The essay reviews Nigeria’s health care system in comparison to USA’s system. Nigeria is a largely populated country in Africa whose health status has been a major issue. It is a fast developing country in relation to its economy but has lagged behind in the health sector. Research shows that the government caters for close to a third of healthcare which is not much considering the country’s large population.
There is need to improve on the government’s involvement in medical care and they could borrow a few ideas from the USA whose health care system is very stable.
POPULATION AND HEALTH STATUS
Nigeria’s is a largely populated country. Its health status however compared to that of the USA is wanting. Average life expectancy, especially for men has decreased over the last decade an indication of declining health care. Nigeria is one of the countries where infectious diseases and epidemics which have been combated with vaccines are still a major problem. For example polio, an infection that is rare in most of the world due to vaccination is still a major problem in Nigeria. Infections such as malaria, cholera, typhoid, meningitis and hepatitis that have been successfully fought in most countries are still very common even when vaccines and medication for these conditions are available.
It does not help that most of the people in need of medical care are the poor due to poor sanitation and unhealthy living conditions. Fake cheap medication has saturated the market and has found a willing market in people who cannot afford quality medication. The government however has and still is cracking down on some of this products.
Spending on medical care has increased by more than 200% over the last five years. However an improvement though not a substantial one has been the decrease in infant mortality and percentage of HIV/AIDS infection. The number of physicians available per a thousand people at 0.2 is pathetically low. This implies that the doctors and medical personnel are overworked and overwhelmed and even if they dedicated all their time to caring for patients the bigger percentage will still lack essential health care.
Compared to the USA the quality of Nigeria’s health status falls way short. This is greatly due to the government’s reluctance to invest heavily in medical care unlike The USA government. Quality medical care and improved health conditions require heavy investment in education, medication, improved sanitation and medical facilities.
AVAILABILITY OF HEALTH SERVICES
Health services in Nigeria are limited in comparison to the population. The number of physicians available to begin with is too low not to mention the poorly facilitated hospitals. Nigeria lacks medical equipment and technology without which knowledge of treatment and curing cannot be applied. Citizens that are financially well off usually will have no problem accessing medical care and as a result the bigger percentages of people are in dire need of health care are the poor.
Accessibility to medical care by the poor is very low. This is a matter the government is supposed take responsibility for. The only way that the government can ensure the bigger population accesses medical care when they need it is by spending and investing in medical facilities, creation of health and proper sanitation awareness, education and training and medical equipment. The government funds a few public hospitals which are clearly not enough. The physicians as a result are overworked and as a result cannot offer quality services.
One very important strategy they can pick from the USA is to train medical practitioners and to ensure they are required by law to offer quality services. In the USA it is a requirement that doctors that are allowed to handle patients are always well rested and of sound mind. The government should consider investing in training of doctors and nurses who are well paid. An increased number of medical personnel and more medical facilities and hospitals would greatly reduce the mortality rates, especially from diseases and infections that are treatable.
The population is intent on utilizing health care provided by the government; the government however has not made conscious effort to utilize available health care and medical discoveries. Unlike The USA readily available medical and health care is not exactly a priority.
Almost the whole population in Nigeria uses the out pocket spending strategy to access health care whenever they need to. This however mostly applies to the high and middle class societies. The poorer population however results to traditional medication and treatment or home therapies when they cannot access or afford public medical care. There is need for the government to encourage and educate on payment strategies that will assure financial risk such as medical insurance.
However, due to macroeconomic problems faced by the Nigerian government health budgets were greatly reduced. This unfortunately coincided with increased demand for health care services. The need for urgent medical care coinciding with lack of its accessibility worsens the problem because it is easier to deal with elimination of disease and infection spread at its beginning stages. Delayed medical care only heightens poor health’s adverse effects.
Research shows that citizens living in urban areas spend more on medication compared to those in rural areas. They are also more educated and concerned about maintaining a healthy lifestyle hence physicians find it more profitable to operate in these areas. The mode of payment here mostly is the out of pocket system, (OOPS). The mode of payment in rural areas is usually in-kind payment, reimbursement and installment payments.
The government can greatly improve payment modes by encouraging adoption of financial risk mechanisms across the country especially insurance and saving.
MACROENVIRONMENTAL INFLUENCES ON THE HEALTH CARE SYSTEM
Most African countries’ political systems are corrupt and very unstable. The government plays a major role in determining the health status of a country. Seeing as it is responsible for the health policies in the country, a corrupt and/or unstable government cannot implement strong policies. The highly recommended decentralized health care policy has proved difficult to implement effectively in most African countries mostly due lack of strategy and poor management. Donor partners also refrain from funding these countries’ health obligations due to their poor accountability or lack thereof, bureaucracy and weak capacity.
Corruption, mismanagement of funds and poor policies by political leaders is a major setback for health improvement.
Socioeconomic classes influence expenditure and access to healthcare. They also influence government intervention in implementing national user fees to address inequities and inefficiencies in the health system. The probability of contracting infections and epidemics usually is higher among poor populations due to their poor access to proper sanitation and medical care. (Khaleghian, 2003)
Cultural influences are fast diminishing due to increased civilization. However in communities that have not embraced civilization and still engage in traditional practices, their failure to seek professional medical care may be influenced by cultural beliefs and ignorance. In such cases they would rather use traditional medication like herbal medicines which more often than not are insufficient and could be dangerous.
Technology has got the biggest influence in the healthcare system. Technology plays a big role in administration of treatment. Knowledge of treatment and medication especially involving situations such as surgery, cancers etc, would be impossible to apply without technology. New age problematic diseases such as cancer, diabetes, high blood pressure are caused by poor lifestyles and heavily depend on technology in their treatment.
PROBLEMS IN THE NIGERIAN HEALTH CARE SYSTEM
Implementation of the exemption system for the poor, where they are exempted from paying user fees has proved to be problematic. Identifying eligible poor beneficiaries and distinguishing the poor from the non poor poses this system ineffective. This is partly due to poor planning, follow up and strategy.
Another problem is the country’s political system. Nigeria has come a long way politically but still has a long way to go in terms of strategy and policy making. They lack effective policy makers and implementers especially in the health sector.
Government expenditure on health care is very low. It is barely enough to cover half the poor population. Proper health care takes a lot of financing and investing. They need to invest in medical training seeing as they lack enough doctors and nurses. Educating the public is also important because educated people are more health conscious and are rarely in a position where they cannot access medical help. This problem however is due to lack of enough funds to improve health care and lack of faith from donors due to mismanagement and poor accountability of the same.
However, the main problem of poor health care usually lies in its cause. Nigeria is battling illnesses like malaria, typhoid and cholera which are a direct result of poor sanitation. Some of the time the poor population suffers from these epidemics because it is poorly educated but most of the time it is because they live in unhealthy conditions with poor access to proper sanitation and clean water. Improving these people’s conditions would improve the health care system in that it would considerably reduce the probability of infection and epidemic occurrences.
COMPARISON BETWEEN USA’S AND NIGERIA’S HEALTH CARE SYSTEM
A health care system comprises of five essential parts. The medical workforce that provides medical services, medical facilities, healthcare therapeutics providers such as pharmaceuticals, health care educational, training and research institutions, and the health care’s financing mechanisms. These components have to be running smoothly for a successful health care system and the USA has ensured their perfect and quality day to day running.
Nigeria’s healthcare system however is wanting in all five components. The medical workforce though qualified is not enough; they lack enough medical facilities and have limited funds. The government needs to work on improving their economy to provide healthcare funds. As they work on their funds though which takes time, an immediate solution would be to improve their management and accountability skills in order to win donors’ trust.
Another solution would be improving their healthcare training and research facilities to encourage more medical trainees and a better environment for medical research. This too requires proper planning and funding which can be taken care of by placing qualified and able personnel where policy making and implementation is required.
The decentralized health care system is a good idea however with proper management and accountability. An essential measurement of the quality of healthcare is equity and efficiency in its provision. One way the government can ensure equity is by exemption of user fees for critical medical care such as pregnancies, malaria patients aged below five, etc.
Decentralization of the health care system involves transferring political and ownership authority for health care delivery from the central health ministry to alternate institutions. It has the effect of improving the quality of service provided and also improves the public’s access to information because the public contributes to decision making.
In conclusion Nigeria’s health care however wanting has room for improvement. With proper planning, sound policies and strict implementation the situation can be improved.