Background

In 2008, the health sector has been characterised by a lack of an effective stewardship role from the government, fragmented health service delivery, inadequate and inefficient financing, weak health infrastructure, weak health information systems with low quality data, limited use and understanding of evidence in planning, a mal-distribution of the health work-force, and poor working coordination. As a result, life expectancy of Nigerians was just 47 years in 2008, and vaccine-preventable diseases, along with infectious and parasitic diseases, remained leading causes of illness and mortality.

Past Reform and Achievements

The Health Sector Reform (HSR) was initiated and adopted in 2004. In 2010, the National Strategic Heath Development Plan (NSHDP) was developed to reduce the morbidity and mortality rates due to communicable diseases, reverse the increasing prevalence of non-communicable diseases, and significantly increase the life expectancy of Nigerians.

The plan and other reform have ensured such health improvements as polio immunity of the population increasing from 46% in 2010 to more than 80% in 2013; introduction of new 10 years covering Cerebro-Spinal Meningitis (CSM) vaccines; total eradication of guinea worms; reduction of the baseline for underweight children (under five) from 27% (baseline) to 24% in 2012; consistent decline in the rate of mother and child mortality since the start of the interventions in 2010; achievement of the WHO elimination of Tuberculosis target of less than one case per 10,000 population at the national level and in all zones; and 45% reduction in post-operative infections in tertiary health facilities across the country.

Challenges and Next Steps

Pending health bills, especially the National Health Insurance Scheme Act (Amendment) Bill, at the National Assembly should be passed without further delay to further improve the health sector and save lives. Effective public-private partnership should be promoted in the health sector to address inadequate, inefficient and ineffective financing of health facilities and services. Efforts should be made to pay healthcare workers adequately and promptly, to check the frequency of industrial strikes led by medical worker unions. Medical practice insurance and effective framework for litigation should be institutionalised to reduce the incidence of medical malpractice in hospitals and medical laboratories. A robust training policy should be adopted to improve the capacity technical medical staff in the proper use and maintenance of newly acquired and modern equipment.