Generally, doctors are over worked worldwide. However, in developed countries the work load on doctors has been reducing with time. The World Health Organization (WHO) standard has been revised down progressively, and is currently at a ratio of 1 doctor to 600 patients.

Great Britain, the world’s first industrialized nation is a sovereign state, with a monarchy and parliamentary system of Government. She has a physician/patient ratio of 1:440 which exceeds WHO standard (Nigeria’s poor ratio of 1: 3500 reduces the quality of care expected to be given; which is even gloomier at state level, as Benue & Katsina states is about one doctor to 10, 000 & 15,000 patients respectively)

The UK's health care system is one of the most efficient in the world in terms of access and quality to care. The UK has a government-sponsored universal healthcare system called the National Health Service (NHS). Citizens are entitled to healthcare under this system, but have the option to buy private health insurance as well. The NHS Plan promises more power and information for patients, more hospitals and beds, more doctors and nurses, significantly shorter waiting times for appointments, improved healthcare for older patients, and tougher standards for NHS organizations. Public healthcare to all UK permanent residents is free at the point of need, being paid for from general taxation.

India medical care (a developing country with population close to a billion) was revolutionalized by Dr Prathap C Reddy, Chairman, Apollo Hospitals Group, by bringing it at par with the best to India. What motivated him was the belief that public sector and charity hospitals needed to be complemented by strong corporate-sector medical institutions. He set out to revolutionize the unaddressed health-care needs of a section of India’s growing middle class.
Today India is home to some of the finest surgeons, doctors, and dentists in the world. India is one of the largest medical providers that offer accessible quality services to Arabic nations, as well as medical travelers from around the world (including Nigeria).
In addition, numerous outpatient, clinic and hospital’s throughout India are accredited and certified, providing high quality and high-end medical services that is affordable to travelers from the Middle East, Africa nations, and around the world.
By bringing to India world-class medical care, advanced technology, best practices and, by persuading Indian doctors living abroad to return home, Dr. Reddy succeeded in creating what has now become Asia’s foremost health system. Apollo today holds world records in heart, liver, lung, kidney and other solid organ transplants. Apollo has served over 37 million people across it 54 hospitals and over 120 clinics in the past three decades.
Though India is yet to meet WHO recommended doctor to population ratio condition, it is making good progress in that direction.

Our health sector in Nigeria still contends with brain drain, incessant doctor strikes, shortage of specialists, dilapidated facilities, poor funding and revenue loss to Indian/Israeli hospitals (We lose at least $800m every year to overseas {about 35% to India} for treatment. On cancer treatment, Nigeria loses about $24m yearly on medical tourism to India).

The nations healthcare challenges ranges from; lack of electricity, lack of trained medical personnel, lack of medical facilities, poor health financing, poor sanitation and hygiene, noise pollution, infectious diseases, poor sewage disposal, poor population-bed ratio, non-availability of ambulance should there be emergency, poor solid waste disposal, disaster management, disease surveillance, lack of good roads and proper transport system to enable both medical personnel and patients to get to health care locations, improper co-ordination of donor funds.
Others are insecurity, fake and sub-standard drugs; for example, in 1993, adulterated paracetamol syrup caused the death of many children in Oyo and Benue States, while in 2008, lots of children died from a brand of teething medication.

The diagnostic facilities even in our Teaching Hospitals are obsolete, as physicians still use equipment acquired in the 1980s to diagnose diseases that emerged in the 21st century.
Nigeria is the only Africa country and one of the 3 countries why the world is not yet polio-free.
“Where-To-Be-Born Index,” Nigeria was rated as the worst country for a baby to be born in the world; as it is the first country where pregnant mothers and children die most in the world.

In the last decade of the 20th century, Life expectancy for males & females dropped drastically. The infant mortality rate (IMR) rose significantly. About 52% of under-five deaths are associated with malnutrition. The maternal mortality rate (MMR) of 800 per 100,000 live births is one of the highest in the world. According to World Health Statistics, malaria mortality rate for Nigeria is 156 per 100,000 populations. Nigeria has one of the highest Tuberculosis burden in the world of 311 per 100,000 resulting in the largest challenges in Africa (according to USAID).
This could be attributed to the gross under-funding of the health sector and shortage of skilled medical personnel at the primary health care level.

While scientists in other countries are making headway in providing solutions to diseases such as cancer and HIV/AIDS, our poorly funded research institutions are still battling with providing treatment for malaria and diarrhea.
Worse still, while countries like Ghana, Rwanda and Canada, with population less than 34 million people each, give more than 15 per cent of annual budgets to health care; our government continues to short-change us; last year only five percent budget was set aside to cater for the health of close to 170 million Nigerians.
Over 100,000 applicants show interest in studying Medicine and Surgery annually but less than 5 percent are offered admission due to lack of Infrastructure. If funding is increased, requisite facilities will be put in place, and this in turn would increase the number of applicants admitted to study medicine, increasing the number of medical graduates and reduce the current Doctor-Patient ratio.

Till date, Nigeria does not have a national law regulating its health care practice because the National Health Bill that was proposed to the National Assembly (over 6 years now) is yet to be passed into law (like the Petroleum Industry Bill). It has been argued that the non-existence of health legislation in Nigeria has been the bane of non-performance of the health system. The passage of this bill would ensure that every Nigerian, no matter their economic status, has access to basic and standard health services wherever they live.
Without access to quality, affordable care, a low-income family will often delay going to the doctor and make do with local quacks until their condition deteriorates to the point where more serious medical interventions are needed. Not only does this increase the overall cost of treatment, it also causes a loss of wage resulting in a major financial setback to the family.

Our leaders should desist from playing lip service to diversifying the Nigerian economy and work towards greater industrialization as management of oil revenue has proven inefficacious in driving our economy to bring about the needed level of development. This can be done by direct involvement of Government in Agricultural business, develop our solid minerals potentials and scaling up funds voted for tourism. This will strengthen our economy and ensure stability.

Medical practitioners in Diaspora can be wooed back home by; promoting a stable political climate, putting in place good infrastructure (including POWER) & modern diagnostic facilities, promote country’s good image abroad and make the Country comfortable like (or close to) being overseas.

If our healthcare system were not in comatose, late President Umaru Yar’ Adua may be alive today, as the 7hrs or more time spent on flying him outside the country for medical attention may have been used to save his life…… ‘’A STITCH IN TIME SAVES NINE’’.


Olawale Oyedokun

https://www.youtube.com/watch?v=q5uzwaoWaWY

[size=15pt]Nigeria seek to improve the local healthcare sector[/size]