By GREGORY T. OKERE
The word inequality is defined as difference in size, degree, circumstances, etc.; lack of equality. Social inequality means imbalance, inequity, variation, bias, prejudice, discrimination, unfairness, unfair treatment. The opposite of inequality is equality, uniformity etc.
On the other hand, the word healthcare is defined as the organized provision of medical care to individuals or a community. Wikipedia defined healthcare as the maintenance or improvement of health via the diagnosis, treatment, and prevention of disease, illness, injury, and other physical and mental impairments in human beings. From the foregoing, inequality in healthcare in Nigeria can be defined as discrimination or imbalance in the medical care of individual citizens of Nigeria. It can also be defined as the unfair share of the medical provisions made available for Nigerian citizens through the Federal Ministry of Health and other health agencies.
In recognition of the mandatory equal health provisions accruing to every human being and citizens of the various countries of the world, Article I of the Universal Declaration of Human Rights (UNDHR) provides thus: “All human beings are born free and equal in dignity and rights. They are endowed with reason and conscience and should act towards one another in a spirit of brotherhood.”
Also, Article 25 (1) of UNDHR provide as follows: “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”
Also, Article 16(1) and (2) of the African (Banjul) Charter On Human And Peoples’ Rights recognized and enshrined mandatory equal health provisions as follows:
“1. Every individual shall have the right to enjoy the best attainable state of physical and mental health.
2. States parties to the present Charter shall take the necessary measures to protect the health of their people and to ensure that they receive medical attention when they are sick.” Nigeria as a country is signatory to the above Charters and adopted same in section 16 (2) (d) of the Constitution of the Federal Republic of Nigeria 1999 (as amended) which provides thus “that suitable and adequate shelter, suitable and adequate food, reasonable national minimum living wage, old age care and pensions, and unemployment, sick benefits and welfare of the disabled are provided for all citizens.“
Nevertheless, Nigeria has experienced a great deal of inequality in the healthcare of its citizens whereby certain class of people, especially the politicians spend almost the annual budget of the health sector in medical treatment overseas whereas some people may not have access to the local or domestic medical treatment in the same country. This is as a result of practical application of the policy and system of governance adopted from the 7th commandment of George Orwell’s Animal Farm by majority of Nigerian leaders, administrators, executive and legislators manning the affairs of our country and Health sector in particular. Thus, recently, it was on record that President Muhammadu Buhari spent more than 100 days in an undisclosed hospital in the United Kingdom whereas so many Nigerians with greater and worst health conditions are left unattended to in government hospitals and some have nobody to assist them to gain admission in the hospitals let alone being attended to by our medical practitioners.
The Constitution of the Federal Republic of Nigeria 1999 (as amended), which is the grundnorm also made provision in section 33 to protect the individual lives of its citizens. Basically, the right to life cannot be said to be complete if healthcare or equal access to medical treatment among citizens is undermined or relegated to the background. Thus, the challenges of the health sector is aptly described by a situation analysis in the National Health Policy 2016 (pages xiii and xiv) respectively as follows “The situational analysis undertaken was based on examining the functioning of the Nigerian health system from the perspectives of the strategic thrusts of the NHSDP and WHO health system building blocks. The analysis showed that the Nigerian health system is weak and, hence, underperforming across all building blocks. Health system governance is weak. There is an almost total absence of financial risk protection and the health system is largely unresponsive.
There is inequity in access to services due to variations in socioeconomic status and geographic location. For instance, 11% of births to uneducated mothers occur in health facilities while 91% of births to mothers with more than secondary education occurs in health facilities; 86% of mothers in urban areas receive Ante Natal Care (ANC) from skilled providers, compared to only 48% of mothers in rural areas; and ANC coverage in the North West is 41% compared to 91% in the South East.
Other problems related to health services include: curative-bias of health services delivered at all levels; inefficiencies in the production of services; unaffordability of services provided by the private sector to the poor; limited availability of some services, including Voluntary Counselling and Testing (VCT), Prevention of Mother-To-Child Transmission (PMTCT) and Anti-Retroviral Therapy (ART) low confidence of the consumers in the services provided, especially in public health facilities; absence of a minimum package of health services; lack of proper coordination between the public and private sectors; and poor referral systems”.
In conclusion, there is urgent need to strengthen the health sector in Nigeria through adequate provision, release and implementation of the annual budget to meet the medical need of every Nigerian and shun inequality in healthcare.
Okere writes from Centre for Social Justice (CSJ), Abuja