Public vs Private Hospitals in Nigeria

Accessibility and affordability of good Hospital have been a challenge for Nigeria for as long as we can remember. The public hospital system has been in a state of disarray on account of decades of apathy, low and mismanaged budgetary allocation, inadequate and outdated infrastructure, lack of concrete vision and enforcement from the government’s end.

According to reports from BMC Emergency Medicine , Nigeria is ranked second highest in the rate of road accidents and other emergencies (Deaths, disabilities) among 193 countries of the world. an estimated 27% of India’s 1.3 billion people face the risk of death in the event of a medical emergency on account of poor healthcare infrastructure. The figures further reveal that India has just a single doctor for every 10,189 patients and 2,046 patients are vying for a single hospital bed. (1)

Government Healthcare Expenditure

On October 7, President Muhammadu Buhari presented before both sessions of the National Assembly, a proposed budget of N16.39 trillion (N16,391,023,917,692) for the 2022 fiscal year.

According to the President Muhammadu Buhari, the allocations to Ministries, Departments and Agencies (MDAs) were guided by the strategic objectives of the 2021-2025 National Development Plan, which amongst others include the strengthening of security, and enabling of a healthy populace. 

However, out of the total N16.39 trillion proposed budget, a sum of N711.28 billion (4.3% of the entire budget) will be allocated to the ministry of health, while N1.14 trillion (6.96% of the entire budget) is for the ministry of defence. 

Based on the proposed 2022 budget, and its allocation of N711.28 billion to the ministry of health in pursuit of the goal of a healthy populace, that is N3,453 is what the federal government has earmarked to care for the health of each citizen out of its 206 million citizens.

The capital budget for the ministry of health stands at N194.60 billion, while recurrent expenditure is at N503.98 billion. Although the proposed budget for the ministry is the highest since President Buhari came into power in 2015.

Recall that because of poor health infrastructure and welfare, medical doctors went on strike twice between January and September this year. Beyond the strike, more than 500 doctors indicated interest in a recruitment exercise by the Saudi Arabia Ministry of Health some months ago.

The allocation to the health sector in the 2022 proposed budget is just 4.34% of the entire budget. This means that Nigeria has failed again by 10.66% to meet its 2001 health sector commitment.

Nigeria Budgetary allocation for Healthcare has Increase, but is it Sufficient? What healthcare service can N3,453 provide?

Although this year’s budgetary allocation increased by 29.37% and the cost of healthcare per person is pegged at N3,453 higher than the 2021 figure, what healthcare costs can it cover?

Take an endemic illness like malaria, endemic because malaria accounts for 60% of all clinic attendance in Nigeria. The average cost of seeing a doctor in small clinics is N1,000 naira, the cost of a malaria test is also about N1,000. The cost of drug treatment for uncomplicated malaria is between N1,500 and N2,000. Not counting additional drugs like paracetamol, the average cost of treatment for uncomplicated malaria in a local clinic exceeds the budgetary allocation for each Nigerian. The cost goes way up for complicated malaria diagnoses that require hospitalization, injections and intravenous medication.

It is high time Nigeria give healthcare expenditure the much-needed priority as what other sectors enjoy. 

The Preference for Private Hospital Services

The quality of medical care and excellence of service are the primary differentiation that have driven a competitive advantage private hospitals are thriving on. When spending out of pocket, 70% of Nigerians would choose private healthcare services over a public hospital.

Despite private hospital being five (5) times more expensive, 60% of rural residents and 80% of urban residents would not trust a public hospital facility. The growth of private hospital fuels the contemporary belief that infrastructure of a hospital can impact clinical outcomes, and the difference is stark!

Private Hospital Ward

However, for financially marginalized and rural communities, there may be no other option. Public hospital receive funding from the government, making it mandatory for them to cater to all segments of the population. However, the services have been found to be extremely deficient. 

The shift of the private hospital from welfare motive to business motive is no secret either. The cost of medical inflation in Nigeria was above 16%  as of September 2021. What this indicates, is that for the average Nigerian, getting medical treatment without adequate healthcare insurance is no less than breaking the bank and compromising on the financial future.                                                                                                                                                                               Public Hospital Ward                                                     

Word from OshoBaba

There is a need for accessible qualitative healthcare services in Nigeria, while the vast majority of Nigerians who have little to no insurance need to look at investing in a health insurance plan so that they are not left wanting in times of need.