Dr Francis Faduyile is the newly elected President of the Nigerian Medical Association (NMA). In this interview with Paul Obi, he bears his mind on the health sector and what government needs to do improve healthcare service delivery
With your election as the NMA President, what should the members and Nigerians expect from you?
The first thing to work on is to see how we will improve professionalism amongst our members, and in doing so, we will also see to it that our hospitals are working effectively. We also want to develop a standard operation practice for all types of diseases in this country so that we can have a uniform way of treating patients. On the side of the government, we want to see that the Universal Health Coverage is made a reality. We are hoping to see how we can enforce the National Health Act, as it is, we are happy the Senate has passed that one per cent of the Consolidated Revenue Fund. That one per cent is going to take care of National Health Insurance Scheme (NHIS) and the development of National Primary Health Care Development Agency (NPHCDA). If these things are taken care of and we have funding, I can assure you the health status of the country will improve.
In what strategic areas is the NMA under your leadership ready to engage the federal government in terms of health care service delivery?
We have in recent times had discussion with the Ministry of Health and the NPHCDA on how NMA can collaborate actively with the agency to see that primary healthcare centers are improved, we want to see how our doctors are more interested in the PHCs by having more employment. And because it’s the PHCs that will take care of majority of Nigerians, we have also shown our interest in working with the NPHCDA on immunization. As we know, the immunisation rate has gone down in recent times to 38 per cent even though it is improving with the current executive director. You know doctors are all over the country, we want to get all our members to participate actively to see that all the necessary things needed to strengthen PHC are done. In fact we are working with our members to see how we can cover those PHCs that are not well staffed.
Is the NMA ready to monitor the 1% Consolidated Revenue Fund?
Certainly, we will continue to monitor the one percent that has been approved from the National Health Act. We have to work with the Ministry of Health to see that the money is directed to where it is expected to be spent. We are also going to see that the NHIS enrollment is increased. The current percentage is so low and it is only majorly for the federal government staff. We are encouraging other states to embrace their different states’ health insurance scheme. For example, in recent times, Cross River, Rivers and Lagos have joined. We want to do a lot of advocacy and see that the health of Nigerians, which is the paramount reason why we are in the health sector, is improved.
Will the new GAVI funds be included?
We have to first congratulate ourselves as GAVI has decided to come back. They withdrew at first because of our inability to be transparent with the expenditure. But we are confident that with one of our member as the Executive Director of NPHCDA things will be okay. The ED has shown a lot of transparency, hence we are in talk on how to work together.
The NMA is constantly challenging other health workers, are we going to see some difference?
Sincerely I don’t think that statement is totally correct, in the health sector we work as a team, and even when we have a team, there’s a leader, it’s when you challenge the leadership, that you have the leader now enforcing and making sure to say look, I’m a leader. We have had in recent times where members of the health sector try to show independence. This is not about doctors; it is about patients’ care. Today if you go to the hospital and you have lots of confusing terminology and management, the only group that will suffer it is the masses. And that is why NMA has been striving to make sure that we maintain sanity. We certainly believe in team work and we have decided that we will engage our brothers and sisters who are practitioners for us to sit down and discuss. In 2013 they set up the Yayale Ahmed Committee that went all over the country to see how the health systems are run in those different countries, they came out with their recommendations and it was at the point of approving and writing it out that our brothers who are professionals started objecting. I must tell you, we have scientists, pharmacists, nurses, doctors who are members of the committee that made those recommendations. You see, when you are talking about how things should be run, we should not forget that they can’t be made or totally domesticated in Nigeria. if the white paper from the Yayale Ahmed panel is released, it will calm a lot of nerves and we will see some sanity and positive direction. We want to appeal that people should always understand that the doctors are fighting for the interest of the patients.
How will you rate the federal government in terms of healthcare delivery?
Well, it will not be too good for you to look in isolation of this current government because there has been decadence in the healthcare management for a long time. If you want to rate what is on ground I think we have not done well, we have not moved to a position that we can say we have had so many great improvements. And one of the major reasons is the budget that is given to health; it’s ironical that it was in Abuja in 2001 that we had this declaration. Last year was 4.4 percent, this year I think it is three point something percent and this amount is not enough to take care of the health of Nigerians. You must also understand that sickness is becoming more dynamic, for example, we are having more of non-communicable diseases in Nigeria. How much are we ready to take care of. The drugs for cancers are very expensive, chemotherapy and other things that they need are things that are crucially out of reach. The PHCs government promised to build in each ward in the country is not there. Do we even have personnel to manage them? The project will not make any difference if you don’t have personnel. At a time I heard the minister saying that Nigeria has too many doctors and can’t keep all the doctors, that is why all the doctors are getting out of the country. I think it is not correct. The ratio of doctors to patients in Nigeria is one to 6,000 and the ideal is supposed to be one to 450. You see at every instance we lack nothing less than ten doctors in any area that you find yourself.
Will NMA expand its outreach programmes and other forms of charity?
NMA has always been doing health and medical outreaches every two to three months, and we have some other NGOs that have come around that we are going to work with in other to give free health treatment to Nigerians.