Nigeria’s health sector is in dire straits. Things are falling apart and if something urgent is not done the health sector may collapse and set the country’s efforts in the sector back by more than 20 years.
The grim reality is that the annual health budget is inadequate; basic medical consumables are scarce; equipment and facilities are far from adequate; the work environment is not conducive, and above all there is a frightening dearth of personnel in the health sector. With a doctor-patient ratio of 1:2,753, Nigeria is abysmally far from the World Health Organisation (WHO)-recommended doctor-patient ratio of 1:600. In addition, the remuneration is relatively poor.
On top of all of these shortcomings, came the Covid-19 pandemic which stretched the country’s health facilities and personnel beyond limit. The country lost some doctors and other frontline health workers. Nigeria, like other countries of the world, is still battling with the Corona virus scourge which has assumed a more frightening dimension because of the new Delta variant.
Nigeria’s health care delivery capacity was further stretched when the National Association of Resident Doctors (NARD), on Monday, August 2, 2021 proceded on an indefinite strike as a result of unfulfilled promises on the part of the federal government and other sundry issues. The strike action by NARD has seriously disrupted health care delivery, leaving patients stranded in public hospitals.
It is because of this highly depleted workforce, following the NARD strike action, that Nigerians were stunned to hear that the Assembly of Healthcare Professionals Association (AHPA), together with the Joint Health Sector Unions (JOHESU), which is the umbrella body of all health workers’ unions and associations in the country, have served the federal government a 15-day ultimatum to proceed on strike if the government fails to address “outstanding welfare issues” of its members.
The two unions’ threat is coming barely six days after the Nigerian Medical Association (NMA) issued a 21-day ultimatum to the government to commence its own strike. According to the unions, they have shown unparalleled patriotism despite the government’s “nonchalant attitude” to the welfare of health workers.
Some health experts and watchers of developments in the sector have said the Minister of Labour, Dr Chris Ngige’s handling of the NARD protest was very poor. It must be noted that in spite of being a medical doctor himself, Ngige does not seem to understand the dynamics of what is happening in the medical world.
In a recent interview, when asked if he was not worried that members of the National Association of Resident Doctors were leaving the shores of Nigeria in droves, Ngige said he was not worried as Nigeria does not lack doctors. Ngige’s claim is a sharp contradiction to current realities. As stated above, Nigeria’s one doctor to 1,2753 patients is a far cry from WHO’s prescription of a doctor to a maximum of 600 patients. Even the UK with 2.8 doctors per 1000 patients does not pride itself of having enough doctors, yet Ngige is beating his chest that Nigeria is self sufficient with its amount of doctors!
Rather than negotiating, Ngige chose to threaten the leadership of NARD with the “No work, No pay” policy. The doctors did not bat an eye lid. He followed up with another threat to sack the striking doctors and when the doctors still did not budge, he has dragged the matter to the National Industrial Court for arbitration. While the face-off lasts, patients are suffering and even dying.
If nothing is done to check the proposed strike action by the members of the Nigerian Medical Association, the Joint Health Sector Unions as well as the Assembly of Health Professionals Association, and also recall the members of the National Association of Resident Doctors who have been on strike for five weeks now, it will be a total shutdown of the health sector.
Just before the health sector shuts down, Ngige, along with his health counterpart, Osagie Ehanire, should suppress pride, reach out to the various medical and health associations and resume negotiations. The government must start by picking the demands of the doctors that are not too capital intensive with a view to off-setting them.
For the demands that are capital intensive and cannot be immediately taken care of, government should appeal for more time, make concrete commitments with strong re-assurance to meeting such commitments. At a time like this, what the doctors need is assurance that the government is serious. The members of the government negotiating team must invoke their persuasive skills and convince the doctors.
Allowing the health sector to shut down, especially against the backdrop of the threatening Delta variant of Covid-19, simply put, is an open invitation to disaster, that is better imagined than experienced!