Nigeria’s collapsing health infrastructure requires urgent action – ALPs

The leadership of the Association of Lady Pharmacists (ALPs) has called on the Federal Government and state governments to take immediate action to address the deteriorating state of Nigeria’s public healthcare infrastructure, warning that the system is on the verge of total collapse.

The call comes as the World Health Organisation (WHO) ranked Nigeria 187th out of 191 countries in its global assessment of health systems performance, with experts describing the rating as a reflection of the critical challenges facing the sector, including inadequate infrastructure, a shortage of healthcare professionals, and weak health systems that continue to hinder progress towards universal health coverage by 2030.

A particularly glaring gap is the vast number of non-functional healthcare centres, which leave citizens exposed to preventable and often ruinous out-of-pocket medical expenditure. Whilst the country has over 34,000 primary healthcare (PHC) centres, data from BMJ Global Health reveals that an estimated 80 per cent are non-operational, with only about 20 per cent functioning effectively to serve the public.

In separate interviews, three national leaders of the ALPs – Pharm. (Mrs) Scholastica Lan, national chairman; Pharm. (Mrs) Regina Chichi-Agir, director of pharmaceutical services, Benue State, and national treasurer of the ALPs; and Pharm. Titilayo Onedo, director of pharmaceutical services at the National Orthopaedic Hospital, Igbobi, lamented the dilapidated state of the country’s healthcare infrastructure and called on the Federal Government to urgently intensify its efforts to upgrade the system in the interest of improved patient outcomes.

Pharm. Lan cited a scenario all too common in public hospitals across the country, where practitioners are without even the most basic medical consumables -disposable gloves, cotton wool, syringes, drip stands – making it impossible to care for patients properly. She argued that without the requisite tools, healthcare workers cannot be expected to perform miracles. “You have the people to work for you, but they don’t have the tools to work with. There’s no miracle any healthcare personnel can perform when there is no equipment,” she stated.

She attributed the growing migration of healthcare workers to poor working conditions and inadequate infrastructure, describing the situation as having created a significant gap in the nation’s healthcare workforce. She urged the government to invest in improving healthcare facilities as a matter of urgency, both to ensure better patient outcomes and to stem the rising tide of the so-called “Japa” syndrome — the mass emigration of professionals in search of better opportunities abroad.

“Why are our professionals leaving Nigeria? America has just opened its doors to medical personnel, and I can tell you there will be serious migration. Why? Because there are proper systems and working conditions over there,” she explained.

The ALPs national chairman further underscored her point by highlighting the prevalence of medical tourism among government officials – a clear indication, she argued, of their lack of confidence in the country’s own healthcare delivery system, whilst ordinary Nigerians are left to make do with what little the system offers.

“Virtually none of our government officials patronise any government hospital in Nigeria. Why is that? It means that standards need to be raised considerably. If you look at private hospitals, why do patients recover more quickly? It is because there has been genuine investment in infrastructure. Such well-equipped private hospitals exist in different parts of the country. Our Vice President, during the late President Buhari’s tenure, had a knee surgery at one such facility and recovered without difficulty. The question is: how many ordinary citizens can afford that? The government needs to raise the standard of care in public hospitals,” she said.

Lan maintained that Nigeria possesses highly trained healthcare professionals – including oncology pharmacists, critical care pharmacists, and nephrology pharmacists, among other specialists – but lamented that many are unable to function to their full potential owing to poor infrastructure and an absence of adequate equipment.

Pharm. (Mrs) Chichi-Agir similarly described the state of the country’s healthcare system as dismally poor. Drawing on her observations in rural communities, she noted that many residents resort to various herbal concoctions in the absence of accessible orthodox healthcare, a trend she linked to the rising incidence of cancer in the country. She expressed deep concern about the absence of qualified healthcare practitioners, pharmacists included, in remote areas, noting that this creates fertile ground for drug abuse and misuse of all kinds.

The Benue State Director of Pharmaceutical Services disclosed that her inspection visits across the state had given her direct, first-hand exposure to the scale of the gaps in the system, with a chronic shortage of healthcare practitioners creating room for numerous irregular practices, even within hospital settings. She implored the government to act without delay.

“When we visit those remote villages, we see unqualified individuals selling all manner of drugs and doing whatever they please with their clients in the name of healthcare. It is only by providence that we are not in an even worse state. And I am not surprised that we are seeing so many different kinds of cancer, given some of what is going on,” she said.

“If I were to rate Nigerian healthcare services,” she added, “I would have to say they are poor.”

Pharm. Onedo acknowledged and commended the Federal Government for the modest investments it has made – citing, for instance, the approval of the consultant pharmacist cadre in some states – but urged the government to do considerably more in terms of infrastructural investment, expressing hope that this would bring about a marked improvement in the overall state of the healthcare system.

Onedo noted in particular that upgraded facilities would boost staff morale and motivate healthcare workers to deliver better services. She also argued that improved working conditions would go a long way towards discouraging the mass emigration of professionals, stressing that most of those who leave do not do so out of preference, but out of necessity.

“I want to say that not many people genuinely want to emigrate and become, in a sense, second-class citizens elsewhere. They want to stay here. But when you remain, and the things you reasonably expect do not materialise, it becomes deeply discouraging. The gaps are real, and the government must find urgent solutions to them,” she said.