Have we, the Citizens, done our Part?
It is a period of election in Nigeria. Vote counting is going on all across the country, and hopefully we will have one of the candidates declared president in the next few days. But that’s not the end to the current voting period as, in the next two weeks, we will be electing the governors of the 36 states in Nigeria. In the months prior to the presidential election, we debated intensively over the type of leadership we seek for our country and the hopes of what our leaders should deliver. However, there are very few voices out there holding our government to account for their performance when it comes to health. This must change. The leaders of this country are not going to report back to us from the goodness of their hearts; they will do so only if we demand answers from them. Questioning our politicians on health issues is our challenge and citizen duty for the next year and beyond.
We were told recently that Nigeria now has the largest economy in Africa. We know because it was measured and the economy was re-based with huge efforts. We are generally proud of this fact, even if it has not really affected our lives. We know that electricity generated in Nigeria is between 3,000 and 4,000 Megawatts, and, by knowing this fact, Nigerians are able to demand better. Now we also are beginning to know what the “voting population” is, how to analyse votes from across the country and what it means to have 25% in two thirds of the states.
Now is the time to change our focus to the health sector. We must ask the right questions. To do this, we Nigerians must educate ourselves on the indicators that matter the most for health. We must follow the data and use the data that is publicly available to ask the right questions.
There is data on the funds that are going into the sector. We know that, in 2014, N264Billion was budgeted for the health sector in Nigeria. We deserve to ask and be told how this was spent on our behalf. We know that the Global Fund granted US$ 1.5B to Nigeria in the last eight years. In our states, we must find out how this money is budgeted and if it is truly spent on the health sector.
Then we must look at the outputs. There is some good news. The most recent case of Polio in Nigeria was on the 24 July 2014. If we can keep it off, we are about two and half years away to being declared polio-free. We know that our HIV prevalence has reduced to 3.3% from 3.6% in 2009, but we also know that, of the over 3 million people infected, just 600,000 are on life-saving antiretrovirals. We know that of every 100,000 women that go into childbirth, 560 die. Since 2000, GAVI has supported immunization in Nigeria with close to $400M, in addition to the millions budgeted to NPHCDA every year, and yet only 65% of children have received their DTP3 vaccine (by Nigeria’s official estimates); survey data puts this at a lot less. We know that life expectancy at birth in Nigeria is just 52 years.
In terms of health services, things are no better. We have had the most number of strikes in the health sector in the past five years than any period in Nigeria’s history. Industrial harmony in the sector is at a whole time low.
In his talk at TEDxEuston 2014, Chude Jideonwu articulated the message that “in a democracy, the most important office is not that of the government, but that of the citizens.” This responsibility means that we must invest some effort, firstly in educating ourselves with the information we need as citizens and secondly to use this data to hold our leaders accountable for their promises.
Last weekend, we went to the polls in our numbers and made our choices on the next set of leaders. But we cannot wait another four years. Active citizenship is an all-year commitment.
We would love to hear from you. Have you had a good experience of healthcare in Nigeria? Have you had a poor experience in the health sector? Is there an individual or organisation who is doing good work in health in Nigeria that you would like to tell us about? Do you have any confidential tips about the disbursement of funds or delivery of a programme? Or praise for a doctor or nurse or midwife or pharmacist? Drop us a line at firstname.lastname@example.org.
Join us in building a more accountable health sector in Nigeria.