Closing Health Equity Gaps in Nigeria

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The global community recently commemorated this year’s World Health Day on 7 April, 2024, with stakeholders calling for more concerted efforts towards bridging health equity gaps. This, they say, will help to ensure that everyone enjoys access to good health as a right. With the theme, “My Health, My Right,” the 2024 anniversary focused on the urgent need to protect the lives of millions who have been increasingly threatened by diseases and disasters which have led to deaths and disabilities.

Established in 1948, by the World Health Organisation (WHO), as a day to draw attention to a specific health topic of concern to people all over the world, the apex health body emphasised that this year’s theme was chosen to champion the right of everyone, everywhere to have access to essential health services.

It is noteworthy that the WHO specifically seized the occasion of the 2024 commemoration to reveal the alarming discovery that, of the 140 countries that recognise health as a human right in their constitutions, only a few are implementing the law; with, at least, 4.5 billion people — more than half of the world’s population —not fully covered by essential health services in 2021. The implication here is that governments and other relevant stakeholders must do more to invest in healthcare delivery. This has become a particularly urgent imperative in a world that is increasingly grappling with conflicts, hunger, economic downturns, as well as climate crises occasioned by harmful practices.

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The Nigerian experience is a critical replica of the global scenario, with many movements but limited progress in health equity. Disparities in access to healthcare and health outcomes continue to challenge the well-being of millions of the citizens. The stark differences in health outcomes based on socio-economic status, geographical location, and other determinants highlight the urgent need for concerted efforts to close these gaps and ensure equitable access to healthcare for all Nigerians.

That the Nigerian government itself is aware of these gaps is laudable. In his statement on the World Health Day, the Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, noted that “despite progress, persistent obstacles including inadequate infrastructure and healthcare workforce shortages persist, prompting a redoubling of efforts to prioritise primary healthcare services for all Nigerians”.

However, beyond ensuring that it fulfils its promise of prioritising primary healthcare services, the government must decisively combat other barriers to equitable access to healthcare. These include massive brain drain, medicine insecurity, limited infrastructure, heavy reliance on drug importation, shortage of raw materials for local pharma manufacturers, scarcity of essential medicines, and inadequate investment in local drug production, to mention a few.

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While the Federal Government’s initiatives, such as the Basic Health Care Provision Fund (BHCPF) and the Nigeria Health Sector Renewal and Investment Initiative, are commendable, it is imperative for the health sector leadership to expedite action on the proposed issuance of executive order to reduce escalating prices of drugs. This, we believe, will make quality medicines more accessible and affordable to every Nigerian.

Beyond this, the prevailing harsh economy has further revealed that local pharma companies cannot flourish without the availability of single digit loans, favourable policies and a generally conducive business environment. These are fundamental obligations of the government to local industries, which constitute the major drivers of economic growth and, in this case, citizens’ overall wellness.

Equally important in bridging health equity gaps in the country is equipping hospitals with quality infrastructure and personnel capable of professionally addressing the healthcare needs of the citizenry. The absurd doctor-to-patient ratio of 1: 10,000 (as against the recommended ratio of 1:600), needs to be urgently reversed for patients to have equitable access to health. Building and equipping more health facilities, especially in underserved rural areas, and ensuring they have adequate staffing and resources to provide quality care, will tremendously help to strengthen healthcare infrastructure across the country.

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It is also important to emphasise that, from all indications, government alone cannot weather the storm of closing health equity gaps. Therefore, fostering and leveraging strategic partnerships with targeted stakeholders will bolster government’s limited resources in adequately catering for the healthcare needs of Nigerians. The Nigerian First Lady, Senator Oluremi Tinubu, on the occasion of the World Health Day, reiterated this perspective that all hands must be on deck for universal health coverage to be the reality of every Nigerian. She said, “I use this opportunity to call on all well-meaning Nigerians, organisations and bodies, to help remove all barriers to actualising health for all in Nigeria.”

Once more, government and all other stakeholders must realise that, at the heart of health equity lies the fundamental right of every Nigerian to good health. It is a right that should not be dictated by anyone’s income, ethnicity, or where they live. Therefore, the prevailing stark contrasts in health outcomes between the affluent and the indigent, between urban centres and rural communities, is not only morally unacceptable but also undermines the overall development and stability of our nation. The time to bridge this divide is now.

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