Nigeria’s health sector: Much spent, little gotten

From Fred Ezeh, Abuja

In last five years, Nigeria budgeted over N2 trillion for its health sector, with a significant amount of the money released for capital projects and other interventions. Some was through the platform, Basic Health Care Provision Fund (BHCPF), while others came through various platforms, for improved health care system.

There has also been significant intervention, financially and otherwise, from foreign governments, donor agencies, United Nations and European Union agencies for the improvement of the health care system in Nigeria.

Data from the World Bank indicated that Nigeria’s public spending on health care amounts to 3.75 per cent of its $495 billion of its gross domestic products (GDP).Untitled 8 7

In spite of this fact, health services in Nigeria continue to decline, with many Nigerians, including political leaders, increasingly losing interest and confidence in the system.

The unexpected arrival of COVID-19 in 2020 further exposed the deplorable state of the health system in Nigeria. Makeshift provisions were quickly put up to accommodate large numbers of people seeking medical attention. Private sector also intervened through the platform, Coalition Against COVID-19 (CACOVID), established to assist government in combating the COVID-19 pandemic.

Presidential complaint

A few years ago, the First Lady, Mrs. Aisha Buhari, openly condemned the administrative rot and infrastructural decadence in the health sector when her son was forced to visit a hospital in Nigeria for minor medical attention.

The rot and loss of confidence, perhaps, increased public interest in medical services abroad (medical tourism) for those who could afford it. Political leaders led the way, spending billions of naira annually on medical bills abroad. There are reports that over N5 billion ($1.2b) is expended annually on medical tourism abroad, mostly on oncology services and other ailments.

Protest in London

Meanwhile, there was a peaceful protest at Nigeria’s Embassy in London, days ago, against the presence of President Muhammadu Buhari in the United Kingdom for routine medical checks. This was after almost two years since the President’s last visit for the same purpose.

The protesters in London said it was inexplicable that the President could leave Nigeria amid doctors’ strike and come to London to receive quality medical care from a working health system, thus leaving people in Nigeria, particularly poor people in rural communities, to die of minor ailments in bad hospitals.

They demanded that the President return to Nigeria as quickly as possible, fix the hospitals and make use of them alongside his family members, and also compel those in his government to use them too, in order to boost public confidence in the quality state of Nigerian hospitals, as well as services rendered there.

However, contrary to the position of the protesters, a cross-section of Nigerians converged at the Nigeria House in London to show solidarity and support for the Buhari-led administration. They said the President was doing well and should be supported to continue.

Patients’ lamentation

Meanwhile, the situation worsened some days ago when medical doctors, under the umbrella of National Association of Resident Doctors (NARD), withdrew their services from hospitals over unpaid salaries, entitlements of their members in some states and other labour-related issues.

The recurrent industrial action of the doctors often worsens the deplorable state of health care service delivery, with patients having to feel the negative impact. Expectedly, patients in affected hospitals across Nigeria began to feel the impact a few hours into the nationwide strike by the medical doctors, which commenced April 1.

Rebecca Onah, a patient on admission at Wuse General Hospital, Abuja, screamed, “Not again!” when she heard about the nationwide strike that took of at midnight of April 1, 2021.

She said: “There should be a permanent solution to this unending strike by medical doctors. It’s unexpected that these set of people rendering essential services should abandon hospitals where the common man in the society gets medical services because of arrears of salary and other entitlements.”

Khadijat Bello, a patient at Federal Medical Centre (FMC), Jabi, Abuja, expressed concern over the pathetic situation in the hospitals, predicting that the industrial action would have negative impacts on her health, which, she said, was beginning to improve.

She appealed to the Federal Government to attend to the needs of the doctors so they can return to the hospitals as soon as possible to save lives.

Another patient, Kelechi Emeri, expressed sympathy for caregivers who could not afford the services of a private hospital, with fear that many lives may be lost before the strike is over and doctors return to the hospitals.

He said: “I moved my brother to a private hospital in Apo from Maitama General Hospital, Abuja, immediately I got a hint of the proposed strike. It cost me a fortune. I did that because I could afford it. What of those that could not afford the services of private hospitals? They would be left to their fate.

“It’s a shameful and inconsiderate that the President jetted out of the country to London for what he called routine medical checkup when medical doctors are on nationwide strike. Our political leaders should fix the health care system in Nigeria for the benefit of the rich and the poor.”

NARD president’s


NARD president, Dr. Uyilawa Okhuaihesuyi, accused political leaders of not being interested in developing the health care system for the benefit of other classes of Nigerians who might not be able to travel abroad for medical care.

He said: “COVID-19 obviously exposed the rot in Nigeria’s health system. We shouted loudly long before COVID-19 came. We embarked on several strikes to demand improved health care system but nothing was done until COVID-19 came and further exposed our weak health care system.”

He explained that the nationwide strike was all-encompassing: “First was to reawaken the consciousness of the Federal Government on the need to improve the health care system for the benefit of Nigerians, and, second, to offset the debt owed medical doctors and other issues already highlighted with government.”

He acknowledged that the industrial action would affect smooth delivery of health care services across government-owned hospitals but apologized to Nigerians and solicited their understanding and support in the fight for the betterment of the health system.

He said that National Executive Committee of NARD, at its meeting, bemoaned the suffering of its members on GIFMIS payment platform who have not been paid salaries for four months due to delay in biometric capturing by IPPIS department as well as other challenges highlighted by the doctors.

Similarly, a senior official of Nigerian Medical Association (NMA), said the situation of public health care in Nigeria was deteriorating because of poor attention from government.


He said: “Imagine the President and officials in his government taking pleasure in foreign medical care. That’s exactly what happened to public education system that led us to where we are in public education and health systems today.”

Some medical doctors suggested that medical attention abroad be restricted to complications that could be difficult to resolve within Nigeria.

An Abuja-based medical doctor who preferred to be identified as Dr. Kasimu, said, “This suggestion may be difficult to implement because of the freedom granted by the Constitution on that matter.

“However, it will take the collective effort of Nigerians and political will of the ruling class to implement. COVID-19 lockdown taught everybody a lesson. Everybody was restricted indoors, meaning that everybody must consume homemade items. It was a good example of what is required for a better country.”