Why do we still have limited access to healthcare in Nigeria?

Nigeria has been a WHO member country for so long but yet still ranks low (187th out of 191 member countries) in the healthcare system performance index. In passing of the recently celebrated World Health day on the 7th of April, 2019 with the theme “Health for all”, the message for the year is that universal health coverage is attainable. This message exposes the fact that despite the progress being made in countries all over the world, millions of people still don’t have access to healthcare.

Nigeria was poorly ranked in the first global healthcare access report and is one of the countries that’s still struggling to make healthcare services available and accessible to all its citizens. How do you think inadequate facilities, low allocation of funds, lack of enabling environment for medical personnel, corruption and political instability influence access to healthcare? What other barriers are there to accessing healthcare in Nigeria? Does Nigeria lack the fundamental framework for a functional health system?

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One of the problems is lack of confidence in the quality of care we are being provided

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This is a good one. I think inadequate facilities has been a prevalent problem when it comes to issues regarding healthcare. I believe that changes should be made in the framework of the healthcare system because if changes aren’t made, the present one’s become obsolete

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Shortage of manpower, inadequate health facilities and lack or total absent of commitment to work etc are some of the fundamental problem with providing adequate health care.
Nigeria has the framework, the problem is delivery.
Corruption is the virus, like the HIV virus, that government has not found a cure for. Until a cure for corruption is found and implemented fully, Nigeria will continue to suffer set backs especially in the health sector.
Recently, in one health facility in Edo State where NHIS services are offered, it was learnt that the hospital management placed strigent laws on assessing NHIS. The reason being that, high rate of absenteeism was linked to easy assess to NHIS. Also, charges were reviewed upwards, reason being that, if less people are able to afford it, the hospital staff will not be over worked.
Other barriers to assessing health care in Nigeria is

  1. Ignorance
  2. Stigma
  3. Poverty
  4. Lack of empathy from health workers/ management
  5. Too little focus or emphasis on traditional medicine
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Truly, all those points mentioned (and more) contribute to this problem but talking about whether we as a country lack the fundamental framework, I’ll say no, we don’t. I believe that having a decentralized system is the best option for us, if only we could get it right at the PHC and healthcare financing levels. But as with many other sectors, we have got beautiful structures and frameworks in place, with grandiose and highfalutin policies with next to no implementation and enforcement. This might sound like an overkill, but I believe that the first point of call is with our management and government because health for all is truly achievable.

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I totally agree with this.
However, as regards “implementation”; the problem is not just the lack of implementation but the coordination of what is currently being implemented, in my opinion (there could be more).

So many activities are being carried out by ministries and partner agencies as well as donor bodies in the country.

The lack of coordination reduces the level of impact any program would have upon implementation. Effort and resources need to be concerted across these different implementing bodies and partner agencies. That way a systematic improvement in health service delivery can be seen.

It’s a systemic and multi-faceted issue where tiny bits of corruption or at the very least, a lack of transparency has contributed to over time.

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It is due to mismanagement of limited resources available as a result of failed Nigerian system. The leaders are to blame for lack of trust and not having respect for life. Education couple with good functioning judicial system will help sanitize the society and restore human dignity. Life is sacred and until we value life, there is no amount of resources that will help fix the decayed healthcare system in Nigeria. Both Leaders and individuals are fantastically corrupt.

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Apart from curruption, lack of facilities, awareness and many other factors listed above, gender inequality as promoted by some cultural practise can also result in low access to health care especially by women and children because women not seen to have equal right to men are being denied equal access to health care information hence access to health care by women and children will be low this reducing healthcare coverage by all

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