A RECENT report commissioned by the World Health Organisation (WHO) has painted a dismal picture of the health of Nigerians, particularly children and their mothers. The report titled "Opportunities for Africa's Newborn" published in Geneva , Switzerland , said that in Nigeria alone, over a quarter of a million babies die every year. This number could be reduced to less than half if government adopted a proactive health care policy.
The overall picture of avoidable deaths among children in Africa is a cause for concern. For instance, whereas Africa accounts for 11 per cent of the world's population, it recorded more than 25 per cent of the world's newborn deaths. The report traced the unacceptably high rate of newborn deaths and maternal deaths in Africa to inefficient health policies in a climate of mass poverty, pointing out that mothers and newborns in poor families face more challenges in accessing timely, high quality health care compared to wealthier families. The report concluded by recommending that African governments should adopt a systematic health care policy and support that specifically benefits the poor. It also called for African governments to be held accountable for eliminating inequities in their health sector.
Much of the observations made by the WHO tally with the experience of Nigeria's poor in both urban and rural areas and have had the misfortune of seeking medical assistance from the health establishments. In rural Nigeria , the poverty level is such that many families cannot afford the cost of ante-natal and post-natal care. Even in general hospitals where many believe services to be free or, at any rate, highly subsidised, patients are often directed to source their prescribed medicaments at their cost from outside the hospital. Moreover, with unattractive conditions of service there are not enough doctors and nurses in our hospitals, many having migrated abroad. For instance, although doctor-patient ratio in Nigeria is nowhere near the United Nations guidelines, Nigerian doctors practising in the United States of America number in their thousands.
The poor in Nigeria cannot afford to patronise private clinics. They cannot even get past the door as the "consultation fee" insisted upon prior to examination and treatment is immediately out of reach. Many of our people are forced by economic circumstances to seek help from native healers, quacks, and other quasi medical establishments of doubtful quality. Rural women often deliver their babies not in hospitals and clinics, but at home. When complications of childbirth arise in these places, death is almost a certainty. The WHO report said that each year, approximately 300,000 babies in Africa die on the first day of their birth, mostly from lack of adequate maternal and neonatal care.
The baby having been born is still not out of danger as there is the need for continuing healthcare and regular immunisation. Many Nigerian babies do not live to their fifth birthday. Sometimes these babies are wasted through ignorance. The Oral Rehydration Therapy (ORT), a salt-and-sugar life saver easily made in the home is unknown to many of our rural poor. The various immunisation campaigns tend to cover urban areas whilst remote areas are neglected due to logistical problems. At other times, superstition and bigotry have adversely affected the health of our children. A good example is the resistance to polio vaccine in parts of the country.
The shame of the WHO report is that Nigeria's health sector seems to be sliding backwards from its glorious past when ministers like Professor Olikoye Ransome-Kuti revolutionised health care delivery by focusing on primary health care. It seems their efforts have not been sustained so that today the state of our health care is being compared with those of war-torn countries .
Our inability to take care of the health of our people shows Nigeria as an uncaring society, and yet the protection of life and property of the citizen is the primary responsibility of all governments. Our nonchalance in the face of a growing crisis at practically all levels of civilised living is incomprehensible to the outside world. None of the countries with which we are being compared is anywhere as rich as Nigeria , yet we continue to hug the last position in almost every index of human well-being. In a recent assessment, Nigeria ranked 125 out of 151 countries in the human development index.
Although we may have more than $40 billion in external reserves and less than $5 billion in foreign debt, we seem unable to use our wealth to transform the lives of our people. We rank low even among the poor countries of the world. On infant mortality, for instance, we share the table with Chad, Niger, Haiti , and Cambodia . In maternal mortality we are at par with Haiti and worse than neighbouring Niger.
Health management is a duty for all governments at federal, state and local levels, but there has been a systematic failure in all three tiers as a result of unsound policies, corruption and neglect. It will be helpful if in future ministers upon assuming office are given tasks and targets in a manner that enables their productivity to be measured. We must revisit primary health care and save our children and their mothers from avoidable deaths and a life of misery.
