Paul A. Obi urges the need to strengthen healthcare as part of the mechanism for redressing social inequalities in the country
Public health is a powerful tool to level the playing field, to bend the arc of our country away from distrust and disparities and back towards equity and justice.
Leana S. Wen,
Professor of Emergency and Health Policy
Nigeria presently is facing various challenges of social policy; its economy is tanking, living cost skyrocketing and discontent is ripe, such that the people are constantly looking for answers. For now, it appears only healthcare service delivery is ticking the box within the prism of governmental social policy. Yet, as known globally, the dynamics of Nigeria's public health sector have not shrunk nor falter to the point of total collapse. Thus, Nigeria's health sector remains astute even as more improvement is required, and necessary as well. More so, Nigeria has become the global destination for recruitment of healthcare workers for the West and other developed countries in the Northern hemisphere. Succinctly, all these impacts within the health sector are dependent on the chief policymaker at the helm of the country's health care sector.
Here, the appointment of Prof Muhammad Ali Pate as the Coordinating Minister of Health and Social Welfare came as no shock, but received applause in view of Pate's past trajectory within the health sector. Unlike other sectors, President Bola Tinubu's ability to headhunt Pate sits among the top best decisions in the assemblage of his cabinet and ministerial team by the government. This salient decision not only had public servants in the Three Arms Zone, Abuja nodding their heads in affirmation, but also got policymakers in global health governance in Geneva, New York, London, Washington D.C, Addis Ababa, Dakar, Cape Town and Beijing in solidarity with Nigeria. Pate comes with the best global network to reinvigorate the health sector for good.
The ebb and flow of affirmation on Pate's position, role and ability is cast on his past performance both as the Executive Director of the National Primary Health Care Development Agency (NPHCDA) and as Minister of State for Health under former President Goodluck Jonathan. As a key player in global health governance, Pate comes with the tack and sack capable of repositioning Nigeria's health system from the rudimentary to the modern. Still, he has moved past those past records staging one of Nigeria's audacious steps towards modernizing the nation's health care system, and in turn, advancing the frontiers of President Tinubu's health agenda in no small measure. In all, these remarkable steps within the sector goes beyond mere policy to deliberate acts that have impacts on the downtrodden, mothers and children both at the primary and tertiary levels of health care service delivery.
Speaking recently, on the modernization drive of Nigeria's health sector, Pate explained that "certainly, our approach to modernizing healthcare information systems and promoting electronic health records (EHRs) in Nigeria is rooted in strategic planning aligned with several guiding principles and initiatives outlined in documents such as the Renewed Hope Agenda, the Nigeria Health Sector Renewal document, and the Nigeria Agenda 2050. One of the pivotal aspects of our strategy is the development of a comprehensive digital healthcare policy. Recognizing its crucial role in providing a road map for digital healthcare solutions, this policy aims to guide stakeholders such as healthcare providers, patients, investors, regulators, and other ecosystem participants."
As the world moves towards digitization, Pate, in following Tinubu's template, is pushing the frontiers of technology, and how tech can help facilitate the nation's health care service delivery to the poorest of the poor as part of the broader concept of primary health and social policy also. Within this context, it requires not just the federal government, but also a buy-in from the states and federating units across the country. According to Pate, "when we started, we embarked on a deliberative process to understand the expectations of Nigerians through the People's Voices Survey. We examined the experiences and expectations of Nigerians, the burden of diseases and how it is evolving, what is working well and what is failing, the state of health infrastructure, human resources, financing, and the overall state of health of Nigeria."
The minister further added that "the states, development partners, civil society, and the private sector to articulate an
Agenda that aligns with the President's overall reform agenda (The Renewed Hope Agenda). This agenda in health aims to save lives, reduce physical and financial pain, promote health, and ensure it is accessible to all Nigerians. Since announcing the health agenda, we have been actively implementing it. Over the last several months, we have made considerable progress implementing the four pillars, which I will report on regarding our accomplishments, not just our future aspirations," but also, "to build human capital, improve health and well-being of our people to drive future prosperity in our country."
Beyond these approaches, human capital development and the rural health care system are all being strengthened under Pate's leadership at the Federal Ministry of Health. For instance, the Basic Health Care Provision Fund implemented by NPHCDA has been activated and revamped with the disbursement of N25 billion for implementation. Further, Nigeria's total enrolment in medical schools that include medicine, nursing and other related health professions has increased from 28, 000 to 64,000 annually. Also, about 2400 medical and health officers have been recruited and posted to rural areas to enable and facilitate primary healthcare across the country. This is in addition to the 1200 primary healthcare facilities that have been built in the country to create more access to rural dwellers and bridge the gap of inequality in healthcare service delivery and social welfare.
Notwithstanding all these stellar performances under Pate, and the Minister of State for Health, Dr Tunji Alausa, Nigeria still has many rivers to cross in order to attain satisfactory status within the global health ranking. Our performance in global healthcare ranking is still abysmal, owing to the gap in healthcare infrastructural development and modernization. This is why the modernization and digitalization of the Nigerian health care system championed by Pate remains cogent and exigent. For example, though, the country ranks high in healthcare manpower; Nigeria has not been ranked among the best healthcare countries in the world for some time now, nor ranked among the 100 thresholds. Thus, the next phase of the modernization drive in which the minister is so passionate about should endeavour to expedite action on advanced healthcare technologies, systems, digitalization and sophisticated health infrastructure capable of withstanding Germany, India and Japan.
Again, as earlier enunciated, Nigeria's healthcare manpower is great; but its clinical delivery, particularly, after-care services remain porous across the broad spectrum of the nation's health facilities - both primary and tertiary health facilities. That's why in most instances, surgical operations and clinical services can go well; but in the end, patients in most of the health facilities are not provided with the best after-care medical services. In public health and medical facilities, the case is worse due to the lackadaisical attitudes of healthcare providers. Regrettably, this sorry state of our healthcare system has continued unabated for too long. It therefore requires urgent intervention and a declaration of an emergency in that area. Likewise, there is an urgency to democratise tertiary healthcare services across the country. This should be followed with establishment of specialised hospitals and medical centres outside the state capitals at least two each across the six geopolitical zones of the country. It will also be in the best interest of the minister to minimise or avoid unwarranted industrial disagreement and bickering with most of the healthcare unions and associations. Every good employer is known and associated with harmonious co-existence with his workers. Policy makers and the workers who implement the policies should constantly be seen as equal consociate in service delivery of any kind for public good.
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As Pate pushes forward the frontiers of President Tinubu's health agenda, the critical puzzle in all of this is how to strengthen healthcare as part of the mechanism for redressing social inequalities in the country. Perhaps, as the opening quote of this piece by Wen posits, how can Nigeria use healthcare as a social welfare tool to respond to the crisis of lack and penury that has occasioned one of our existential threats - poor healthcare, by lifting many Nigerians left behind through the agency of affordable healthcare system? More fundamentally, beyond the policy hurdles and the many talk shops that have come to characterise Nigeria's health sector, Pate and his team must now go pass those challenges, to delivering profound and well-conceived agenda, action plan and implementable policies that will recentre Nigeria's healthcare as best and top-notch. It starts with addressing the clinical gaps - poor after-care services, enthroning a modernised healthcare system and democratising tertiary healthcare not only for the rich and plutocrats in metropolis, but also for the many poor in semi-urban centres and rural areas longing for a renewed hope agenda -in action.
