Fixing Nigerian Healthcare: This policy wahala

by Nnewuiha Obinna

 

At a health outreach a few weeks ago, a lady came in looking very worried. Her 6-month old daughter wasn’t breathing properly and had been restless all night. I asked why the child hasn’t been taken to the hospital, only to discover that she had been seen by a doctor a few days earlier. The problem however remains money to pay for the chest x-ray and basic investigations that would be necessary to arrive at a proper diagnosis, so that treatment may begin. That money stood in the way between life and death for a child much too young to understand what exactly was going on around her.

All health systems are built in a bid to reconcile unlimited health needs with limited resources. The case for a super-efficient health system becomes even more important when you consider the fact that inflation plus a swelling population is not exactly the recipe for controlling cost and providing high quality service.
If everything was working as it should, or as we usually say- if everything was working ‘ideally’, health systems would do 4 things for us:

  • Provide health access to everyone who needs it…
  • Access would be high quality: drugs, facility and staff
  • At a cost that is affordable to whoever is paying- either the government or the individual.
  • While ensuring quality work-life and job satisfaction of the healthcare workers that care for the population.

Okay, so let me welcome you back to the real world where essential trade-offs have to occur in order to ensure there’s a sustainable system that is at the very least equitable.
In a bid to reach where we are going- i.e. achieving the 4 broad targets for our health system, we would have to think up a strategy to get there, yes?
This plan of action, or direction in which we want to steer ourselves would usually be formulated and written down in order to serve as a guide. If the ideals of an efficient health system form the promise land– we may well say our policy document is our compass. For in developing policy directions for any cause, we must first figure out where we want to go, and how best to arrive there.

So are these policies the same as rules or laws? Nope! Policies are the guiding principles from which the actions that are in the best interest of an organization or state are taken. If we say for instance- that our desire is to create a society that guarantees the treatment of all children under 5 years irrespective of social status or ability to pay- then to bring this vision to reality, we must go about the process of structuring policies that guide our achievement of this target.

In the light of the above, we may still ask sincerely? “who all this talk epp sef?”
You see our dear country has a set of policy guidelines for virtually every aspect of our health care. Where it doesn’t exist, there are at least ideals which that arm of the health system was set up to achieve and challenges it was built to solve. Whether these policies are being implemented and if they are achieving set out targets are genuine issues that determine whether there are drugs in your General hospital or doctors available to carry out an emergency surgery if one is hit by a ‘stray’ bullet. This set off broad visions for where we want our health system to be, is the template from which rules, laws, guidelines and action eventually stem from.

Over the course of the year, we shall be discussing various policy options for our health system. Why don’t we have enough health workers and what options are there for recruiting more? Is there a better way to manage the continuous population increase that is fast outstripping our national capacity to cater for? What are we currently doing about reducing the burden of diseases such as HIV/ AIDS?

Together, we would be looking at system-wide issues as it relates to funding, availability and access to quality health care across the country. Your contribution will be very key in ensuring we engage properly and learn from each other. I know we shall disagree on some viewpoints; lol, but I would do well to appeal in advance- lets be kind enough to remain on the topic and make our assertions from a premise built on facts and available data.

Next week, we would look at the budget for health in 2017. How much dey there abeg?


Nnewuihe Obinna is a medical doctor at the intersection of medicine, economics and improving the Public’s health. He is passionate about improving health through research, evidence based therapy and policy.

He currently serves on the Steering committee of the Commonwealth Youth Health Network where he holds the position of Coordinator, Research and Programs. He tweets as @ob_001

One comment

  1. Yes o. time to start talking one on one, the government is generally by the people,let we the people step in beyond just “The Vote”. the availability of good healthcare is in our best interest and we should work on it. Together.

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