Over the years, the public health system in Nigeria has had some landmark achievements. For example, in 2014, the swift public health response to the Ebola outbreak was responsible for containing this deadly epidemic.
However, it hasn’t always been all success for the system, there have also been some major issues with public health in Nigeria and in this post; we will look at the system from both angles.
Public Health in Nigeria: A General Overview
Typically, the response to disease outbreak in Nigeria has been the combined effort of the Nigerian Government and international donor agencies. But beyond these, there is a need for the government to protect against these threats by installing strong public health infrastructures and health-care systems.
One of the mainstays of a robust public health system is the presence of a functioning healthcare system. And this starts from the most basic level which is the primary healthcare system.
Unfortunately, the inadequate programs designed to address these health problems in Nigeria have led to the little improvement in health status of the populace. However, the launch of a new health policy in 2016 seems to be changing things for the better.
Currently, the major public health challenges in the country are infectious diseases, control of vector some diseases, maternal mortality, infant mortality, poor sanitation and hygiene, disease surveillance, non-communicable diseases and road traffic injuries among others.
Let’s take a look at some of these predominant challenges and the response the government has provided in stemming the tide of these diseases.
Non-communicable Diseases (NCDs)
NCDs are also known as chronic diseases. These diseases are typically long duration and generally slow progression. There are four main types of noncommunicable diseases: cardiovascular diseases (like heart attacks and stroke), cancers, chronic respiratory diseases (such as chronic obstructed pulmonary disease and asthma) and diabetes.
Currently, NCDs represent the leading cause of death globally. In 2015, they were responsible for over 80% of premature in low and middle-income countries like Nigeria.
It is estimated by the WHO, that deaths from NCDs are likely to increase globally by 17% over the next 10 years.
The major risk factors for the predominant NCDs are tobacco use; physical inactivity; harmful use of alcohol and unhealthy diet.
These risk factors are driven by social and economic determinants that exist outside the domain of the health sector. These include poverty, globalization, trade, education, urbanization, climate change, employment conditions and gender disparities among others
Nigeria is currently working with the WHO to develop and implement comprehensive policies and strategies for the management of the major NCDs.
Neglected Tropical Diseases (NTDs)
NTDs include diseases like filariasis, onchocerciasis, schistosomiasis, trachoma and soil transmitted helminthes.
In 2016, it was revealed that 66.6 million people received treatment for an NTD in Nigeria while 62.4 million people in need did not receive treatment for NTD in that same year.
The treatment coverage has been fluctuating over the last few years with regards to NTDs. The coverage for lymphatic filariasis in Nigeria increased from 50% in 2015 to 54% in 2016 with over 123 million people needing treatment. Also, the treatment coverage for onchocerciasis in Nigeria decreased from 74% in 2015 to 67% in 2016 with over 53.1 million people needing treatment.
Another NTD, schistosomiasis has infected over 25 million school-aged children with less than 10 million of these children gaining access to treatment.
In terms of solving this health concern, there is the need to increase the budgetary allocation for NTDs at the national level. Also, providing timely data to the Expanded Special Project for the Elimination of Neglected Tropical Diseases (ESPEN) is mandatory to enable monitoring and planning.
HIV/AIDS is another public health concern although the response of international agencies and the Nigerian Government has greatly reduced the prevalence of this disease. Currently, the prevalence rate is relatively low in the country with just a little over 3 million people in the country reportedly living with AIDS. However, this accounts for the second largest epidemic in the world.
The major cause of HIV/AIDS has been traced to unprotected heterosexual sex which accounts for 80% of new HIV infections in Nigeria, with the majority of remaining HIV infections occurring in key affected populations such as sex workers.
Malaria has been a public health problem for several decades in Nigeria. In 2016, Nigeria had the highest out of fifteen countries who accounted for 80% of global malaria deaths with approximately 51 million cases and 207,000 deaths reported annually.
This means that an estimated 30% of the total malaria burden in Africa can be traced to Nigeria. It has also been revealed that 97 % of the total population (approximately 173 million) is at risk of infection.
The Nigerian Government and donor agencies have been actively involved in managing the malaria epidemic with subsidized treatment and increasing access to this treatment.
Early in 2018, there were reported cases of Lassa fever in states like Bauchi, Gombe, Plateau and Rivers state. However, the number of cases has been declining thanks to the prompt response of the Nigerian Government and that of donor agencies.
In November 2018, it was reported that there was an outbreak of yellow fever in Edo state, however, the Nigeria Centre for Disease Control (NCDC), National Primary Health Care Development Agency (NPHCDA) and World Health Organisation (WHO) have been working round the clock to prevent the spread of this disease.
When it comes to infectious diseases, the public health system in Nigeria has been able to contain most cases. However, there are some parts of the country where the system is facing numerous challenges. For instance, in the Northeastern part of the country, the Boko Haram insurgency which has reportedly displaced over 2 million Nigerians coupled with the non functioning health infrastructures in this region has made health care delivery difficult.
In fact, eradicating infectious diseases has been difficult in the North. For example, Nigeria is one of the three countries in the world that is yet to eradicate the polio virus and this is because of the inefficient public health system in North-Eastern region.