A medical expert and chairman of the Association for Advancement of Family Planning in Nigeria, Dr. Ejike Oji, has said the country is a dangerous place for women to deliver babies.
According to Oji, who is president/CEO of Ejike Oji Community Development Foundation, Nigeria has the second highest maternal mortality rate in the world.
He said comprehensive health insurance scheme was the answer to Nigeria’s health challenges.
Where can you place Nigeria on maternal and child mortality?
Nigeria has the second highest maternal death in the world. This means Nigeria is about the most dangerous place for a woman to have a baby. In the latest World Health Organisation (WHO) ranking in the healthcare globally, Nigeria was rated second on the bottom in a chart of about 189 countries. Nigeria was 187 on the list. We are only better than Congo DRPC and Myanmar. This explains why maternal deaths are high. Also infant mortality is high in Nigeria.
What is responsible for all this?
Is very simple. For almost 40 years, we paid no attention to our healthcare system. If you remember during the Yakubu Gowon regime, there was a time doctors went on strike because the healthcare system was collapsing. They were complaining that the budget was small. In response, the military regime sacked all the doctors. Professors of medicine were given 48 hours to pack out from the residential houses. That was when our healthcare system started taking nosedive because those doctors couldn’t take the insult, as they were top medical professionals trained outside Nigeria, who, owing to their love the country, returned to work.
When this happened, some countries took advantage of this. They employed these doctors. Countries like Saudi Arabia and Zambian employed these doctors. Following this, the quality of training of doctors dropped because those top physicians had left. Since then there has been a lot of problems. We go from, one strike to another. The result this is that a lot of our doctors have left the country. There are many of them in the United States of America, where association of Nigerian doctors has almost 25,000 to 30,000 doctors.
The other side of it is that hospitals in the country are not well equipped.
There have been talks about health insurance scheme. How should Nigeria go about it?
The right thing is that we must get our health insurance right. That is the only way. All the major countries in the world, their healthcare are being financed through insurance or through direct tax. In Germany, they tax for health. Every German pays tax that goes to health insurance and the same thing with England. They get their health insurance from the tax. So you can see it is contributory, either by tax or by health insurance.
What will be the role of government?
The Federal Government should show leadership by increasing health budget to at least the minimum recommended by African Union (AU). The AU said states should raise their budget for health to 15 per cent of the total budget. Secondly, there must be capacity building for the healthcare workers. There must be training and retraining. Also, the performance management system must be put in place and standardised. If you go to hospital A, those procedure and protocol should be observed, just as in hospital B. So if you are being managed of malaria in hospital B, if go to hospital C it is the same thing. Those are the key.
I think also that this is the time Nigerian should start suing doctors. By the time a doctor is convicted for negligence, they will sit up. That is another form of monitoring and evaluation.
We also need to strengthen our teaching institutions, to make them world standard. There should be continuous exchange of ideas. In the 70s, there was this one year mandatory programme abroad for resident doctors. They embarked on it before being signed up. Such programme should be brought back.