Gone are the days when royalties visit the University College Hospital (UCH) in Ibadan from overseas for treatment. Today, the reverse is the case, as Nigerians are now heading overseas for treatment or related reasons. A nation’s ability to develop depends heavily on its health.

Key Points

Numerous challenges of medical practice in Nigeria affect healthcare professionals and the citizens seeking healthcare in one way or another.
These challenges are lack of jobs, insufficient healthcare professionals, ignorance on the part of patients, limited accessibility of healthcare schemes, violence against doctors, and poor funding of healthcare.
Solutions for change in medical practice in Nigeria require collective action from a range of stakeholders, including the public and commercial sectors, civil society, and foreign allies.
To improve the medical practice in Nigeria, the government must finance extensive infrastructure projects, the acquisition of machinery, and the hiring of personnel.
It is also critical to enhance the working circumstances for healthcare professionals and give them access to sufficient training programs, lucrative employment possibilities, and industry-leading compensation.

Every day, young and agile medical doctors are leaving the country for greener pastures in the health sector abroad.

Medical practice in Nigeria has become a herculean task for the following reasons and can also be tackled by the solutions provided alongside;

1. LACK OF JOBS

It used to be thought that a medical doctor could not be unemployed. But that isn’t the case in Nigeria. Starting from housemanship (first year of medical practice post-graduation), many doctors remain at home for many months in search of placement because, at this early stage of practice, they are not allowed to work in hospitals without supervision.

The same struggle is also encountered during the search for a facility to undergo residency training to become specialists. The same vicious cycle is repeated when it is time to work as a consultant, as most hospitals cannot afford to pay for sufficient consulting services. This is likely the reason most doctors inadvertently travel overseas for better employment and practice.

For the rest who do not follow the residency route, they risk lacking employment, as most health centres do not want to employ doctors because they prefer to cut costs by employing community health workers to serve as doctors.

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In a country that deviates far from the World Health Organization’s recommended doctor-patient ratio of 1:600, there needs to be a coordinated effort by relevant authorities to ensure that when doctors graduate, they are immediately posted for housemanship, just like it is done for graduates for the National Youth Service Corps (NYSC).

There is also a dearth of specialists in various fields thereby depriving Nigerians from accessing the best of specialist care in the country.

To curtail this, provisions should be made for young doctors interested in residency training by the government by increasing the capacities of hospitals on ground or providing more facilities to accommodate them.

When this is done, patients with terminal conditions like cancer will not have to wait for long periods on the queue or travel long distances to see a specialist.

2. LACK OF SUFFICIENT HEALTH PERSONNEL IN MEDICAL PRACTICE

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Doctors are human, not robots, and are surely not demigods. The stress of consulting many patients during working hours and even extra hours (without extra bonuses) can be very tiring and lead to physician burnout and fatigue.

In cases of common emergencies like road accidents, building collapses, and petrol tanker explosions, lots of casualties do not access adequate care because of the shortage of medical doctors in hospitals. The available few are overwhelmed and this can lead to avoidable deaths.

How can this then be tackled?

The World Health Organization’s (WHO) recommendation of doctor-patient ratio is a good place to start. It was made to ensure that quality care is given to patients while reducing physician burnout. The population of this country has definitely increased exponentially and would require more doctors be employed to meet up with the expanding population.

3. IGNORANCE ON THE SIDE OF PATIENTS

Ignorance has led to many avoidable deaths or disabilities especially from conditions that would have otherwise been properly managed.

Such ignorance is expressed in erroneous views and superstitious beliefs about vaccines like Anti-polio, convulsions, and faith in herbal concoctions instead of prescribed medications.

To curb this trend, awareness and enlightenment campaigns have to be done by the Ministry of Health in conjunction with the National Orientation Agency to help sensitize Nigerians on various health conditions either with online/print media, radio/television or SMS messages.

4. DEFICIENT HEALTH INSURANCE SCHEME

The importance of health insurance cannot be overemphasised as it affords patients access to quality and affordable care. Many Nigerians save money for education, house rent, building of personal homes and for entertainment but forget healthcare.

However with a working health insurance scheme that covers at least basic medications and procedures for patients, medical practice will be easier to carry out. A lot has to be done by the relevant authorities to educate Nigerians about health insurance and its numerous benefits. They should also make it more accessible to all irrespective of location.

5. SUBSTANDARD/FAKE DRUGS

It is one thing for a doctor to carry out a correct diagnosis and give the right prescription and another thing for the patient to access the right unadulterated medications that will alleviate their ailment.

After self-medication, another enemy of successful treatment of patients and medical practice in Nigeria is the myriad of fake and substandard drugs in circulation.

The National Agency for Food and Drug Administration and Control (NAFDAC), and the Pharmaceutical Society of Nigeria should do more in the fight against fake and substandard drugs which have been responsible for a lot of deaths in this country. Adequate checks should also be done before issuing licenses to pharmaceutical shops to operate in the country.

6. VIOLENCE AGAINST DOCTORS

The incessant strike actions by medical bodies are testaments to the fact that medical practice in Nigeria is far from what is desired. The welfare and security of doctors are not paramount which often leave innocent doctors at the mercy of ill-informed patients and their relations.

Some of these people also resort to intimidating the doctor in charge. Sometimes, paying off medical bills becomes a struggle especially as there are hardly sufficient security personnel in the hospitals most of the time.

The National Health Act 2014, section 21(3), gives the health personnel every right not to attend to a user who is verbally or physically abusive. To curb this menace, the government should ensure that adequate protection is maintained in health facilities as well as quick and decisive punishments given to perpetrators.

Avenues should also be made available to patients/relatives to make complaints against perceived wrongdoings instead of resorting to violence.

7. POOR FUNDING OF THE HEALTH SECTOR

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The Abuja Declaration of 2001 recommends that, at least, 15% of the National budget be allocated to the health sector. This is sadly not the case in Nigeria. Consequently, poor funding has resulted in meagre remuneration of not only doctors but also other health workers, induced poor working conditions, and poor health infrastructure.

Nigeria’s population has risen exponentially in the past three decades and as such in need of more and better equipped health facilities, manned by an adequate number of motivated staff.

In recent times, epidemics and pandemics are increasingly becoming points of concern to the country. Therefore, doctors and other health workers are needed in their numbers to help tackle disease conditions ravaging the nation.

For a long time the hazard allowance had been a paltry ₦5,000 which is hardly reasonable when compared to the risk and hazards which the doctors are exposed to.

With adequate funding of the health sector, patients will also easily access medical equipment and accessories without having to suffer as they wait for these little things to be bought first by their loved ones before treatment can commence.

With adequate allocation of funds to the health sector, better diagnostic equipment would be bought and help in aiding adequate diagnosis of disease conditions. Also other equipment to aid workers do their jobs efficiently would be provided.

With the right things in place, an appreciable number of health workers would gladly practice in Nigeria as far as their pay can meet their every need in a thriving economy.

SOLUTIONS FOR CHANGE IN MEDICAL PRACTICE IN NIGERIA

Solutions for change in medical practice in Nigeria require collective action from a range of stakeholders, including the public and commercial sectors, civil society, and foreign allies.

Naturally, the government is the first to propose a solution.

Nigeria requires a strong administrative policy base to address these issues, one that facilitates collaboration and priority setting among diverse stakeholders and the health staff. The government’s low budgetary commitments are being caused by inadequate planning and management methods for human resources.

As a result, it’s critical to enhance the working circumstances for healthcare professionals and give them access to sufficient training programs, lucrative employment possibilities, and industry-leading compensation.

Healthcare is expensive, and to truly provide high-quality healthcare and medical practice, the government must finance extensive infrastructure projects, the acquisition of machinery, and the hiring of personnel.

Hospitals are to be mandated to hire only the essential number of personnel and eliminate ghost workers, who are common in many establishments. Following that, earnings and results can be quantified, and compensation will depend on the actual activities of patients and the provision of services.

In Nigeria, primary healthcare is the foundation of true excellent health and needs to be easily accessible to the public, both in terms of location and cost. So therefore, the government should ensure that PHCs are well equipped and easily accessible to all citizens. Also, the National Health Insurance Scheme’s (NHIS) viability must also be guaranteed by the government, updated, and made functionally appropriate in terms of technology.

Healthcare professionals in private hospitals must improve the quality of their medical practice. To ensure that they provide high-quality healthcare, they need to be encouraged to grow and given more regulatory support.

The wealthy

No one can afford to be ill. For this reason, wealthy Nigerians have to be urged to make healthcare investments, even if they do so initially for themselves. They may do so out of self-interest, wanting to go to a reputable hospital in the event that they become ill. Whatever they construct locally will nevertheless have an effect on the entire country.

Additionally, the public needs to be made aware of and educated about health-related issues to alter and transform Nigerians’ behaviour and attitudes toward obtaining health care.

Nigeria as a nation needs to solve its health worker shortfall through a multimodal strategy that takes into account both the supply and demand sides of the health workforce equation. This is a thorough plan to deal with the lack of health workers and improve medical practice:

Education and training

Scholarships: To boost the number of people entering the field, provide scholarships to individuals seeking degrees in health-related fields.
Curriculum review: To make sure that curriculum stays current and includes best practices and new technology, they should be reviewed and updated on a regular basis.
In-service training: Give current healthcare professionals frequent training chances to advance their knowledge and abilities.

Strategies for retention

Competitive compensation: To deter people from leaving the health industry for other careers, make sure that health workers’ pay is comparable to that of other industries. Retain talent by providing incentives like housing allowances, travel expenses, and other perks.
Career development: Provide opportunities for professional growth and clearly defined career progression pathways.
Working conditions: Make sure that medical facilities are properly maintained and equipped to enhance the working hours and environment. Health workers who opt to work in rural or underserved regions can be offered additional financial and non-financial incentives as part of the rural deployment strategy.
Bonding: Implement programs that provide educational sponsorship to students in return for their promise to work for a set amount of time in underprivileged communities.
Infrastructure: Provide health facilities with the tools and materials they need to operate efficiently by developing the infrastructure in rural areas.

Rules and laws

Recruitment: To guarantee that hiring procedures are open and merit-based, standardize them throughout the nation.
Licensing and accreditation: Through regular evaluations, make sure that all healthcare providers and facilities adhere to the necessary requirements.
Adopt telemedicine: Utilize technology to close the gap and enable patients to consult with medical specialists without having to travel great distances. This is especially important in remote places.
E-learning: Provide training courses and courses online to provide on-going medical education.
Diaspora engagement: Create initiatives that motivate Nigerian medical professionals working overseas to give back their skills and knowledge by returning for extended periods of time or as temporary employees.

HOW TELEMEDICINE CAN HELP

Telemedicine is the use of telecommunication technology to consult with healthcare professionals that are close or far away from your location. If you are willing, Kompletecare offers telemedicine as an avenue to bring healthcare services to you at your own convenience. Just a click on the link, you are connected with access to medical needs and all inquiries you may want answers to.

The Kompletecare platform cares for medical practitioners looking to navigate through the challenges of medical practice in Nigeria through telemedicine. If you feel wary or worn out from the challenges, you can use the technological devices available to you to reach out for the services you need.

FREQUENTLY ASKED QUESTIONS

1. What are the challenges in the healthcare sector in Nigeria?

The Nigerian healthcare sector experiences challenges, which are:

Insufficient information was provided to the patients.
Insufficient funding exists for infrastructure construction and upkeep.
Most Nigerians cannot afford the high cost of healthcare.
There are an inadequate number of staff members who are paid and trained appropriately.
Putting a national priority on healthcare.

2. What are the challenges of medical doctors in Nigeria?

The majority of Nigerians are aware of the inadequate infrastructure, high workload, lack of development possibilities, and equipment shortages that exist in the health system. Also, some of the unique obstacles that individual medical doctors encounter while pursuing their educational and professional objectives are not as well appreciated.

3. What are the six major challenges to the primary health care program in Nigeria?

Currently, the majority of PHCs in Nigeria are unable to provide basic healthcare services due to a variety of problems, including

Inadequate staffing,
Out-dated equipment,
Unequal distribution of healthcare workers,
Low-quality healthcare services,
Dilapidated infrastructure,
A shortage of essential medications.

4. How can we improve the health care system in Nigeria?

Nigerian health care can be reformed when the policies:

Boost the gathering and tracking of health data.
Boost employee growth in the medical field.
Make sure the necessary medication is available.
Enhance immunization initiatives.
Encourage the treatment of diseases that are on the rise.
Boost nutrition and the availability of food.

5. What is healthcare like in Nigeria?

Nigerians get care from a variety of unofficial sources, including traditional birth attendants, community health workers, marabouts and spiritual healers, medicine merchants, and medical personnel and auxiliaries. The system is based on a combination of fee-for-service, little health insurance, and quasi-tax support.

6. What are the different types of healthcare systems in Nigeria?

Nigeria has a heterogeneous healthcare system that combines both modern and traditional medical practices, as well as state and private health providers. The three levels of government are jointly in charge of providing health care.

7. Is there a shortage of doctors in Nigeria?

Yes, there is an acute scarcity of doctors in Nigeria. Nigeria is seeing a significant migration of highly qualified healthcare professionals. Far from the advised 1:600 ratio, Nigeria’s doctor-to-patient ratio is a frightening 1:9083.

CONCLUSION

Are you a doctor practicing in Nigeria or the diaspora? Feel free to join the conversation on the salient issues and challenges of medical practice in Nigeria as well as solutions for change.

You could also get rewarded while doing the things you love by Registering on KompleteCare Telemedicine platform today.