In some areas, 2024 brought a glimmer of hope to Nigeria’s health sector. But overall, it was a year of ups and downs. Some areas saw progress, while others still faced obstacles.
On the bright side, there was a new focus on basic healthcare, possible budget increases, better facilities, and more doctors and nurses being hired and trained in the local areas.
Efforts to fight diseases showed some success. Better monitoring, vaccine drives, and community participation helped cut down on outbreaks of illnesses like Lassa fever, malaria, and polio. The country made big strides towards making its own vaccines and treatments for common diseases, reducing its reliance on imports.
Some states saw mothers and children getting better care. This came from easier access to check-ups during pregnancy, skilled help during birth, and care after delivery. Programmes to tackle poor nutrition and child health played a key part in these good results.
The national and state governments, along with private companies, put more money into health research. This led to better outcomes for often-overlooked tropical diseases and long-term health conditions.
The Federal Government set aside N2.5 trillion for the country’s health sector from December 2023 to November 2024. This huge sum went to key areas like hiring doctors and nurses, buying ambulances, and building facilities.
Is spending on health working?
But did this spending lead to better care and experiences for patients? A point to ponder.
Work continues, to beef up the overall health system. Efforts to gather and study data, manage supplies better, and create rules for smoother teamwork in healthcare are showing results. The aim is to help more people get basic healthcare, yet the big problems persisted, like shortage of funding and financing, poor infrastructure, and shortage of healthcare workers, particularly doctors and nurses.
Halfway through the year, President Bola Tinubu took a big step. He signed an order to make healthcare cheaper and easier to get in Nigeria. This move showed that the Federal government indeed wants to fix healthcare and build a stronger, fairer system for everyone in the country. But intentions are one thing. Actions are another.
The policy, in line with the Nigeria Health Sector Renewal Investment Initiative (NHSRII), seeks to unleash the Nigerian pharmaceutical industry’s potential, boost its role in economic growth, and establish Nigeria as a global centre for health products and technology production.
Despite these steps forward, the past year brought major hurdles for Nigeria’s health sector. Key issues persisted, including lack of funds, poor infrastructure, and insufficient healthcare workers.
Japa hits health hard
The Japa syndrome, or exodus of healthcare experts, shows no sign of slowing down. Many skilled doctors, nurses, and other medical staff continue to leave for better opportunities abroad. This has led to more staff shortages in rural areas, which hurts the quality and availability of healthcare services.
Lack of funds for healthcare remained a big problem limiting the government’s ability to equip health facilities, buy essential medicines and supplies, and run effective public health programmes.
At the start of 2024, hopes rose when there was a push to increase the Federal Government’s budget for health and social sectors in the 2024 spending plan.
While the 2024 percentage allocation to the health sector was higher than in 2023, the total sum was actually less than the sum allocated for the previous year. The allocation of N1.23 trillion to health in 2024, which was less than 5 percent of the total proposed expenditure of N27.5 trillion compared to N1.3 trillion or 4.6 percent of the 2023 fiscal year budget was a downgrade.
But then, it was really not a surprising development as the health sector in Nigeria has consistently been underfunded even though investing in health has always been promoted as a strategic and vital investment in the country’s human resource and economic prosperity.
Poor power supply, lack of water degrade health system
In addition, poor infrastructure such as a lack of reliable electricity supply, crumbling medical facilities, and limited access to clean water and sanitation further restricted healthcare services. Infectious diseases, including new variations of COVID-19 and other emerging pathogens, presented major challenges to the Nigerian health system. The threat of antimicrobial resistance was amplified by the lack of quality antibiotics and inadequate infection control measures.
The extent of disparities in access to quality healthcare varied across the states and socio-economic levels, with the most significant obstacles being found among groups at the lower rung of development. Going forward, the healthcare system still faces challenges in delivering services due to accountability issues. While the idea of providing improved quality health services to all Nigerians without compromising their financial security is admirable and achievable, it is certainly not a picnic. No one knows this better than the government at the top.
2025: Better outcomes if…
Whereas
President Bola Tinubu’s Renewed Hope Agenda emphasises the significance of health for Nigerians and their overall welfare, the aim to prioritise preventive healthcare and improve the quality of hospital services, is another thing. This will remain the primary focus in 2025.
During the signing of the Sector-Wide Compact in Abuja, Prof. Muhammad Pate, the Coordinating Minister of Health and Social Welfare, highlighted the necessity of ensuring that all Nigerians have access to affordable and high-quality health services to enhance population health outcomes.
To establish an efficient, equitable, and high-quality health system, the Federal Government has adopted a strategic framework aimed at saving lives and alleviating the long-standing physical and financial burdens associated with healthcare access. This initiative is fundamentally linked to the goal of achieving Universal Health Coverage.
The launch of the Health Sector Renewal agenda represents a significant step towards reforming and implementing the National Health System as outlined in the National Health Act. Hence the Sector-Wide Compact reflects a collective understanding that health is essential for the accumulation of human capital.
Nigerians continue to aspire to a healthy and economically productive population that grows sustainably, supported by a health system that addresses the needs of all citizens in the context of the nation’s socioeconomic development. The signing of the Sector-Wide Compact signifies a commitment to align with the priorities outlined in the Renewed Hope Health Sector Blueprint, which aims to enhance governance, ensure accountability, and tackle the high rates of maternal, newborn, and child morbidity and mortality.
In the new year, there is hope that this initiative will unlock the healthcare value chain through state-led medical industrialisation in collaboration with the private sector, thereby strengthening the nation’s resilience and health security.
From hindsight, the foundational basis of the Sector-Wide Compact approach was to redesign the Basic Health Care Provision Fund (BHCPF) comprising at least 1 percent of the Consolidated Revenue Fund provided by the National Health Act (2014). It is hoped that the primary purpose of this agenda is attained.
It will ensure more equitable allocation of resources to the poor and disadvantaged populations in the country while ensuring mobilisation of additional development partner financial resources to a common pool or aligned in parallel with the sector-wide approach.
With $2.5 billion to $3.0 billion in pooled and non-pooled financing expected to be mobilised between 2024-2026 to be channeled to improve the primary health system, the hope for continuity and accountability in this perspective is highly anticipated in the new year.
There is a laudable plan to redesign the Basic Health Care Provision Fund (BHCPF) and double the number of fully functional Primary Healthcare Centers receiving decentralised facility financing for infrastructure upgrades, and operational costs to ensure delivery of high quality essential Primary Health Care packages.
If there are no compromises, the ambitious plan to gradually increase the number of fully functional Primary Healthcare Centers from 8,809 to 17,618 by 2027 in the 36 States and the Federal Capital Territory (FCT) is achievable. It is a task that must be done. Already, an allocation of N260 billion has been earmarked for this purpose, largely perceived to be a major step towards enhancing the country’s healthcare infrastructure. This too would be a major point of interest in 2025 and beyond.
All the signals of commitment apparent in 2024 must be properly followed up and the deliverables to bring improvements in the funding mechanisms for primary health care are entrenched with an integrated monitoring and accountability framework. The sector-wide approach to improve the coordination and drive for better alignment between the government and development partners will remain in focus.
In prioritising best-buy investments in community health models as a critical entry point to public health services, the retraining of up to 120,000 front-line health workers that kicked off in 2024 would continue to be in focus.
As a collaborative effort across the Federal and State Governments, as well as key development partners, it is hoped that there would be realistic monitoring and evaluation process, follow-ups, and/or feedback on the impact of this initiative toward the much-expected enhancement of the health workforce through the appropriate deployment of beneficiaries of the training exercise.
[Vanguard]