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Photo illustration by John Lyman

For the sake of all Nigerians, let’s hope that President-elect Bola Tinubu prioritizes the country’s failing healthcare sector.

In 2018, the Nigerian government attempted to revamp the country’s failing healthcare sector by embarking on a series of reforms.

One such policy is the Basic Health Care Provision Fund (BHCPF) which was launched in a bid to improve access to primary care, especially for low-income and vulnerable Nigerians.

According to The Lancet, corruption in Nigeria’s healthcare sector is a particular concern because it can lead to brain drain where the best and brightest seek better opportunities abroad. Nigeria ranks 150 out of 180 countries where public sector corruption is a particular problem.

Recall that at one point there were no working cancer treatment machines in any of the nation’s hospitals. Although the situation has slightly improved with the procurement of five cancer machines for teaching hospitals and the national hospital in Abuja.

Because of corruption and an underfunded healthcare sector, in 2018 alone, the country recorded 211,052 cases of breast, prostate, cervical, colorectum, and non-Hodgkin’s lymphoma cancers.

Nigeria’s healthcare sector woes have been worsened by the mass exodus of healthcare professionals. According to some estimates, Nigeria lost an estimated 9,000 doctors to the United Kingdom, Canada, and other countries between 2016 and 2018.

Regrettably, the dearth of quality healthcare in Nigeria is largely due to a lack of quality healthcare infrastructure and the continuous depletion of medical specialists. Data released by the country’s central bank shows that in 2022, Nigerians spent $11 billion on health-related services abroad between 2010 and 2020.

While some elite and middle-class Nigerians can afford to embrace medical tourism and private healthcare, for millions of poor Nigerians, they are forced to turn to government-owned medical facilities (where they are available), or the dangerous option of self-medication.

Many Nigerians simply do not have access to affordable healthcare. This explains the rise of maternal and infant mortality rates in the country. According to some estimates, Nigeria’s infant mortality rate is estimated to be 54.740 deaths per 1,000 live births and the country’s maternal mortality rate is 576 per 100,000 live births.

Ultimately, while it seems there has been a reawakening of political will to improve the country’s healthcare sector, the political will hasn’t translated into structural reforms. Effective policy implementation remains a major determinant to ensuring the success of healthcare reforms in Nigeria.

A major yardstick in measuring the success of healthcare reforms is the accessibility of quality and affordable healthcare for the millions of Nigerians living in poverty. This is where the Nigeria Health Insurance Authority (NHIA) and other stakeholders can make a difference in the implementation of the National Health Insurance Scheme (NHIS).

Healthcare insurance is one of the mechanisms for providing financial protection from the costs of healthcare services. It must be said that Nigeria isn’t alone in this regard. After decades of debate, the U.S. Congress finally passed the Affordable Care Act in 2010.

The NHIA Act was enacted to ensure that healthcare insurance is made compulsory for every Nigerian and legal resident; to promote, regulate and integrate healthcare insurance schemes in the country and improve and harness private sector participation in the provision of healthcare services.

Healthcare insurance has existed for almost two decades in Nigeria even prior to the enactment of the NHIA Act. Yet, its uptake still remains abysmal. The uptake of the NHIS is currently below 5%, while healthcare insurance penetration in Ghana is estimated to be 68.6% and 90% in Rwanda.

In Nigeria, most of those currently insured are employed in the formal sector; government employees for example. Comparative uptake within the informal sector remains critically low and this could be due to a number of factors. First, awareness within that sector is low. Second, the payment of requisite premiums is a choice many low-income Nigerians would rather not make, considering its opportunity cost, especially in a depressed economy where inflation is high and disposable income is low.

The government has largely failed to fix many of the wrongs currently impeding quality healthcare in Nigeria. Bola Tinubu is scheduled to be sworn in as president on May 29, let’s hope for the sake of all Nigerians that he prioritizes the country’s ailing healthcare sector.

Dele Ogundahunsi is co-founder and Managing Editor of Healthnika, a multimedia online publishing startup based in Nigeria. He is also a Marketing Strategist and Social Impact enthusiast.