Democracy as a path to health for all
(Nigerian Tribune) - The choice of the theme for this year’s International Day of Democracy, ‘Democracy as a path to health for all’ is very significant and poignant. The expectation of the promoters of the theme is that democracy should deliver verifiable dividends to people living in democracies. And one of these dividends is accessible, affordable and quality health care for all. This is also one of the Millennium Development Goals (MDGs) which set a goal of health for all by 2015.
The theme is also sending a very strong message to countries like Nigeria. It is no longer news that the impressive economic growth recorded in Nigeria in the last decade has existed in parallel with declining well-being of Nigerians. Health indicators remain very poor and this can be linked to the rising poverty of Nigerians in spite of being an oil-rich country. Private expenditure on health is higher than public expenditure on health. In fact, much of the public expenditure on health hardly reaches their intended destination. Hence fund is annually allocated to the health sector during the annual budget rituals, but Nigerians hardly see their effects on public health outcomes.
Under-five mortality and infant mortality rates rose significantly in 2011 and fell short of the targets for 2011 and 2015. The number of infant deaths per 1,000 live birth soared by over 40 per cent between 2008 and 2011. Nigeria has one of the highest maternal mortality rates in the world. Many of the diseases still occurring in some parts of the country are those that had been eradicated in most parts of the world. In short, life remains very short and cheap in Nigeria. The life expectancy rate is below 50 years, compared to 75 years in Israel.
Beyond the official statistics, the sheer number of Nigerians known to have lost their lives in avoidable circumstances due to the poor state of our hospitals and health care facilities is just numerous. Ironically, wealthy Nigerians make trips to India, Israel, Malaysia, the UK and other western countries in search of solutions to their medical conditions. Two prominent Nigerians are currently said to be in hospitals in Europe for medical attention.
We think it is in the interest of all Nigerians and in the enlightened interest of the privileged few, who are in positions of authority to make a difference to the status of health care and health infrastructure in the country by doing something urgently. Hospitals should be changed from being mere consulting clinics to places where Nigerians can obtain easy care for their medical challenges.
Government officials fail to see the inherent gold mine that excellent health facilities can bequeath to the country. Health is not just social infrastructure but also an economic infrastructure that can spin huge income for the country. Excellent health infrastructure, complemented by well trained health care personnel will not only save the huge capital outflows Nigerians spend abroad every year in other countries for health care services, but will also bring medical tourists flooding the country. Hence, any public investment to raise the standard of the nation’s health sector will produce high social and private rate returns that more than compensate for the investments.
The government should also introduce incentives for a more robust and functional public-private partnership (PPP) in the health care sector. The current scope of the health insurance scheme should also be expanded to cover more Nigerians. The current high costs of health care are beyond the reach of many poor Nigerians who then have to turn to non-orthodox sources and charlatans at great risks to their lives.
The message of this year’s International Democracy Day is very loud and clear: government should pay more attention to delivering qualitative, accessible and affordable health care for all its citizens. The Nigerian Tribune fully endorses this clarion call.