Mobilising the health sector for Vision 20:2020

By Alex Abutu.

When President Umaru Yar'Adua took over the reins of power
in 2007, the global health rating of Nigeria was not encouraging.

The country, for instance, was rated only above Afghanistan,
considered the worst in terms of child and maternal mortality.

The implication of the index is that out of every 1,000 live births,
197 children will die, while 80 women out of 1,000 die during childbirth.

Neonatal mortality rate was put at 53 per
1,000.

The WHO's Country Fact Sheet for Nigeria puts life expectancy at
birth at 46 and healthy life expectancy at birth at 41 years for males
and 42 years for females.

It also says that the probability of dying between 15 and 60 years
is 513 for males and 478 for women per every 1,000.

The sheet further puts life expectancy in Nigeria at 45 years for
males and 46 years for females.

According to the records, there are 34,923 physicians in the country,
while the density ratio is 0.28 per 1,000 Nigerians.

There are 210,006 nurses with a density of 1.70 per 1,000 citizens,
while there are 6,444 pharmacists with a density of 0.05 per 1,000
Nigerians.

Analysts say that the situation is worsened by the total absence of
infrastructure at the various tertiary hospitals across the country.

Dr Ugba Ekon, a private medical practitioner, says the absence of
facilities and equipment at the various teaching hospitals has forced
these facilities to venture into minor cases which health centres
should handle.

''Teaching hospitals no longer undertake research as they are all
saddled with treating cases which health centres should treat,'' he
says.

The deteriorating state of the nation's health sector is further
exposed by the discovery of new cases of polio across the federation.

States in the Southern part of the country where polio were never
heard of are now recording such cases.

The Chairman of the National Population Commission, Chief Samu'ila
Makama, recently raised fears that the situation could worsen with
the nation's population reaching 225 million by 2025.

''At the current fertility rate of 5.7 children per woman, Nigeria's
population will double even faster, reaching 225 million by 2025,''
Makama said.

He said that the country would require an additional N1.4 trillion
to meet the health and educational needs of children by 2025.

''In future, Nigeria will need to invest billions more to immunise
its infant population and government expenditure on primary
education must increase from N350 billion in 2000 to more than
N872 billion by 2025.

''Nigeria has one of the fastest growing populations in the world,
growing at 3.2 per cent per annum,'' he added.

Makama noted that the country's population rose from 56 million
in 1963 to 140 million by 2006 within a period of 40 years.

Analysing the population explosion at current growth rate, he said:
‘‘if a couple decides to have five children and their offsprings follow
suit, by the fourth generation there would be 155 offsprings as
grand-children.''

According to him, positive efforts must be made to influence the
rate of population growth as 5.6 million children are born per year
and 15,342 per day in the country.

He said that a strategic plan, with an ambitious target of reducing
national population growth rate from 3.2 per cent to 2 per cent by
2015, was ready for Nigeria.

''The plan will also lay out the modalities for reducing total fertility
rate by 50 per cent of the current level of 5.7 by 2015 as well as
increase the use of modern contraceptives by at least two per cent
annually,'' he said.

Other strategies contained in the plan, according to him, include
delayed marriage, increased birth spacing, prolonged breastfeeding
and delayed commencement of sexual activity.

Commenting on the plan, Alhaji Yayale Ahmed, the Secretary
to the Government of the Federation, says that it will enable the
country to manage its population effectively.

Ahmed says that if the population growth rate is not properly
managed, it can hamper government's effort to fulfil its commitment
to improve the quality of life and standard of living for the people.

But for Dr Dogo Muhammad, the Executive Secretary of the
National Health Insurance Scheme (NHIS), all hope is not lost.

Muhammad says that in spite of the daunting challenges,
Nigeria's chances of meeting the targets set in the Millennium
Development Goals are ''still very bright and promising''.

He says that ''going by the programmes and projects being
implemented by government currently, the possibility of us
meeting the health component of the MDGs is bright''.

Among such programmes is the NHIS/MDGs Maternal and
Under-5 Child Health care Project (MCH) already launched
in six states.

Muhammad says that the MCH project has received N5 billion
from the MDGs Fund, which will be used to provide free
medicare to under-five children and pregnant women in six
pilot states.

He lists the benefiting states as Bayelsa, Gombe, Imo, Oyo,
Niger and Sokoto.

More states, Muhammad says, are expected to come on board
as soon as more funds are injected into the project.

''We expect that the project shall help eliminate physical and
financial barriers to qualitative health care for 621,386 children
under five and pregnant women in the participating states.

''Our hope is that with the project intervention, we shall
achieve a significant reduction in maternal and under-five
mortality rate in these states,'' he says.

The executive secretary also says that the project will ensure
that the international community recognises the genuine and
concerted effort of the Nigerian government to rise to the
challenge of poor maternal and child health in the country.

On her part, Sen. Iyabo Obansanjo-Bello, the Chairman of the
Senate Committee on Health, sees the country's maternal and
child mortality rating as a reflection of the decay in the health sector.

She, however, gives assurance that ''things can be turned around''.

Obasanjo-Bello says the rate pregnant women and children below
five years are dying in the country is ''`very alarming''.

She stresses: ''We must support efforts to curtail these unwanted deaths.''

According to her, the success of the MCH project will help in
repositioning the health sector.

For Mrs Amina Ibrahim, the Senior Special Assistant to the President
on the MDGs, supporting the health sector's revival with funds
accruing from the debt relief granted the country is one of the best
decisions of the current government.

She says that such support will enable Nigeria to meet goals four
and five of the MDGs.

''We must do everything possible to ensure that the maternal and
child mortality rating of Nigeria is reduced,'' she says.

As government articulates strategies to make the economy one of
the world's best 20 by 2020, analysts emphasise the need for a
healthy population because only a healthy populace can drive the
economy to the desired height. (end)