By Msen Nabo
“I am saving to take the next Professional and Linguistic Assessment Board (PLAB) exams”
“What are the requirements for the United States Medical Licensing Examination”
“List of countries and their salary range for medical professionals”
These are some of the questions that have become trendy among medical doctors and other health practitioners in Nigeria. Medical migration aka the Japa syndrome is spreading so fast it seems “everyone” has caught the bug. Vanguard reports at least 40 doctors leave the country weekly.
With current reported statistics of 5,000 Nigerians to 1 doctor, a failing educational system and more young people losing interest in professional courses like Medicine for seemingly faster money making career paths like Influencing, Content creation, Blogging, Tech amongst others, what does the future hold for Nigeria and Africa’s Health Sector?
The Covid-19 Transparency and Accountability Project (#CTAP) championed by Connected Development & BudgIT with support from Skoll and Conrad Hilton Foundation started off in 2020 in 7 African countries(Nigeria, Ghana, Cameroon, Kenya, Liberia, Malawi and Sierra Leone) with sole focus on tracking foreign aids, donations and vaccine distribution to these countries, to ensure equitable and effective distribution. The project will later uncover the brazen corruption, embezzlement and lack of accountability that goes on in the health sector unnoticed.
In Malawi, millions of dollars that came in form of donations were unaccounted for, leading to the dismissal of the labor minister and other government officials involved. In Nigeria, after visiting 783 Primary Healthcare Centres across 34 states, it was discovered that 90% of them fall below the minimum standard set by National Primary Healthcare Development Agency (NPHCDA) despite funding & allocation.
Other inadequacies uncovered in the sector across these countries are understaffing, lack of storage facilities for the COVID Vaccine, lack of power/water supply and in some centers, something as basic as a signage that indicates it’s a PHC was either completely absent or the writings no longer legible. Being the first point of call for medical emergencies, this paints a worrying situation.
Actions Taken so Far and Resulting Impact
Following these findings, the project duration was extended and scaled to 2 more African countries (Senegal and Zimbabwe). This helped in spreading the awareness of demanding accountability and Transparency from government officials by citizens.
A detailed report of these findings with specific focus on each country and its needs was launched. This will help shape conversations between Government and other health stakeholders and inform decisions on the best approach in fixing the system.
Signing of MOU with NPHCDA, Ministry of Budget and Planning: This builds trust and bridges the communication gap between the government and citizens and ensures an effective communication and feedback mechanism.
What more can be done to address these issues?
Putting stronger accountability measures in place. This can be as simple as ensuring more people are involved in the procurement and distribution process, this way a series of signatories are involved thereby making embezzlement more difficult.
Active citizens participation in elections and other processes that influence leadership and policies.
Better working conditions, wages, hazard allowance and other benefits to health practitioners. That way, medical migration may become a thing of the past in future.
A policy that bans medical tourism using taxpayers money! Until politicians are forced to use the poor facilities in their country, they may not see the benefit in fixing it!
Active sensitization on the processes involved in holding public office holders accountable and ensuring electoral consequences on erring officers. Until politicians know there are electoral consequences to their actions, every advocacy will remain activism as usual.
Migration of highly skilled personnels is bad for any nation’s economy. We hope that citizens realize good governance is a right and not a privilege, and rise up to the challenge of demanding more from the government.