How COVID-19 ‘unmasked’ gaps in Nigeria’s health sector

The challenges around Nigeria’s health sector exposed by the COVID-19 pandemic have come to the fore with the production of a documentary film tagged ‘UNMASKED’, which was recently unveiled in Lagos.

Globally, the COVID-19 pandemic is a major public health concern exposing the vicissitudes of the healthcare system of various countries. In Nigeria, it was a particularly peculiar scenario.

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This is what the work of art titled ‘UNMASKED: Leadership, Trust and the COVID-19 Pandemic in Nigeria’ highlighted. The work of art was meant to expose the gaps in the country’s health sector and galvanize collective actions towards tackling the identified challenges.

The 1 hour 40minutes feature documentary film was produced and directed by Femi Odugbemi and coproduced and presented by Kadaria Ahmed with support from MacArthur Foundation, Central Bank of Nigeria (CBN) and PLAC.

The documentary film which focused on the COVID-19 pandemic and its management in Nigeria exposed the gaps in the nation’s health sector as well as the travail of the poor masses at the peak of transmission when the economy was locked down.

It showed the  unpreparedness of different States for emergency as at the time the pandemic struck.

The film brought to light the suffering of people who lived on daily earnings and how the interventions from government, NGOs and wealthy individuals could not suffice. It showed the apparent lack of trust between the government and the people. It however preferred solutions to challenges outlined particularly those of the health sector.

Some of the major issues highlighted in the documentary are non-functional health insurance scheme, corruption, poor leadership, weak infrastructure, poor remuneration for medical and health workers, brain drain, dependence on donor countries for critical items such as vaccines and lack of functional equipment among others.

Experts, who were interviewed in the documentary, recommended making the National Health Insurance Scheme (NHIS) mandatory, resuscitating primary health care in the country as we as stressed the need for more public-private partnerships.

They also called for increased budgetary allocation to health, local production of essential medical tools such as vaccines and protective personal equipment (PPE).

The Director of Mac-Arthur Foundation, Dr. Kole Shetimma who joined the event virtually in his opening remark stressed the need to make health care services more accessible and affordable especially to the poor.

He said, “COVID-19 has taught us that we must make it possible for all citizens including rich and poor to have access to basic health care services.”

Governor Sanwo-Olu during one of the interview sessions in the documentary film identified lack of data as a strong shortcoming in the management of COVID-19, particularly when the State began contact tracing.

He said, “We must be prepared at all time. What ‘Unmasked’ has taught us is to continue to challenge the status quo.

Also, the Central Bank of Nigeria (CBN) Governor, Godwin Emefiele pointed out that the COVID-19 pandemic led to strong cooperation between government and the private sector.

According to him, building a robust healthcare infrastructure was vital from a security perspective, as some nations had imposed restrictions on the exports of vital medical drugs as well as the use of drug patents that could aid in containing the spread of the pandemic.

He disclosed that over N83.9 billion was disbursed in loans to pharmaceutical companies and healthcare practitioners, which according to him is supporting 26 pharmaceutical and 56 medical projects across the country.

He also said that the apex bank was able to mobilise key stakeholders in the Nigerian economy through the CACOVID alliance, which led to the provision of over N25bn in relief materials to affected households, and the set-up of 39 isolation centres across the country.

Emefiele who was represented by Mr. Osita Nwanisobi maintained that addressing the public health crisis along with the downturn in the economy required strong coordination; stressing that the interventions of the CBN and private sector to enhance government’s response to the COVID-19 crisis are not enough to build a sustainable healthcare infrastructure.

Lagos State Commissioner for health, Professor Akin Abayomi in a panel discussion stressed that Nigeria must focus on health and education, else, it will forever be backward.

He stressed the need to resurrect the Primary Health Care centres. “As a State, our focus is on PHCs because 80percent of deliveries take place there. It is also the crux of health care delivery. At the moment, we call it the orphan child because it doesn’t seem to have a parent. It is neither owned by the Federal, State or Local Government, so outs just floating up there,”

“It doesn’t have enough resources allocated to it because there are three tiers of government contributing to it’s sustainability. The FG has tried to regularise this by saying that the governance of PHC reside in the PHC board. Because all other levels of government contribute to the PHC boards, there is no direct ownership and responsibility for the ownership, resourcing a and regulation but that is changing now.

“The FG has made an emphatic decision that PHCs be run by PHC board supervised by the National Primary Health Care Development Agency and Federal Ministry of Health. We hope that with this, there will structure, standardization, harmonization and opportunity for the private sector to participate,” the Professor said.

Also, the Director-General of Nigeria Centre for Disease Control (NCDC), Dr. Chikwe Ihekweazu, said: Documentaries like this help the people, particularly the leaders to reflect, learn and push harder to prevent future outbreaks.

Ihekweazu, who was also one of the panellists, said NCDC is now better prepared for future epidemics and pandemics.

Governor Nasir El-Rufai of Kaduna State noted that public hospitals are best at dealing with infectious diseases than the public health facilities. He however stressed the need to invest heavily in the health sector.