Advocating for an accountable health sector
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Advocating for an accountable health sector

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“Most Nigerians would agree that the health sector hasn’t achieved its full potential, especially considering the human resources that Nigeria has,” said Chief Executive Officer of the Nigeria Centre for Disease Control, Dr Chikwe Ihekweazu.

The “brain drain” of Nigerian health workers to other countries, corruption and poor leadership over many years are some of the reasons Ihekweazu cites for the Nigerian health sector not reaching its potential.

“Almost every family in Nigeria has been affected by inefficiency in the health sector in one way or another, and it’s unfortunate that it happens so frequently that people have become desensitised to it,” said Ihekweazu.

Having worked in the health sector across multiple countries for over 20 years, Ihekweazu has various academic accomplishments including a Fellowship of the Faculty of Public Health in the UK’s Royal College of Medicine. He serves on the board of various organisations focusing on issues in the Nigerian health sector. He urged Nigerians to focus on accountability and transparency while also highlighting several problems currently faced by the health sector in Nigeria.

He urged citizens to play a part in improving the system, as it is never just the government’s role. “The government is never really separate from the citizens because it’s the citizens that vote them in. Health is not high enough on the political agenda in Nigeria, so people have a responsibility, if health matters to them, to advocate for better services and put it higher on the political agenda. “This doesn’t happen enough. One reason for that is we have many other problems and therefore we de-prioritise the health sector because it seems to not be as immediate as the other problems we have such as the economic crisis and the trouble in the North East,” he said.

Ihekweazu believes that the solution is better organisation of resources to serve and protect people’s health. “I think we’ve tried many quick fixes and have come to realise that it doesn’t work: you can’t fix the healthcare system by only fixing a small part of it. You have to consider the entire sector”, he further explained.

“There hasn’t been enough pressure on health institutions regarding what they’re doing with the funds that are available to them. If there was more pressure on the health sector and people felt the positive impact of the little that is allocated or available, they might start demanding for more.

“I think the concept of how much is allocated in the budget is an abstract concept for the ordinary Nigerian because he doesn’t see the benefit or effect from what has been appropriated in the first place. We should focus on an increased efficiency in the spending as much as we do in an increased budget or investment in the public health system,” said Ihekweazu.

“Organisations working to draw citizens into their advocacy for increased health investment should simplify what it actually means,” explained Ihekweazu. “For example, a child can be free of measles with just two shots of a vaccine that cost less than a bottle of Coke. The vaccine is free in almost all countries in the world and yet we cannot deliver those vaccines to our people in Nigeria. Simple messaging as X = Y and with Y you prevent Z.

“If a system is not efficient in delivering measles vaccines in Nigeria that are free then giving them millions of dollars more is not going to solve that. We really need to focus on efficiency of the current spend as well,” he said.

He also notes that corruption is a major factor in Nigeria and there is a need to increase accountability and transparency in the system. “We often think of corruption in terms of contracts and tenders but there’s a lot of corruption through the entire supply chain and we must curb this at every level.”

Since his appointment as head of the country’s public health institute, it has undergone internal restructuring, including properly defined internal control policies to ensure transparency. He adds, “There’s a sense of urgency from the President for the change he promised during his election to happen as quickly as possible. He’s given us the mandate to turn the system around and that is exactly what we are focused on”.

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