Some stakeholders in the health sector agree that Nigeria has recorded significant progress in the past three years in certain areas, especially in the struggle to contain the deadly impact of disease outbreaks.
A glance at Nigeria’s health history, shows that while infectious diseases, such as smallpox and guinea worm, have been successfully eradicated, the successful campaign to check the spread of the deadly Ebola Virus Disease in the country and to halt the scourge of a resurgent Lassa Fever in recent time speaks volumes about the Federal Government’s commitment to ensuring a disease-free society.
Acknowledging this, the National Coordinator of the Nigeria Centre for Disease Control, Dr Chikwe Ihekweazu, in an interview with our correspondents, said that Nigeria had successfully reduced cases of guinea worm infection in the country from more than 600,000 to zero between 1988 and 2000.
Stressing that the eradication of smallpox was generally regarded as one of Nigeria’s greatest achievements in public health care, Ihekweazu added, “Nigeria has successfully responded to outbreaks of many other infectious diseases and continues to works towards the elimination of polio.”
These achievements, no doubt, call for some celebration.
The NCDC boss also said the centre had built a “strong and resilient” public health system to respond to diseases outbreaks. “Across the board, an effective surveillance system, public health laboratory architecture, emergency response, risk communications, as well as a strong public health workforce and partnerships have contributed to the control of these diseases. We recognise that we have improved over the years, but not where we should be,” he said.
Similarly, the President of the Nigeria Medical Association, Dr Francis Faduyile, listed improvement in immunisation, the containment of Ebola in 2014 and the success recorded in the ongoing fight against polio as some of the giant strides that the Federal Government had taken to rid the country or, at least, reduce the spread of infectious diseases.
Also, the President, Healthcare Federation of Nigeria, Ms. Clare Omatseye, noted that the health sector had finally been able to achieve public-private partnership.
“We now have an open and trusting relationship between the public and the private sector in the health system which in the past was not there. We have transparency and openness in the formulation of health policies, a national strategy for the health plan.
“The whole issue of public service partnership is no longer a lip service, but it is now being practised by government. We now see different types of PPPs in Nigeria, where private hospitals co-locate within a teaching hospital environment. We now have equipment financing, where the private sector partner to provide technology to a hospital,” she said.
Omatseye also said that the country’s diagnostic capabilities had improved significantly since the model changed from just having a clinic and everybody trying to put up an x-ray ultrasound or lab in their hospitals to having diagnostics centres, which were not there 16 years ago.
Although they lauded the government for sustaining these gains, the stakeholders also identified key issues, which the Muhammadu Buhari administration need to address urgently in order to fulfill its promise of effective health care service delivery to the people.
Ihekweazu, for example, warned Nigerians not to forget that the country had started to witness the resurgence of some infectious diseases, such as Monkeypox and Yellow Fever.
He said, “As we celebrate these achievements in the health sector, we must remember that disease pathogens continue to evolve and we have started to record cases of emerging and re-emerging infectious diseases.”
Noting that fresh outbreaks of diseases had resulted in loss of lives and low productivity, as well as had negative impact on the national economy, he called on government to focus on building the capacity for a technically competent and determined public health workforce that would protect millions of Nigerians from the danger of infectious diseases.
On his part, Faduyile listed mass migration of qualified health and medical personnel from the country, inadequate funding, poor working conditions, work pressure on medical personnel, inadequate infrastructure, among others, as some of the problems still facing the health sector in Nigeria.
He said, “When you get to some hospitals where there should be three or four doctors, only one doctor is available. Even that one is overworked till he is unable to give his best. The consulting room, the operating theatre and wards now constitute a very hostile environment. These factors will not make the medical practitioner comfortable enough to discharge his duties effectively.”
He called on government at all levels to respect the 15 per cent allocation agreement for the health sector of their total annual budgets
On medical tourism, Omatseye called for more funding of the health sector to build infrastructure, procure more equipment, train health workers, among others.
“We have a policy in place under the National Health Act that states that as long as the facility or the service is not available in the country then the people can go abroad, but we see that this rule has not been obeyed, most people are just allowed to go without checking properly if the facility or the service are being provided for in the country.
One of the promises made by President Muhammadu Buhari at the outset of his administration was to allocate up to 20 per cent of the annual budget to the education sector.
In addition, the President pledged to invest in the training of teachers at the primary, secondary and tertiary levels; promote effective use of teaching aids in primary and secondary schools; provide one meal a day for all primary school pupils across the country and address the out-of-school children phenomenon.
Buhari also promised to increase spending on university education; eliminate or reduce examination malpractices in schools; re-negotiate the 2009 Agreement with the various staff unions in tertiary institutions, among others.
Three years later, unfortunately, most of the promises have been unfulfilled and the education sector, which has been almost crippled by persistent strike actions, is the worse for it.
To the last count, investigations show, the sector is burdened by the presence of nearly 11 million out-of-school children, especially in the northern parts of the country. Also, despite the President’s pledge to inject more funds into education at all levels, adequate funding remains a mirage. The Federal Government allocated a paltry seven per cent to the sector in 2017, in spite of the 20 per cent that Buhari promised.
Also, there have been concerns over a progressive decline in the quality of teaching across the country in recent time. Over 50 per cent of teachers, especially in primary and secondary schools, are believed to be unqualified to teach in these schools.
Cases of examination malpractice seem to have increased in the past three years, despite the courageous efforts of the West African Examinations Council and the Joint Admissions and Matriculation to check them. Moreso, a recent report by the World Bank indicates that a small percentage of Nigerian youth are literate.
Against this backdrop, Emeritus Prof. Michael Omolewa of the University of Ibadan, in an interview with one of our correspondents, described Nigeria’s education sector as being far from achieving a global outlook.
Omolewa said, “I would give the sector 70 per cent for access to tertiary education because of the emergence of more actors at the private level in providing universities, polytechnics and colleges. This has led to an increase in student enrolment.
“However, on the global dimension, the score would be 20 per cent. This is because many institutions have become local in terms of student and staff recruitment.”
Omolewa urged the Federal Government to stop monopolising policy-making so as to get basic and tertiary education right.
He said, “The government should not make policy-making a monopoly, but it should throw issues open for discussion among parents, employers and the civil society, including professional bodies.
“It should also encourage private-public partnership in funding of education and work out the mechanism of sustaining the quality provision of education at all levels. Nigeria should aim at exceling and producing the best and most innovative students who will assist to take the nation forward to the next century.”
Omolewa also said that despite the provision of more space to reduce the high student to teacher ratio currently experienced in basic and higher education sub-sectors, the focus should be on the improved interaction among students and teachers.
“The high student to teacher ratio is not exclusively explained by the affordability factor of public schools because it is also high in many of the private institutions. Other factors include the demand for placement by frustrated parents and the students who are tired of waiting at home doing nothing and with little hope of a breakthrough. The solution is predictably the provision of more space, and that requires greater investment in education which is lacking.
“There are many recommendations depending on the level of education and the subject involved. However, the emphasis is on the need for close attention to pupils and encouragement of interaction between the teacher and the learners,” he said.