President of Nigeria Labour Congress,Comrade Ayuba Wabba has identified the reasons why Nigeria’s health sector is in a horrendous situation.
In a keynote address to mark this year’s International Nursing Week, Wabba said “There are some challenges that beset the system and the possibilities of achieving this lofty aim. These include: poor funding; quantitative and qualitative shortages of human resources for health; infrastructural decay and; professional chauvinism of a few cadres within the health team (i.e. medical and dental practitioners).
“The consequences of not addressing these challenges can be seen in the abysmal health indices of the country, even when compared to other African countries despite our much trumpeted giant of Africa status. Average life expectancy at birth is 54years as against 70years globally and 58years for the African region, according to the World Health Organisation. Under five mortality rate (per 1,000 live births) is 124, as against 48 globally and 95 for Africa, with Nigeria ranked at 171st position out of 178 countries in the 2014 “State of the World’s Mothers” index.
“To roll back this horrendous situation, the challenges identified have to be squarely dealt with. And really, we do not have to reinvent the wheel. Necessary steps have been identified as well even by the state. For example, the April 2001 Abuja Declaration of African Heads of State was explicit when it called for 15% of budgetary provisions to be set aside for healthcare delivery. A few countries like Rwanda have actually met this set aim. There is no excuse for Nigeria to lag behind on this. To make a bad situation worse, the provision for health was just 6.4% last year. The situation with the recently passed 2015 budget is little better.
Wabba noted that “preventive healthcare is of the essence. The heath system has to be so structured as to promote primary health care in a manner that is inclusive of all cadres within the health system for us to attain care and cost effectiveness of health services delivery.”
He also said “Nurses are a force for change precisely because change is itself an attribute of living and nursing is pivotal to the processes that prolong this and indeed good health which go beyond the state of infirmity. As stated in the 1978 Alma Atta declaration, health is: “a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity”. This understanding of health which is universally agreed upon is important for us to grasp what is required for care and cost effectiveness of health services which nurses and other health professionals deliver.
According to the NLC president “The continuous training and re-training of nurses and other professionals is also of the essence for us to enthrone care effectiveness. There are new health challenges and old ones are also acquiring new dimensions. This requires the re-tooling of those who deliver health services. Beyond the qualitative dimension, it needs to be stressed that the number of nurses available in the country fall far below that required for effective care. There are just 1.61 nurses per 1,000 persons requiring nursing care as against 2.8 in Botswana, an African country and 6.4 in Brazil, which is also a Third World country.
“Inadequate remuneration and poor working conditions have further become push factors leading many nurses to seek greener pastures outside the country. This brain drain has worsened an already regrettable situation. But it can be reversed only with the boosting of nurses and other health professionals’ morale. The Federal Government has to revamp the public health system and raise the quantitative and qualitative profile of nurses and health professionals for care and cost effective universal health coverage to be achieved.
Wabba whose emergence as NLC President led to the emergence of Joe Ajaero led faction of the congress used the occasion to advocate for unity.”The task ahead of us is one of intensifying advocacy for the right steps to be taken. To do this, it is also important to prioritise teamwork and harmony in the health sector. This is why we call on medical and dental practitioners to put healthcare delivery first and foremost over professional chauvinist dictates. NANNM and other unions organised under the banner of the Joint Heath Sector Unions (JOHESU) have been active in promoting the voice of health professionals to ensure the building of the healthcare system of our dream. We enjoin the NMA to join in this clarion call as united we can do more to ensure care effectiveness and cost effectiveness in the interest of the teeming millions of Nigerians whose good health should be our overriding inspiration.
