How Nigeria’s economic problems affect healthcare

Nigeria’s economic problems have a significant impact on the country’s healthcare system. Ordinarily, there are a host of opinions among many citizens about how these adverse relationships work to undermine the level of good healthcare delivery to the majority of our citizens.

Towards the end of the last century, there was a mantra which was blared from our radios and televisions, and visible on the pages of newspapers and magazines, about the desirability of achieving health for all by the year 2000.

The first quarter of the 21st century is about to end and today; we are farther away from those lofty objectives than we were in 1997. The year 1997, is not chosen arbitrarily because it was the same year in which a very highly developed Hong Kong was handed over to a still developing China by the British government.

Today, nearly 27 years later, China has risen from a position where it was responsible for about 2.7 per cent of global GDP to about 17 per cent today, while Nigeria by comparison has fallen from being the largest economy in Africa to the fourth-largest.

The backward march has adversely affected every aspect of our lives, not the least of which is the health sector. This week, we shall be looking at some of the ways in which economic challenges affect healthcare in Nigeria. This lack of infrastructure hinders the delivery of quality healthcare services and contributes to poor health outcomes.

The healthcare system in Nigeria is largely underfunded, which leads to a lack of essential medical supplies, equipment, and adequate healthcare facilities. This results in a lower quality of care and limited access to healthcare services for many Nigerians.

At a general hospital in another developing country, one was privileged to see that every possible diagnostic tool available in some of our teaching hospitals was also available there.

In the operating suite of the obstetrics and gynaecology department, there was even an ultrasound machine exclusive for use by that department in the operating room. The hospital had an MRI machine not to mention a CT scanning machine.

The orthopaedic and trauma operating room was equipped with an image intensifier and all theatres were active every blessed day except weekends. The laboratory sent out its results directly to the hospital’s information system which the doctors and nurses could assess by logging on to any computer within the hospital with their user details.

The same was true for the radiology department; no patient was ever given X-ray films to take around from one part of the hospital to another. The pictures and reports are available in the hospital’s intranet system.

Even our teaching hospitals do not have these facilities with the result that everything is requested on physical forms by hand and some members of the staff will have to go to the lab and take possession of the required results. This narrative above was in a general hospital in a small town.

There is no need to talk about what one saw in one tertiary hospital, which is not even a teaching hospital. It suffices to say that because it is a tertiary centre, it has a heliport for receiving medical emergencies in cases deemed too unsafe to undergo road journeys.

Nigeria’s healthcare system is severely underfunded, with healthcare budgets usually insufficient to meet the needs of the population. Such limited funding results in a lack of essential medical supplies, equipment, and medications in healthcare facilities just as we saw in the first paragraph.

When you look across your mind to imagine the structures in place where you have come from, there is no other emotion than sheer anger at what our leaders have done to us. And the rot is accelerating at a dizzying pace. It is clear now that insufficient budget allocations also lead to challenges in maintaining healthcare infrastructure and providing adequate training for healthcare professionals.

The economic challenges in Nigeria have contributed to a phenomenon known as “brain drain,” where many skilled healthcare professionals leave the country in search of better opportunities abroad. This leads to a shortage of qualified healthcare workers in Nigeria, further straining the system.

The result is overworked healthcare personnel, who are poorly paid and forced to make their input with inadequate equipment which is so antiquated in some cases that the readings they produce cannot be relied upon.

Economic difficulties can make healthcare services unaffordable for many Nigerians, especially those living in poverty. This, of course, compounds the problems already being faced by the impoverished majority who barely earn a living wage and have to cope with a lack of electricity, pipe-borne water and rising costs of food and transportation.

This combination generates a lack of access to healthcare services which often leads to delayed treatment, worsening health outcomes, and increased mortality rates, all of which are due to delayed presentation in the hospital. As the referral system is not in evidence, these people start their therapeutic journey from the neighbourhood chemist.

When they do not get better, they go to the herbalist or vice versa. Then they invite the itinerant auxiliary nurse to administer some medications and drips. By the time they have perambulated like this, and there is no improvement, they belatedly go to a hospital where there will by then be no money to pay for the required treatment.

The health insurance system caters only for a tiny percentage of the working population. The teeming majority working for themselves in the informal sector are not covered, and this is where most of the poverty is domiciled, as well as most of the communicable disease conditions.

Overall, Nigeria’s economic problems have a profound impact on its healthcare system, leading to challenges in funding, access to care, healthcare infrastructure, and outbreak preparedness. Addressing these economic issues is crucial to improving healthcare outcomes and ensuring better health for the people of Nigeria.

As if the stated challenges are not severe enough, we have been shocked within the last few days by a further rise in the cost of fuel. All of this is happening in a country where a serving minister reportedly stated a few months ago that obtaining fuel worth N1.6m for a road trip to Enugu from Abuja was no big deal.

In the same Abuja, one private hospital spends 5 million Naira a month on diesel alone for its generators. How is it then possible for such a facility to render quality service? Clearly, economic challenges can also impact Nigeria’s ability to effectively respond to health emergencies such as disease outbreaks.

Limited funding for public health programs and inadequate healthcare infrastructure definitely hinder the country’s ability to detect, prevent, and control outbreaks, thereby putting the population at risk. There is no wonder then, that every year, our populace has to face recurrent outbreaks of communicable disease conditions mainly meningitis, cholera, typhoid fever, yellow fever, Lassa fever and so many others.

To this day, due to inadequate funding, specimens from the affected patients in these conditions have to be taken to other states for diagnosis and confirmation, thereby wasting critical time in stopping infections. In some cases, confirmation is not received until specimens have been sent to laboratories abroad.

Economic challenges contribute to a shortage of skilled healthcare professionals in Nigeria, as many seek better opportunities and higher salaries abroad. The exodus of healthcare workers leads to understaffed healthcare facilities, impacting the quality of care and causing longer wait times for patients.

The shortage of healthcare workers also affects the delivery of specialised medical services, particularly in rural areas. These economic difficulties result in inadequate healthcare infrastructure, including a lack of hospitals, clinics, and medical equipment. Sometimes, fantastic hospitals are built in some places like the immediate past governor of Kogi state did but there is a serious lack of personnel to staff those hospitals even on a locum basis.

The end result is that the envisaged range of healthcare services are not delivered to the very people who need it because although the hospitals have, like in the case of Kogi State, been built to some reasonable standard, people do not want to work there.

The reasons for such a lack of personnel are various. For one, as healthcare workers increasingly escape from economic difficulties at home, there is a rural-to-urban migration of other healthcare workers to take up some of the vacancies left by the “japa group”.

Some others migrate directly from the hinterland straight to foreign countries. Others will not take up such jobs because of the worsening insecurity around the country, even if they have no alternatives. Lastly, many healthcare facilities in Nigeria lack basic amenities such as electricity, running water, and sanitation, which hinders the provision of quality care.

Such poor healthcare infrastructure contributes to overcrowding in hospitals, limited access to care, and overall poor health outcomes. High out-of-pocket expenses for healthcare lead to financial barriers that prevent individuals from seeking necessary medical treatment, so they often avoid hospitals altogether.

Questions and answers

Good morning, doctor. Your efforts in assisting people to solve their medical problems are highly appreciated. May God enrich your knowledge and grant you good health. A 73-year-old widower friend wants to know if masturbation is harmful to his age. Thanks. 08035509XXX

Thank you very much for your comments, prayers and contribution. Masturbation is not harmful to his age and it is not harmful at his age, which is what your question seems to want to clarify.

Good afternoon, Sunday doctor. I am a 19-year-old boy with swelling in my right jaw. The thing is round and moves a bit. It does not pain me, but it has been there since around January this year. It doesn’t used to pain me but now I feel some discomfort when I swallow anything including saliva and it is bigger than it used to be. What should I do sir? 07036509XXX

Thank you for your question. You should see a doctor for a proper examination to determine the character of this swelling. The picture you sent shows it to most likely be a lymph node. Your doctor will take blood samples for various tests and an ultrasound of the swelling. Depending on what the results are, further steps might be taken to remove the swelling for a microscopic examination.

Dear Sunday, doctor, I am a 34-year-old man and anytime, when I go to urinate after I finish and clean up myself, I will see another portion will drop down and stain my trouser. Please, what is the remedy, sir?  Thank you very much for the awesome work you are doing, regards.

Thank you very much for your kind words. This scenario occurs when you either have weak muscles in your pelvic floor or when there has been some damage to your urethra following an operation or an infection such as gonorrhoea or non-gonococcal urethritis. The urethra is the pipe that connects the bladder to the tip of the penis and is responsible for getting urine out of your body. So you should see a doctor for a proper examination to determine what is causing yours to happen. After that, treatment should be possible.

Good day, sir. I am a 24-year-old woman who just had my first baby four months ago. It’s a boy and he likes to play a lot so my friend suggested that I get him a trampoline. But I just want to know if trampolines are dangerous. Thank you.  08034442XXX

Trampolines can be dangerous for kids if proper safety measures are not taken. According to the American Academy of Pediatrics, trampolines should be used with caution and under adult supervision. Some of the potential risks are falling off the trampoline while jumping or landing incorrectly. Such incorrect landings can lead to injuries like sprains, strains, or fractured bones. Multiple kids jumping at the same time can collide with each other and lead to injuries. Trampolines can also malfunction or break, causing injuries, so it is a good precaution to place a mattress or foam under the trampoline. Children can also get trapped in the trampoline’s springs or netting.

Doctor, good day. And well done for all the work you are doing. Sir, I am 26 years old, and I am currently on treatment for peptic ulcer disease with Omeprazole, Clarithromycin and Amoxycillin. However, some of the symptoms that I used to have like heartburn and chest pain have reduced a lot but I continue to have nausea, especially at the sight of food. I have been talking to my doctor and all I have been getting are assurances that things will improve. I am actually tired of complaining to him. What should I do, please? 08056618XXX

Thank you very much for your kind words. With specific reference to your persistent nausea, you need to know that any person undergoing therapy for peptic ulcer may still experience nausea due to several reasons. One of these reasons is medication side effects. Certain medications used to treat gastritis, such as antibiotics or proton pump inhibitors (PPIs), can cause nausea as a side effect. Peptic ulcers can take time to heal, and nausea can persist during the recovery phase. Even with treatment, the stomach lining may still be inflamed, leading to nausea and discomfort. Certain foods can trigger nausea, especially if the person has an underlying food intolerance or sensitivity. Underlying conditions: Other conditions like irritable bowel syndrome (IBS), gastroparesis, or gastroesophageal reflux disease (GERD) can also contribute to nausea. Everyone’s response to therapy is different, and it may take time to find the right combination of treatments to manage your nausea effectively.

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The answer lies in prevention. You have to take serious measures to prevent malaria attacks by using insecticides regularly inside your apartment, sleeping under an insecticide-treated mosquito net, clearing out any pools of stagnant water around your house, and ensuring that your diagnosis of malaria fever is confirmed with proper laboratory testing. Sometimes, what you may have is incompletely treated malaria or a resistant type of illness that then appears as if it is recurrent. The assurance of a successful treatment is to repeat the test when the drug therapy is over so that you can confirm if it is gone or not.

Good day, doctor. I am 24 years old and have not yet married. My periods used to flow for about 4-5 days but in the last 2 or 3 months, the flow has become scanty, and the blood is dark and slimy with a disgusting smell. I cannot quite describe it but even my underwear usually has the same smell anytime I return home from work and remove them. I have seen my doctor on several occasions, but he keeps prescribing the same kinds of antibiotics for me and telling me that this is PID (pelvic inflammatory disease). Sir, I am not even interested in what it is called; I just want a solution. Please advise me on what to do. Thank you. 08023021XXX

Your story is quite interesting. More specifically, you could be suffering from endometritis, an infection of the lining of the uterus which is often caused by various organisms working together in concert. You will need to visit a gynaecologist for a thorough assessment and the proper diagnosis before useful treatment can be obtained. I should add that successful treatment should clean up the blood and rid your pants of the smell.