Nigeria at 51: We will Revive the Health Sector – Hon. Ndudi Elumelu

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KIZITO, African Independent Television, (AIT) reporter in an interview with Honorable Godwin Ndudi Elumelu. Representing Aniocha/Oshimili Federal Constituency and Chairman House Committee on Health   

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Question: sir as the chairman House Committee on Health, how would you assess the Health sector system in our country.
 
 
 Hon. Elumelu: The delivery of health care in the health system involves three actions:
System Inputs, Health Production, and System Output.
System inputs include facilities, personnel, equipment and supplies that are required for health production by health providers who offer health services as System output to patients. Low funding at all levels hampers the performance of the health care system, as reflected in poor quality resources and management.
 
 After many years of neglect, Nigeria’s health system is already failing to deliver even the most basic health services. Inadequate provision of funds and poor management has led to deterioration of equipment and facilities, lack of drugs and poor standards of care.
 
 Poor conditions of service and working conditions have left professional staff highly de-motivated. This may have created a situation in which unofficial payments are demanded for services, with the result that fewer people are now benefiting from government health services.
 
 
 Question:  comparatively sir, is the private health sector in Nigeria better off to our government hospitals?
Hon. Elumelu: The private health care sector is characterized by a general lack of benchmarks in terms of facility standards and quality of services. Private health services have grown markedly during the past two decades, but many of them are still too expensive for most people to use, especially the poor. About 60 per cent of health service expenditure is out-of-pocket and now occurs outside of the public sector on a range of for-profit, not-for-profit, traditional and other practitioners.
 
 
Question: According to the World Bank, Nigeria’s public financing of the social services at 0.3 per cent of GNP is lower in real per capita terms, compared with the late 1970s and early 1980s.
 
 
 Hon. Elumelu: The health management information system is weak. There is a paucity of accurate and timely health financial information. Actual records of national health expenditure to capture total spending, contribution to spending from various sources, and claims on spending by different users of funds are not complete and mostly inaccurate. Alternative sources of financing, such as the Drug Revolving Funds that were instituted some years ago, have not been properly implemented and have collapsed in most cases.
 
 There is also rigidity in the system due to hierarchical bureaucracy and the resultant lack of control by managers over day-to-day operations of their facilities. There are no performance-based incentives for managers of public health facilities. Because of the lack of accountability, the scarce resources available to publicly run hospitals are often ineffectively or inefficiently applied. Services delivered by public providers are unresponsive and unaccountable to users. Quality (clinical and consumer perception) is often a problem with both sectors.
 
 
 Question: Despite the long-standing realization and need of an affordable contributory financing for health care, there has been slow movement towards the implementation of a national health insurance scheme?
 
 
Hon. Elumelu: There is an inadequate and inappropriate mix of personnel. Training of health personnel (continuing medical education and training) has not been properly funded or implemented and even when this is achieved, the continued retention of health personnel is not guaranteed due to poor service conditions and external incentives (brain drain syndrome).
 
This has further compounded the inadequacy of trained and skilled human resources for health sector.
 
 
Question: finally sir, what are the challenges being faced in the Health sector today.
 
Hon. Elumelu: Nigeria as a nation is facing so many challenges in the health sector, which are: poor financing of health care services, the role of PPP, infrastructural decay, no incentives- poor remuneration, no attraction to work in rural areas, Malpractices: medical negligence, quackery, indiscipline etc. all these has affected our health system. 

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