President Buhari’s Minister of Health By Bolaji Samson Aregbeshola

President Buhari has appointed Professor Isaac Adewole as the Federal Minister of Health to help achieve his administration’s plan of health for all. But can the current Health Minister bring about the needed change in the health sector?
The Federal Ministry of Health has over the years focused on the running and management of hospital services rather than strengthening the health system of the country. Now, we have a very weak health system and the health sector is on the verge of total collapse. Over 70 per cent of Nigerians who pay out of pocket for health care are bearing the brunt. Carrying out an holistic health care reform is the only way the Buhari administration can address the issue of weak health system, disharmony among health workers, incessant strikes, inadequate physical infrastructure, materials and technology as well as lack of governance and regulation—all of which remains unaddressed and threatening the survival of the country’s health care system.



In my article titled “An embarrassing health care system” and which was published on August 5, 2014 by an online newspaper, I surmised that employing the services of health systems expert is capable of addressing the problems facing the Nigerian health sector besides health systems experts are capable of devising tools policy makers and health actors can use or apply in addressing the challenges, weaknesses, deterioration and deficiencies of the Nigerian health system.



Federal Ministry of Health and all health programs and policies across the states have over the years been focused on hospital services. The believe that the head of any health care establishment must be a medical doctor has led to poor administration and management of the health sector contributing to the deterioration of the health care system and an increase in mortality rate.



Truth be told, the discord and disharmony among health care workers is killing the health system. The battle for supremacy and superiority among health care professionals has hindered the growth and progress of the health sector.



Every health care professional is important in the delivery of health care services as well as in the prevention, protection and promotion of health across the country but unfortunately, some professionals see themselves as the all-in-all as far as the health care profession is concerned and whittle down the importance, contribution and relevance of other professionals in the health sector.



This is why the Federal and State Ministries of Health have not been able to fulfill their responsibilities of protecting the health of all Nigerians and providing health care services to vulnerable populations. Their focus is on hospital services which favour certain practitioners, hence, the poor improvement in the health status of the general public.



The system is plagued by incessant strike, disharmony among health workers, inadequate resources and weak institutions in addition to high rate of mortality and low life expectancy. This has continued to occur under the watch of the Federal Ministry of Health.



Hospital services are important component of a health system in every country. They aim to meet the health care needs and demands of the population but have failed to improve the health status of Nigerians as well as the health of the population. That is the reason we need to pay attention to system problems and the health system as a whole.



In spite of the huge funds to hospital services on a yearly basis, most hospitals at the primary, secondary and tertiary levels are not living up to expectation. This has led to a situation where the high and mighty in the Nigerian society seek medical treatment outside the country while the poor people are left at the mercy of poor functioning hospitals.



Dr Phyllida Travis of World Health Organization and her colleagues in 2004 said that ‘’disease programs are unlikely to improve across health system unless health system is strengthened’’. Evidence suggests that weak health systems hinder the achievement of Millennium Development Goals, the improvement in population health and health outcomes. It is quite unfortunate that many states across the federation are currently battling the spread of Lassa fever which has killed many people within a short space of time. This is currently a great source of concern because our health care system is weak.



Studies have shown that the health sector of any country will not achieve its goal and objective of improving population health unless the issue of weak health system is addressed. The Nigerian health sector is on the verge of total collapse because we focus on hospital services to the detriment of addressing system problems.



We cannot do the same thing over and over again and expect different result especially as we have a new government that came to power based on the message of change. It is high time policy makers in the health sector, political actors and health stakeholders’ pay attention to strengthening the Nigerian health system by addressing the system problems that hinder the performance of the health system. The over 70 per cent of the Nigerian population who live below the poverty line face financial hardship and are further impoverished as a result of the failure of political actors and health care policy makers to address the issue of high out of pocket payments which includes direct payment for health care services and user fees.



There is a need for President Buhari’s Minister of Health to come up with plans and programs for the health sector using systems thinking. The president no doubt have the improvement in health of the Nigerian population as one of his administration’s agenda but the current Minister of Health, Professor Isaac Adewole must not be tempted to fall into the trap of focusing on hospital services and disease specific programs for the health sector.



It’s time for the Nigerian health sector to experience change in the true sense of the word. President Buhari has finally named Professor Adewole as his choice for the Minister of Health. Regardless of his professional background and academic achievements as an Obstetrician & Gynecologist, there is a general consensus among health systems expert that strengthening the Nigeria health system is critical to the improvement of health outcomes but it is up to Professor Isaac Adewole and the Minister of State for Health to use their administrative skill and experience to achieve this end goal. The Nigerian health system must be strengthened for the health of Nigerian population to be protected and improved.



Now that the APC is at the center, the right to health care should be the priority of the Buhari administration as health development is critical to economic growth except we are paying lip service to the revival of our economy which is currently in deep recession.