shortage of surgeons, anaesthetists and technicians to effectively carry out all the necessary lifesaving procedures needed by Nigerians.

"Many Nigerians who are meant to receive surgical interventions are unable to get it because either they stay near health facilities which do not offer surgical services or there are no capable hands to perform the surgeries.

"80 per cent of Nigeria's population can access the hospital within two hours but the challenge is that many of those hospitals cannot provide emergency surgical care. We need 20 surgeons, anaesthetists and technicians per 100,000 people, but what we have currently in the country is 1 per 760,000. So it is obvious that we still have a very long way to go," he said.

Such surgeries, he said, include "lifesaving caesarean sections, orthopaedic surgeries that prevent lifelong disability and simple procedures to treat cataracts, clubbed feet and cleft palates that dramatically enhance a person's quality of life."

Mr Ameh said Nigeria needs to reposition its healthcare system "because the country is meant to be doing 5,000 surgical procedures every year to be able to address the surgical needs of Nigerians population."

"We are doing a maximum of just 116 surgeries per 100,000 populations. Many hospitals do not also report their surgical mortality and as such the government does not really know what is going on. Only 0.25 per cent of our secondary health facilities report their surgical mortality and that is low," he said.

Five-year project

Mr Ameh explained that the plan is a five-year project with the target of having 75 per cent of Nigeria's population having easy access to surgical care.

"We should be able to upgrade to five per 100,000 in terms of experts in the field and 50 per cent of the population should have financial risk protection. Injuries cause a lot of mortality compared to communicable diseases, yet there has been no significant focus on them."

He said some of the problems are also pertinent to tertiary health institutions.

He said some of the factors hindering quality, timely, efficient surgeries in Nigeria especially in the tertiary health institutions include lack of light (electricity), shortage/lack of surgical theatre, lack of personnel with medical expertise, lack of necessary equipment such as X-ray machines, CT Scan Machines, MRI Machines, among others.

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