Lagos — A currency scarcity in Nigeria, caused by the replacement of old bank notes, is causing delays in accessing healthcare services and even costing lives, in a system that relies heavily on out-of-pocket expenses, health experts and patients warn.
The Nigerian government, in late 2022, announced the decision to redesign some notes and replace the old ones in circulation by January 2023. But the poor circulation of the new notes created a shortage as old notes could no longer be used as legal tender.
The scarcity of the new notes led the country's supreme court to order an extension of the deadline for the use of old notes to 31 December, 2023. The Nigerian government has, however, re-circulate the old notes and businesses are refusing to accept the old notes as legal tender.
Banks are struggling to keep up with the demand for new notes, leaving many Nigerians who depend on cash transactions for their daily needs struggling.
The situation is affecting access to healthcare services in a country where, according to the World Health Organization, more than 70 per cent of health expenditure is out-of-pocket.
Some Nigerians are embracing digital and mobile payment options, but the system is often slow and sometimes fails to function.
Shema'u Labaran, a resident of Kano state, died during labour after a hospital reportedly put her Caesarean section on hold while awaiting payment from her husband.
According to Bello Baffa, Shema'u husband, the hospital would not receive old notes and as he did not have the new notes, he had to do digital transfer that took three hours to be completed.
"After they admitted Shema'u, they discovered that she could not deliver by herself, that she must undergo a (Caesarean) operation. I agreed and paid the money, still through transfer. There was an additional three-hour delay before they received the alert and operated on my wife. The baby was brought out dead and the mother also died," Bello Baffa, Shema's husband, said.
The hospital refuted Baffa's claims but says it has launched an investigation into the case.
Sodiq Temitope, a 27-year-old worker at a publishing firm, was feeling feverish and wanted to get a diagnosis in a clinic in Ogun, southwestern Nigeria. He told SciDev.Net that the clinic's cashier insisted on cash payment and refused his offer of paying through mobile banking.
"I told them I did not have cash, but I could make a [digital payment] transfer. They refused. They drew my blood and got my urine [sample] but insisted they will do nothing till I gave them cash," he explained.
Temitope said that his diagnosis and treatment were delayed as he had to go scouting for cash for hours even though he was ill and feverish.
Tanimola Akande, a professor of public health at the University of Ilorin, Nigeria, told SciDev.Net that such cases are arising because of the heavy dependence on out-of-pocket healthcare expenses in Nigeria. He said that the crisis has worsened because many health facilities, particularly in rural areas, are not accepting digital payments.
Is the problem persisting?
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"A number of health companies are now transiting to this mode of payment but network services are not good enough for seamless transactions," Akande said. "With this situation, there is a lot of delay in accessing care and also in providing healthcare. This may result in loss of lives for emergency cases."
Simeon Oyinguh, national deputy secretary of the Nigerian Medical Association, described the situation as "unfortunate" and urged healthcare providers to embrace digital payment to avert an escalating crisis.
This piece was produced by SciDev.Net's Sub-Saharan Africa English desk.
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