Nigeria Can’t Afford One Doctor to 600 Patients Ratio, FG Tells UN, WHO

Onyebuichi Ezigbo in Abuja
The federal government at the weekend disclosed that Nigeria was unlikely to meet the recommendation of the United Nations and the World Health Organisation’s (WHO) ratio of one doctor to 600 patients.

The Minister of Labour and Employment, Senator Chris Ngige, made this disclosure at a two-day quarterly meeting of the Nigeria Health Commissioners Forum in Abuja on Friday.

The two-day forum was held under the theme, Building a stronger health sector in Nigeria through collaboration and strategic partnership’.
The meeting was primarily convened to discuss how to strengthen the health system at the sub-national levels, with an overall objective of achieving Universal Health Coverage (UHC).

Speaking at the meeting, the minister said: “We are not a United Nations’ country, we are a developing country. So, when such figures are given, I will tell them every rule has an exception. We are not yet there”.

“So, we shall make do with what we have. And when they’re saying he said yes. Surplus doctors. We have surpluses. I keep on telling them that we have not deployed our medical manpower proportionately, and adequately as we should do.

“How many doctors do we have in the rural areas and in the suburbs since everybody is in the townships, with a medical and dental council data showing 4,000 doctors every year. Before, it used to be 3000, before the private universities came a lot of them were not doing medicine including Afe Babalola and others.

“We are now at about 4000 plus, the people even trained abroad are coming back from Russia and Ukraine and the rest of them, all Medical and Dental Council of Nigeria (MDCN), are registering them.
“Almost everybody has come to Abuja, Lagos and Port Harcourt to stay. We have 10,000 primary care centres that are unmanned as at the last count.”
Lagos State Commissioner for Health, Prof. Akin Abayomi, called on state governors to create an enabling environment for physicians in their states.

Abayomi said that there were more than 20,000 Nigerian born physicians outside the country doing extremely well.
“This is why our governors should create an enabling environment for our physicians. By now, Nigeria should not be talking about brain drain. Rather, it should be talking about bringing back our physicians to the country,” he stressed.
Speaking on how the state was responding to COVID-19, Abayomi said Lagos state used the experience it had acquired in 2014, when it responded to the Ebola outbreak.

“This experience has helped us to effectively control the spread of the virus in the state despite our huge population.
“We had robust data collection supporting our policy decision making. We built a system of data collection, analysis and interpretation along the lines of each pillar of the Emergency Operations Centre (EOC).

“We then invested in technology to automate our data collection system through the information and implementation of the Lagos state emergency response system (LASERS), which allowed us to get data in real time for our response.”

The health commissioner, however, advised that the civil service should not be used to structure or manage any-pandemic, instead, a quick policy should be developed to raise funds for effective pandemic management, otherwise, the whole system would go down.
Abayomi disclosed that Lagos was emergency ready to defeat an imminent deadlier fourth wave of the COVID-19 pandemic and future pandemics in the state, adding that the state had learnt from the first three waves.

Meanwhile, The Director-General, Nigeria Centre for Disease Control (NCDC), Dr Chikwe Ihekweazu, told the commissioners that states should play a critical role in strengthening the health security of the country.

Ihekweazu, who represented Dr. Priscilla Ibekwe, Director, Special Duties, NCDC, added that the state had the responsibility for the health of her population, including preparedness and response to outbreaks of diseases.
“States have the resources, expertise and experience to strengthen the response to the coronavirus pandemic and other disease outbreaks in the country.

“We need stronger political commitment, leadership, and funding to fight against any outbreaks,” he added.
Senior Health Specialist, International Finance Corporation of the World Bank Group, Dr Onoriode Ezire, said that conditions for inclusion of a state in a world bank project included; “A common agreement between the Ministry of Finance and the Executive Governors on a set of transparent eligibility criteria.
“States will only be included in a project if the state’s participation would contribute to a meaningful improvement of that development indicator.

”Demonstrated commitment to reform by that state and demonstration of ongoing commitment throughout the life of a project.
“These include; meeting minimum performance criteria, adopting state legislation needed to establish an enabling environment for reform, and establishing the appropriate institutional framework to implement a reform programme,” he explained.
Ezire noted that the design of multi-state operations would pay close attention to ensuring conditions for mutual accountability of both the federal and state governments.

He commended the “Federal government for providing the enabling environment and a more level playing field for states, and states for delivering on the results to which they have committed, through their participation in the project,” he said.
In her remarks, Cross River Health Commissioner, Dr Betta Edu, who spoke on behalf of the Commissioners said that the meeting was vital to promoting experience sharing, collaboration across states, learning and fostering of sub-national development towards building a resilient health system in the country.

The meeting focused on health issues such as the Basic Health Care Provision Fund; strengthening Primary Health Care; HIV/AIDS control with its multisectoral consequences; UHC, Health Insurance, as well as various high impact interventions being implemented either directly or with development partners.
The meeting also identified challenges and outlined the implementation of partnership support at the subnational level, and articulated measures to address them for adoption.