How underfunding cripples health care delivery, by experts 

By Job Osazuwa

The current economic challenges afflicting the country are causing several major crises. Besides the poverty and hardship being spread by recession, medical experts are getting worried that more Nigerians are developing psychiatric conditions.

Recently, health experts, non-governmental organisations (NGOs), health-related agencies and members of the Health Writers Association of Nigeria (HEWAN) converged on the Lagos University Teaching Hospital (LUTH), Lagos State, to seek ways for better health care delivery in Nigeria. The symposium was organised by HEWAN.

At the event, underfunding by government at all levels was identified as a major problem in the health sector. Many lamented that Nigeria was still top on the list of African countries that were not paying the much attention to the health challenges of citizens.

More Nigerians suffer insanity

At the symposium, a consultant psychiatrist at the Federal Neuropsychiatric Hospital, Yaba, Lagos, Dr. Stephen Oluwaniyi, said the recession had adversely affected health care service, adding that government has been under intense pressure to reduce spending on public sector.

He disclosed that there was a 59 per cent increase in new psychiatric cases at the Yaba facility in 2016. While saying that patients who seek early treatment could live meaningful and positive lives, Oluwaniyi lamented that the Yaba hospital was inadequate for the health needs of the entire state.

He described health as physical, mental and social wellbeing, and not just the absence of disease. According to him, many Nigerians were suffering mental disorders requiring medical care but they frequently mistake these conditions for “spiritual attacks.” He described them as the most endangered of psychiatric patients.

Oluwaniyi listed the causes of negative mental health as neglect, poor antenatal care, abuse, hardship, exposure to infection, genetic disorders and poor nutrition. Others are physical inactivity, lack of sleep, pitiable living wages, poor transportation system, job loss and unfavourable government policies.

The doctor warned that persistent, chronic stress could get out of hand if not checked. He submitted that, for example, people who feel tense, even when asleep, need urgent medical attention.

The expert, however, said resilient people with cognitive flexibility and active coping skills could overcome any difficult situation that could lead to mental issues in others. To prevent more Nigerians from going insane, he recommended healthy sleep, avoiding excessive alcohol and revolution of the primary health care system by the government.

At the symposium, Chief Medical Director of LUTH, Prof. Christopher Bode, said journalists disseminating information on diverse health issues was an onerous duty, as newsmen needed to report adequate, correct and timely information to the populace.

“It means that you have to forget your profession as a journalist and dig into different areas of medicine in order to report accurately. Funding health institutions is something we really need to emphasise, but giving out the right news is also important so that rumours will not fill the gap,” he said.

He noted that it was necessary for journalists to collaborate with health care managers to advance the cause of the common man who cannot afford to travel abroad to access top-rate health care services.

Bode lamented that out-of-pocket payment for medical bills had worsened health care delivery in Nigeria. He said, if people could have a long-term plan to own a house or buy and insure a car, there should also be functional health insurance cover.

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He explained that, “Health insurance that is not effective in Nigeria makes things very difficult for health care delivery. There is a limit to what LUTH can do in assisting patients because we need to keep the facility running for other patients to benefit from.”  

The CMD commended the Federal Government for recently initiating the “no work, no pay” policy. He said the decision had helped in reducing incessant strikes that had crippled the health sector in the past. He added that strike was not the best option for resolving industrial matters, because humanity and even God would be offended to see people receiving salary for service not rendered. He added that he usually felt ashamed whenever Nigerians travelled abroad for minor ailments.

The CMD, Lagos State University Teaching Hospital (LASUTH), Prof. Olawale Oke, also harped on the need for journalists to collaborate with medical practitioners to achieve factual and in-depth reporting, for the benefit of patients.

All the speakers at the event, from the public and private sectors, agreed that increased health care funding by government would prevent many diseases, boost life expectancy and put a halt to avoidable deaths.

The programme officer of the Health Reform Foundation of Nigeria (HERFON), Ms Anu Rotimi, told Daily Sun that poor and vulnerable Nigerians had been at the receiving end of the shallow health care services available in the country.

She said it was unfortunate that the Abuja 2001 Health Budget Declaration, which Nigeria was signatory to, had remained a mere fantasy.

“At the Abuja assembly, it was agreed by African countries that, at least, 15 per cent of their annual national budgets would be dedicated to health. It is interesting to know that countries like Rwanda, Togo, Zambia and Tanzania have since achieved the target, while many states in Nigeria are still struggling between 2 and 7x per cent, except Bauchi State that has achieved the percentage,” she said.

What media must do

HERFON urged the media to actively bring issues surrounding health budgets and finance to the public space, to ensure that government meets its commitment towards adequate funding of  the health sector.

Speaking on the “Role of Media in Advocating Increased Health Sector Budget in Nigeria,” the group said there was the need to build strong partnerships to advance child and family health so as to prevent avoidable deaths.

Rotimi said: “Over the years, evidence has shown that the media plays a vital role in mobilising people for national development. It is the connection between the people and government. Advocating improved health outcomes is a role for all stakeholders, in which journalists are critical stakeholders.

“It is interesting to note the interplay of both intrinsic and extrinsic factors that determine what good health is all about. Appropriate allocation, prompt release and value for money, utilisation of health funds are important, and not just mere reduction in maternal mortality rate or infant mortality rate, but much more transparent utilisation of funds allocated to health.”

She charged the media to remind government to honour its various commitments on health financing: “When there is poor funding on health, all other sectors of the economy would be affected.” She also wants the government to honour the National Health Act that says 1 per cent of the Consolidated Revenue Fund should be allocated to the health sector.

Regretting that health stories rarely make it to the cover pages of newspapers, she listed other challenges of health finance reporting in Nigeria as “limited investigation on health sector funding; inadequate reporting on health finance; limited expertise and interest groups to track and report outcomes on health financing; and limited demand in accountability by the media on health budget.”

Rotimi stated that there was the need for journalists to write or broadcast stories that could enhance funding of the health sector, push for more focus on health funding and draw the attention of policymakers to matters of national health care.