How to develop health sector, by NARD — Features — The Guardian Nigeria News – Nigeria and World News – Guardian Nigeria
Dr. Abdullahi
Dr. Dele Abdullahi is a physician in Family Medicine at the University of Ilorin Teaching Hospital (UITH) Kwara State and President, Nigerian Association of Resident Doctors (NARD). Abdullahi, in this interview with CHUKWUMA MUANYA, speaks on how to develop the health sector, among other issues.
What is your blueprint on how to develop the sector?
In as much as this is still largely the prerogative of the government, as a progressive collaborative association, we have Ideas on ways to improve the health care system, reverse the brain drain and medical tourism through strategic improvement of our healthcare facilities, improved health care financing, improved welfare for healthcare workers, improved and diversified medical training and collaborative efforts with the private sector to ensure provision of the basic healthcare needs of every individual within the shores of our country.
We have advices on quaternary health facilities, ways to ride on the good work of Senator Oloriegbe on the National Health Insurance Authority (NHIA) Act to find ways to reduce burden of cost of health are for the average citizen, and so on
Mr. President has just presented the budget proposal for 2024. Are you okay with what is there for health? If not, what is your recommendation?
The allocation is a mockery of the state of emergency declaration as it calls to query the commitment of the Federal Government to ensuring adequate healthcare within our system. Our stand will always be 15 per cent as it was declared in Abuja in 2001 by the African Union, then we can evaluate the efficiency of how these funds are out into use and if we will have need for more, a healthy workforce is an efficient workforce and adequate healthcare services is a basic right of every Nigerian.
How can the country tackle this acute shortage of doctors?
Not to belabour us with so much English, treat the doctors well, the workers, the trainers and all other allied healthcare workers; that way, we can keep what we have to a large extent, create policies that aid seamless integration of doctors into the labour market. You can’t leave any healthcare worker in society with no job and expect you will meet them there whenever you are ready to employ them. Talk more to the doctors, we are essential commodities being jostled for from different communities beyond our shores.
Increase the production of more doctors, we need to support our medical schools as much as possible and fund ways to continually sustain them both at undergraduate and postgraduate levels. Finally, we should make the work environment more conducive and effective while presenting ways to secure the future of healthcare workers. Like every other Nigerian, all we want is a good life, a good working environment and a sustainable/secured community to work in where we can raise our families and live a pleasant life.
The Budget Office alleged that some doctors who left the country are still receiving salaries after colluding with the management of teaching hospitals. How true is this? What is the update?
Well, I do not have information to affirm or refute these claims. It has been stated by agencies of the government at different fora and I have to say I am disappointed that the government can indict themselves in this manner, to state that they have information that employees of government and their Ministries Department and Agencies (MDAs) are colluding to defraud the Federal Government and till date not one prosecution or example sounds abysmal to say the least.
To use it as the reason for the inefficiency of government to ensure adequate manpower in our hospitals thereby denying the Nigerian populace their basic right to health is disturbing to know and pathetic.
The association neither employs nor manages the human resources of the government agencies. Our grouse is with ensuring adequate welfare of our members and optimal care for every Nigerian citizen. We can’t help the government do their job and we won’t accept their inefficiency in managing the human resource they oversee as the basis for not providing what they should.
How can Nigeria curb frequent strike actions in the health sector?
Thank you for this question. First, I wish to reiterate that strikes by unions are never to punish the government but a last gasp attempt to attract the attention of the government and get the government to fulfill most times what they promised. We hate to go on strike, but most times, the government leaves us no other choiceStrikes are mostly due to the negligence of government to ensure the crucial things are done in the healthcare sector; the pervasive attitude of government to the welfare of healthcare workers, insensitivity of government to the trials and problems of the workers, and insincerity of government in carrying out documented agreements.
To make a clear example, the story that our hospitals are short staffed is known to all, the last executive paid lip service over and over to it. They set up a committee on brain drain only to ignore all the recommendations of the committee, dwelled mostly on blame games to no practical solution.
This current government is six months old and we are still yet to see a practical approach to solving the issue. A Memorandum of Understanding (MoU), stating the circular to ease manpower shortage was brought out by June 5, 2023, was signed, but the government reneged on the agreement.
When the officials representing the government have a mind that regardless of whatever paperwork is signed we can always decide not to adhere to it, then negotiation becomes difficult and there is a lack of trust between the union and government. Hence the need to down tools, however painful it is to get the government to do what they promised and to see the problems affecting their own agencies.
What are the major demands of doctors that if they get, there will be assurances of industrial harmony and higher chances of not running off to the United Kingdom (UK) among others?
This is a little bit tricky as I cannot say categorically that if these measures are put in place no doctor will leave our shores again. Doctors leave for different reasons but if we are talking about the identified push factors for the mass exodus then I can tell you the government needs to improve the working conditions and massively increase the staffing of all our health institutions making service delivery more efficient and conducive for the members of staff.
The remuneration of healthcare workers should be commensurate with the economic reality, increment should not just be arbitrary like you are giving a child candy to stop crying, the remuneration should be seen to ensure the basic amenities for livelihood of the healthcare worker is ensured. The government needs to create clear and practicable retirement plans for healthcare workers that gives the assurance that post years of service their future is secured.
Our facilities require massive upgrades for more efficient working and better job satisfaction, you can’t train healthcare workers in a field and we don’t even have the basic structure for them to work and compete with their colleagues from other spheres. The list is endless as it includes security in our communities and all but the above should encompass what my union stands for.
Do you recommend that Mr President declares a state of emergency in the health sector?
I think that ship has sailed as the National Council on Health already made that recommendation based on the reality at hand, which was why when I saw the budget proposal for health stood at a mere five per cent of the current budget I was confused about what they are proposing.
It is not about the arbitrary digits of the amount the five per cent translates to, as this amount has to be compared with previous amounts using the economic indices at the different times. Though the money may be more, the economic reality and price of goods are also more. So, in reality the healthcare system has less funds to work with in a country that says the healthcare is failing.
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