Today, I’ll be talking about something that’s close to everyone’s heart, because I’m sure nobody in Nigeria has been unaffected by the Nigerian healthcare system in some way.
When I was in my final year of medical school, my youngest brother came to Nigeria, and while we were communicating with him, he became critically ill. We needed to transfer him to a larger hospital in Lagos for advanced treatments. Like nearly a billion people worldwide, he found herself in the wrong place at the wrong time. It’s not that the help he needed wasn’t available anywhere, but it just wasn’t available where he was.
We tried organizing an air ambulance service for him but we found out, it doesn’t exist in Lagos. We have no option than to start organizing one from Johannesburg, nearly 7 hours away, but sadly, he died before it could get to him. This tragic experience motivated me to start working on the problem of people being in the wrong place at the wrong time, with hospitals available far away. But as I moved to Nigeria, I realized healthcare was a much bigger issue than I had anticipated.
So today, I’ll be discussing how we can fix healthcare in Nigeria. In my research, I came up with five pillars of healthcare with the five major issues that I feel that if we could fix, we could have something closer to a world-class healthcare system and maybe move up that ranking slightly.
Task-shifting
Primary healthcare expansion
Maternal and child health services
Sustainable healthcare financing
Tertiary healthcare centralization
The first pillar is task-shifting. Why? Because of the severe shortage of healthcare professionals in Nigeria. In Greece, for example, there are 116 doctors for every 100,000 people. In Germany, there are 112. In places like the US slightly fewer they have about 54 doctors for every 100,000 people. In Nigeria, there’s just one doctor for every 100,000 people. In West African countries like Mali, Chad, and Togo, it’s even worse. How do we approach the same level of healthcare as countries with 116 doctors per 100,000 people without shifting the responsibilities or at least some of the responsibilities of a typical doctor – perhaps the community pharmacists, biomedical scientists, biomedical engineers people that have studied the sciences in a world versed in humans and pharmacology, but perhaps don’t have this fancy medical degree and there’s good evidence behind it.
The second pillar is primary healthcare. Primary healthcare can meet 90% of our health needs at a fraction of the cost of tertiary care. In my book, I use Dangote as an example. He has two factories in Nigeria that supply most of West Africa, and the real lifeblood of his company is not the factories themselves but the local sellers who bring his product to the people. Similarly, primary healthcare in local communities can meet the vast majority of our healthcare needs and is far cheaper than relying on tertiary hospitals.
The third pillar is maternal and child health services. Given the alarming neonatal death rates in Nigeria, prioritizing maternal and child healthcare could significantly reduce unnecessary deaths and improve outcomes for mothers and children.
The fourth pillar is sustainable healthcare financing. Nigeria’s entire GDP is around $375 billion, but the UK spends about $200 billion on healthcare alone every year. Our healthcare budget is only about $1 billion, that means that it would take us 200 years of our health care budgets to be able to accumulate what the UK spends on health care in a single year. Moreover, we face severe fiscal constraints, with most of the budget going toward debt repayment, leaving little for healthcare. This financial imbalance severely limits our ability to fund the healthcare system adequately.
Finally, the fifth pillar is tertiary healthcare centralization. Larger hospitals that specialize in treating critical illnesses are more efficient and cost-effective. Patients tend to fare better in specialized centers, and centralizing healthcare could improve patient outcomes and reduce the overall cost of care. This approach could also mitigate the impact of the fragmented healthcare system we currently have, where many hospitals are underfunded and poorly equipped.
The purpose of this article is to encourage everyone to really get people tweeting about it, going to see their local politicians, writing letters and really thinking about how we can solve this big problem of healthcare. Because like I said at the beginning, it’s something that has affected and will continue to affect our friends, our mothers, our kids, all across Nigeria. And fixing this problem for every $1 invested in healthcare you get $2 back into the economy so fixing this problem is really the key to not just creating healthier Nigerians but actually a healthier West African population.
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