Tackling Healthcare system challenges In Nigeria

There is perhaps no better time to talk about tackling health system challenges in light of the ongoing Corona virus pandemic.

The health system of a country is the pool of entities, intelligence, facilities, policies, procedures, practices, and inventory available in/to the country for the health maintenance, protection and promotion, and the provision of health needs of people within the country.

Health system objectives of a country are achieved by the collaboration of six components identified by the World Health Organization as the building blocks of health system, they include:

– Service Delivery
– Health Workforce
– Information
– Medical Products, vaccines & technologies
– Financing
– Leadership/Governance

These components have specific roles to play in achieving the health objectives of a country’s health system.

However, assessment of these objectives usually show that such specific roles to be played by all components are interdependent, with leadership/governance playing a central role to all other components.

This article aims to explore five problems in the health system of Nigeria, and suggest how leadership/governance can help solve them.

1. Poor statistics and data generation.
Due to the outdated methods of medical record keeping, accurate data and statistics of diseases and patients are not easily and readily available.

This can be blamed for various health system problems including grossly incorrect estimation of health situations and outcomes.

Health information system (health informatics) and health information management can bring solutions to this problem when they are incorporated into the basic training curriculum for health professionals, and provisions made for specialization in these fields through advanced training and in professional practice.

Also, through Scientific health research and accurate documentation, generating and preserving accurate, relevant, and up-to-date data and statistics on health matters in the country can be accomplished.

2. Mismanagement of allocated funds and generated revenue
Solving this problem from the foundation demands that Nigerian youths be adequately informed of the root causes of corruption which includes dependence on access to public funds for immediate satisfaction of personal needs instead of personal efforts to create value and wealth.

Through education and home training, moral values and awareness should be instilled in growing persons to help them make soundly ethical decisions that advance public good.

This will equip such persons with good management skills which they can utilize in leadership for planning and decision making.

For reasonable, sustainable success in this direction, all sectors of the economy must get involved in pushing accountability from public officials from campaign promises to actual governance.

3. Poor regulation of professional practices
This contributes to poor patient care, treatment failures, poor health standards, disabilities, and increase in cases of preventable deaths.

To solve this problem, guidelines and policies should be implemented in training of health professionals to make it easier for them to adopt ethical conduct in all situations.

Training for health professionals should help them build sympathy, empathy, understanding, patience which will help them in providing adequate patient care.

4. Poor infrastructure.
Nigeria health care system is poorly equipped to adequately meet the health needs of the Nigerian population.

This borders on leadership failure which is attributable to poor management culture, and corruption in national, ministerial, and systems leadership.

There needs to be a system that ensures adequate funding and management of health infrastructure and political will is critical.

In addition, maintenance and management skills should be included in the training curriculum of health professionals.

This approach will address mismanagement and poor maintenance of health infrastructure and other health care resources.

5. Poor health insurance coverage
Legislation on the National Health Insurance Scheme has been unable to successfully reach its goals one of which includes the provision of social and financial risk protection by reducing the cost of healthcare and providing equitable access to basic health care services.

That has been a challenge especially with regards to vulnerable groups.

Possible solutions to this include acquisition and documentation of population data in national information database.

Through this, proper estimations can be made about social health service budgets and coverage.

Also, NHIS policy should be reviewed and updated at all levels of the healthcare delivery system to reflect the reality of the nation’s health plans, goals, and budgets.

The populace especially those in the informal sector should be educated on the existence, values, and appropriate use of health insurance services in the country with appropriate policies to ensure they are covered under health insurance as well.

The above five problems and their solutions linked to leadership/governance are only few out of many problems facing the health system of Nigeria.

Activities of other components of health system contribute to these problems, hence, successfully solving them requires joint effort of all components.

We end with a quote from the April issue of Healthy Naija

“The current global pandemic presents an opportunity to assess country health systems in a bid to strengthen them”

Our hope is that Nigeria takes that opportunity


Edeh Emmanuel Henry Paul

Sika Emily Ditari

Pharmacists in training at the University of Port Harcourt

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