Sodiq Ojuroungbe
As President Bola Tinubu marks one year in office, the Nigeria Medical Association and Nigeria Association of Resident Doctors have lauded his bold decision-making processes as it affect the healthcare sector.
They offered a mixed evaluation of Tinubu’s first year in office, noting that the commendations come amidst heightened anticipation for tangible improvements in Nigeria’s healthcare system.
The physicians noted that the first year of Tinubu’s administration was marked by difficult but necessary decisions, with some early signs of progress made amidst significant challenges.
Speaking exclusively with PUNCH Healthwise, the president of NARD, Dr Dele Abdullahi, emphasized the importance of examining the administration’s efforts within the context of pre-existing conditions in the health sector.
He acknowledged the significant challenges inherited by the administration, including a severe manpower shortage, dilapidated facilities, and a toxic work environment.
Despite these obstacles, the NARD president said there are signs of progress, citing improvements in recruitment processes and initiatives to address infrastructure deficits.
He explained, “Examining President Tinubu’s one year in office through the lens of the health sector might be challenging, as it requires considering the pre-existing conditions and what has been achieved so far.
“To critically appraise any achievement, you have to look at the state of the implementation of the ideology that the government has put on the ground. And if that is the focus for which you wish to appraise the first year in office, it might be a little bit difficult to see any form of positive achievement.
“But if you put into consideration the rot that was already on the ground in the health sector before the first year of the president, the sovereign crisis that was in the health sector before the new Ministry of Health led by Professor Muhammad Ali Pate took over, and how far they have gone to regain the confidence of the average Nigerian doctor in the positivity of the health sector, then you have to rate the first year as positive; you have to rate the first year as a great achievement.
“Because you need to understand that the dearth of manpower gap, the dilapidated state of health facilities, and poor and toxic working environment is not a thing of now; it has been there for a long term ago.
“And when people talk about Japa syndrome, this is something that started many years ago. And currently, it is not going to be realistic to expect that this can be over within one year.
“Right now, if you look at the health sector, you will see it is not something appreciable or significant to appraise any government about. But based on the different ideologies and policies that have been put forward by this current ministry of health, you can say there is a flicker of hope and a shining light at the end of the tunnel.
“Looking at how the ministry is addressing the challenges faced by each facility, such as power supply, lack of equipment, and basic security, one might acknowledge progress, even though standard security measures and state-of-the-art facilities are yet to be achieved. There remains hope that further improvements can be made.
“Are we saying the healthcare facility is good enough for the average Nigerian? No! But are we saying there is hope that we can actually have an improvement in the health sector? Yes, there is hope and improvement in the health sector and we really appreciate the current administration for the current direction.”
The NARD president, however, stressed the need for improved remuneration and working conditions to retain healthcare professionals.
He suggested that the government should offer competitive incentives to discourage doctors from seeking opportunities abroad.
Abdullahi said, “If we produce a large number of doctors unless we are able to retain them in these facilities, we are not going to have any improvement. So, to help protect the health sector in Nigeria, we need to look for ways to retain our healthcare workers, especially the doctors.
“We have to work on their remuneration and whatever increase in salary that we are doing, we need to know we are in competition with whatever opportunities these healthcare workers have in other countries. We need to look at other areas of their welfare such as housing, and transportation and try to augment these areas of welfare so as to convince them on the importance of staying.”
On his part, the Chairman of the NMA’s South West Zone, Dr Babatunde Rosiji pointed out the adverse impacts of broader economic policies on healthcare.
The medical practitioner, who doubles as the NMA chairman for Ekiti State, condemned the removal of fuel subsidies and the floating of the naira without proper strategy.
He stressed that the policies have detrimental effects on patients’ ability to afford medications.
While acknowledging the administration’s tough policy decisions and their far-reaching consequences, he called for targeted measures to mitigate these impacts.
He added, “If we put the one year of President Bola Tinubu in focus, I will summarise it as a one year of a government that is trying to take tough decisions for the future of the country but unfortunately, didn’t make the necessary preparation and they didn’t lay the proper framework and groundwork for the implementation of those policies.
“For example, look at the fuel subsidy issue. As good a policy as it is, a few things should have come ahead of it to make life comfortable for the citizens. But the step has been taken and we are where we are.
“Look at the floating of the dollar; as good and as beautiful as it is, today, due to the forex and the high exchange rates, we have many patients that can’t afford their medications. We have many patients with chronic illnesses like hypertension, diabetes, and infectious diseases requiring antibiotics who can’t lay their hands on such medications.
“For the government, it is a policy, but for these patients, it’s more than a policy. It is actually taking medication out of their reach as much as possible.
“And on the Japa trend, the forex crisis has also heightened the velocity of the Japa trend because if a doctor, for instance, is earning 2000 pounds, or let’s say $3,000, which is more than that anyway, outside the country, if you are exchanging it to naira at 400 naira plus, which the administration meant, we are talking about probably N1.2m. Somebody might say the money is not much. But now at N1,500 to a dollar, that is N4.5m. So an average young person will begin to say, oh, how many years am I going to work in Nigeria to make this kind of money?
“This forms an extra impetus for our young doctors to want to go out. And come to think of it, we now said, oh, people are leaving the country. We are doubling the carrying capacity of medical schools. We are forgetting the fact that brain drain is not only about young medical professionals, even professors are leaving, senior consultants are leaving.
“So, if you are doubling the current capacity of medical schools, who is going to train those medical students? Who is going to train those health workers?
“I think this one year, the government has made tough decisions but those tough decisions have far-reaching consequences that in this second year if we don’t sit down as a country to mitigate some of the challenges that have arisen from these tough decisions, there may be a problem.”
Rosiji highlighted the benefits of increased financial autonomy for state governments.
“And on a bright note anyway, I think because of the operations of government at the federal level, many of our state governments now have more funds at their disposal.
“Let me use Ekiti State as an example. As of today, because of those interventions, it has tripled down to our governor being able to pay promotion arrears, implement staff-friendly initiatives and other things like that. And then, even salary arrears that are being owed have been paid.
“So, it’s not all darkness and gloom. There are bright sides but those policies have had some consequences on people which the government needs to really sit down and take necessary steps to address,” he maintained.
Rosiji, however, urged the government to address the push factors driving healthcare workers away and enhance the attractiveness of staying in Nigeria through better pay and working conditions.
He stated, “I like talking about the push and the pull factors. The push factors are factors in our environment that is driving our health workers away; insecurity, poor exchange rates or poor amenities generally, and poor infrastructure in the hospital. So the government should work on these push factors to minimise them as much as possible.
“And then the pull factors, you know, basically what they pay on the outside, I mean in the greener pastures as it is called. Let the government make juicy offers to workers who have decided to stay back.
“Give special allowances that will make people think twice before they consider; it might not be exactly what is outside, but it is something that we serve as an impetus to stay.
“And I believe if the government does this, we should be able to make something out of the current situation.”
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