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Hope for Nigeria

The Health of Nigeria

cpuojt September 23, 2016 General No Comments on The Health of Nigeria

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The Health of Nigeria – With a population of about 186 million, Nigeria is the most populous country in Africa. Health is the main concern of the country.
Health of Nigeria

The public health system in Nigeria is weak, particularly at the primary care level. It is estimated that the government spends less than 5 percent of the national budget on health.
The private healthcare system is vigorous and provides care for a substantial proportion of the Nigerian population. However, the heavy reliance on the private healthcare sector introduces case management and health surveillance challenges
Healthcare provision in Nigeria is a synchronized responsibility of the three tiers of government in the country. Private providers of healthcare have a detectable role to play in healthcare delivery

 

OVERVIEW

The Health of Nigeria is in a poor condition and this is traceable to several factors especially the gross under-funding of the health sector and lack of skilled medical personnel at the primary health care level.


Nigeria is one of the several main health-staff-exporting countries in Africa. As a result of inadequate infrastructure and poor compensation packages, a large number of physicians, nurses and other medical professionals have moved away to developed countries in search of fulfilling and profitable positions. Related to brain drain is the problem of geographical distribution of health care professionals. There is an uneven concentration of medical professionals in urban areas. Health workers in underserved areas typically have motivational problems at work which may be reflected in a variety of circumstances, but common sign include: lack of courtesy to patients; failure to turn up at work on time and high levels of absence; poor process quality such as failure to do proper patient examinations and; failure to treat patients in a appropriate manner. These challenges can be tackling by increased funding of the health sector and the introduction of numerous incentives to health workers to compose working in unattractive areas more appealing.

Health infrastructure

The federal government's part is typically limited to coordinating the affairs of the university teaching hospitals, Federal Medical Centres a tertiary healthcare while the state government manages the various general hospitals (secondary healthcare) and the local government focuses on primary healthcare, which is regulated by the federal government through the NPHCDA.

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The health sector in Nigeria in overall is a concurrent responsibility of the three tiers of government (Federal, State and Local), but responsibility for the funding of the PHCs lies with the local government authorities . Like all other sectors in Nigeria, it has been faced with daunting challenges. Hence, healthcare services provision at the main healthcare centres has been negatively impact by the challenges with serious implications for quality of services given in the PHCs and by delay, the quality of healthcare services available to the down-trodden at the grass root and rural areas. Valuation of the health care system in Nigeria in recent times does not only indicate that it is non-productive; efforts for improvement have not had any obvious impact.
Health insurance
Health insurance in Nigeria has a difficult historic development from its inception in the year 1962 up to its revision by the National HealthInsurance Scheme or NHIS, Act 35 of 1999. Nigeria as a country has a population that exceeds 178 million people with developing the economy and an infrastructure that needs to be improved; the Nigerian health system is faced with adverse hindrances such as financial crisis, disease outbreaks and political instability. In 2004, the insurance coverage was assessed to be at 150,000 lives which later increased to about 5 million in 2014 (a 3% of the total Nigerian population). Lastly, The Nigerian healthcare system is made up of private and public managed medical facilities.

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Cancer care

A new bone marrow donor program opened in 2012 and the second in Africa.In cooperation with the University of Nigeria, They collect DNA swabs from people who wants to help a person with leukemia, lymphoma, or sickle cell disease to find a well-matched donor for a life-saving bone marrow transplant. It hopes to expand to include cord blood donations in the future.

 

Mental health

Nigeria is a typical case of a developing nation. The country is generally short of physicians and, with a population of over 120 million, they have less than 100 psychiatrists. The majority of general practitioners are without postgraduate training and situated in private practice, in most cases working on their own. This group of physicians, along with others in government-owned institutions, offer primary care services. Unfortunately, these services are mainly located in urban areas, and mostly in the rural areas, where the majority of the populace (approximately 70%) reside, are deprived of health services. Part of the government's efforts in meeting some of this challenge, between 5 and 15 local health facilities have been built In each local government area (district) of the country. Specially trained individuals with or without a medical background and different educational levels run these facilities.

 

Water supply and sanitation
Access to a developed water source stagnated at 47% from 1990 to 2006 but increased to 54% in 2010. In urban areas, access to a better water source actually decreased from 80% to 65% in 2006, but it then recovered to 74% in 2010. However, in urban areas entree to standpipes substituted to a large extent to piped water access.
Water supply and sanitation are not provided resourcefully in Nigeria

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ISSUES

Transparency in Nigeria's public pharmaceutical

Pharmaceuticals are an essential section of health care systems worldwide, thus, regulatory weaknesses in the governance of the pharmaceutical system damagingly impact health outcomes especially in developing countries. Nigeria is one of the countries whose pharmaceutical system control by corruption and has struggled to curtail the production and substandard drugs trafficking. In 2001, the National Agency for Food and Drug Administration and Control (NAFDAC) experienced an organizational restructuring causing in reforms to reduce counterfeit drugs and better regulate pharmaceuticals. But always remember there is still room for improvement. This study evaluated the perceived level of transparency and possible vulnerability to the corruption that exists in four vital areas of Nigeria's pharmaceutical sector: procurement, registration, inspection (separated into inspection of ports and of establishments), and distribution.

 

Geographic inequality

Different regional and local factors that influence the quality or quantity present in one location that influenced the healthcare in Nigeria. The healthcare system in Nigeria has shown spatial variation in terms of quality and availability of facilities in relative to need. However, this is largely as a result of the level of state and local government participation and investment in health care programs. Also, the Nigerian ministry of health frequently spends about 70% of its budget in urban areas around 50% of the population resides.

Health worker situation in Nigeria

Among the many challenges in the health system in Nigeria, is acute shortage of competent health care providers. As a result of insufficient infrastructure and poor compensation packages, a sizeable number of physicians, nurses and other medical professionals are going to developed countries in search of fulfilling and lucrative positions. In fact, some of these countries have established recruiting agencies and examination protocols targeting the best and brightest medical minds in Nigeria, prompt the government to require that these agencies register with the Federal Ministry of Health and operate within a conventional framework. Nigeria is a major health-staff-exporting nation, accounting for 432 out of a total of 2000 nurses that move out of Africa between April 2000 and March 2001 . This figure comes out to be underreported as it fails to take into account the enormous number of nurses who migrate abroad under a different cause. The efflux has resulted in shortages in local health facilities and drastically impacted access.

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Factors driving human resource challenges in health sector in Nigeria

The major factors driving this problem have been identified and these include:
(i)Insufficiently resourced and neglected health systems;
(ii) Management practices and structures and Poor human resources planning;
(iii)Unsatisfactory working conditions characterized by lack of professional autonomy; poor supervision and support; long working hours; unsafe workplaces; heavy workloads; inadequate career structures; poor remuneration/unfair pay; limited or no access to professional development opportunities; and poor access to needed tools, supplies, and information;
(iv)Internal and international migration of health workers.

 

Health status

Life Expectancy
According to the latest WHO data published in 2015 life expectancy in Nigeria is: Male 53.4, female 55.6 and total life expectancy is 54.5 which give Nigeria a World Life Expectancy ranking of 171.

Top 10 causes of death in Nigeria.

1. Influenza and Pneumonia
According to the latest WHO data published in, may 2014 Influenza and Pneumonia Deaths in Nigeria attain 290,238 or 15.22% of total deaths. The age adjusted Death Rate is 234.12 per 100,000 of population ranks Nigeria #4 in the world

2. HIV/AIDS
Of all people living with HIV globally, 9% of them live in Nigeria. Although HIV prevalence among adults is extremely small (3.2%) compared to other sub-Saharan African countries such as South Africa (19.1%) andmZambia (12.5%), the mass of Nigeria's population means that there were 3.2 million people living with HIV in 2013.
Nigeria, together with Uganda and South Africa, account for almost half of all annual new HIV infections in sub-Saharan Africa. This is despite accomplishing a 35% reduction in new infections between 2005 and 2013.
Approximately 210,000 people died from AIDS- associated illnesses in Nigeria in 2013, which is 14% of the global total. Since 2005, there has been no reduction in the number of annual deaths, indicate to the fact that only 20% of people living with HIV in Nigeria are accessing antiretroviral treatment (ART)
Heterosexual unprotected sex accounts for about 80% of new HIV infections in Nigeria, with the major of remaining HIV infections among key affected populations.

3. Stroke
Stroke is a leading cause of morbidity and mortality worldwide, and it is likely to worsen in developing countries over the next two decades according to the projections by the World Health Organization (WHO). Nigeria stands to risk the further damage of its resources as a result of the increasing prevalence of stroke and other cardiovascular diseases because of epidemiological transition. The current prevalence of stroke in Nigeria is 1.14 per 1000 while the 30-day case fatality rate is higher as 40%. Management of the disease is largely conservative while there is little or no support for high-quality research. Major prevention is the key to reducing the burden of the disease in a country with such poor resources.

4. Coronary heart disease

Coronary Heart Disease (CHD) remains a major cause of morbidity and a leading contributor to mortality worldwide. The World Health Report estimated that in 1998, 78% of the burden of non-communicable diseases (NCDs) and 85% of the CHD burden come from the low and middle-income countries. This CHD burden afflicts both men and women, with CHD deaths for about 34% of all deaths in women and 28% in men in 1998. Nigeria has witnessed tremendous socio-economic revolution and rural-urban migration which have led to the emergence of non-communicable diseases.

5. Diarrhoea
Diarrhoea diseases are among the leading causes of morbidity and mortality in under-five-children (U-5C) in Nigeria. Insufficient safe water, sanitation, and hygiene account for the disease burden. Cases of diarrhoea still occur in top proportion in the study area despite government-oriented interventions.

6. Malaria
Malaria is transmitted throughout Nigeria with the entire population at risk. The 2015 Nigeria Malaria Indicator Survey (MIS) reported a fever prevalence of 41 percent in children. Of those with fever, 66 percent sought advice or treatment, and only 30 percent went to the public sector. Microscopy data from the 2015 MIS show that the popularity of malaria in children under five years of age is 27 percent with wide regional differences. The duration of the transmission season at the time from year-round transmission in the south to 3 months or less in the north. Plasmodium falciparum is the predominant malaria species.

7. Diabetes Mellitus
Diabetes mellitus (DM) is a diverse group of metabolic disorders that is often associated with a high illness burden in developing countries such as Nigeria. Nigeria, with a population of 158 million people, is a packed country in Africa and accounts for one-sixth of Africa’s population. Approximately 50% of Nigerians are urban resident and the country has a cultural diversity and 398 documented ethnic groups

8. Meningitis
According to the latest WHO data published in may 2014 Meningitis Deaths in Nigeria reached 75,630 or 3.97% of total deaths. The adjusted age Death Rate is 41.79 per 100,000 of population ranks Nigeria #5 in the world.

9. Prostate cancer
Prostate cancer research in Nigeria is growing and multifaceted. According to the latest WHO data issue in May 2014 Prostate Cancer Deaths in Nigeria reached 9,629 or 0.51% of total deaths. The age adjusted Death Rate is 41.48 per 100,000 population that ranks Nigeria #11 in the world

10. Liver Cancer

According to the latest WHO data published in may 2014 Liver Disease Deaths in Nigeria reached 37,329 or 1.96% of total deaths. The adjusted age Death Rate is 38.60 per 100,000 of population ranks Nigeria #13 in the world.

 

References:

Health in Nigeria

Water Supply and Sanitation in Nigeria

History of Health Insurance in Nigeria
Mental Health and Primary Care in Nigeria

The Nigeria health sector and human resource challenges

Nigeria Life Expectancy”
Hygiene and sanitation risk factors of diarrhoeal disease among under-five children in Ibadan, Nigeria
The burden of stroke in Nigeria
HIV and AIDS in Nigeria

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