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Addressing Nigeria’s Poverty Level Through Its Health System

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Wednesday, March 28, 2018 /12:26 PM /FDC 

For a country blessed with abundant natural resources and a growing population, Nigeria’s poverty level is worrying. The African Development Bank has reported that about 152 million Nigerians are living on less than $2 a day, representing a poverty population of about 80%.

Between 2004 and 2010 alone poverty increased by 64% and while 2017 saw a recovery from recession, the positive economic outlook did not translate to improved well-being for the average Nigerian.

Unemployment rose from 14% in Q1’17 to 18% in Q3’17 and the misery index, the addition of the inflation rate, underemployment and unemployment, increased to 56% at the end of Q3’17 up from in 53% in Q1’17. However, this has dropped to 54.33 using February 2018’s inflation data.

The recently released 2017 GDP report by the National Bureau of Statistics shows that the Nigerian economy grew by 0.83% in 2017 while its population in-creased by 2.6%, highlighting the fact that Nigeria’s output is unable to feed its growing population. Left unaddressed, Nigeria is set to over-take India, which has five times Nigeria’s population, as the poorest country in the world by 2018.

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While poverty alleviation programs, such as the National Poverty Eradication Pro-gram (NAPEP) and the National Economic Empowerment and Development Strategy (NEEDS) have been introduced over the years, a vital element to tackling. 

Link between Poverty and Health care

Investing in health care can help tackle poverty by improving the learning and earning capabilities of citizens which would in turn increase economic growth and development. Research has shown that a 40% in-crease in life expectancy has the likelihood of increasing annual growth rate by 1.4 percentage points while a 10% decrease in malaria rate is connected to a 0.3% increase in growth rate.

Excluding poor citizens from efficient health coverage, common in most developing countries, only keeps them poorer and unable to function in the society.

Poor health is a liability both at a personal and national level with the potential of hindering human development indicators. Low-income earners are at a greater risk of falling ill given their limited access to information and health care facilities. Poor health impairs learning and productivity of citizens, draining savings and limiting earnings. Some of the constraints to accessing good healthcare include affordability, a lack of information and underfunded institutions. If these are not addressed, poor health will continue to trap communities in poverty for generations, feeding the vicious poverty cycle.

Challenges

Nigerians remain vulnerable to illnesses such as malaria as a result of the nation’s poor healthcare sys-tem. The lack of access and affordability to quality healthcare is likely the greatest challenge. Low quality public sector facilities available to the poor are unable to effectively address health needs and consequently keep people poor and ill. The National Health Insurance Scheme (NHIS), established under Act 35 of 1999, set out to close this gap by providing easy and affordable access to healthcare for all Nigerians. However, since its introduction, the scheme has covered less than 5% of Nigeria’s total popula-tion.20 Average out of pocket expenditure as part of total health expenditure still stands at a high of about 72%.21 This makes Nigerians vulnerable to fluctuations in the price of services.

If Nigerians had better access to insurance coverage, they would not be subject to price fluctuations. Instead they would pay a definite premium and price for services. With over 70 licensed Health Maintenance Organizations (HMOs), health coverage of Nigerians is at a sup-optimal level. Proper funding and regulation would go a long way in fixing this problem.

Way Forward

In addressing the health dimensions of poverty, information goes a long way. Many Nigerians do not have sufficient information about the benefits of immunizations, clean water and clean living environments. Health policies that nudge Nigerians in the right direction such as the refusal of admission into primary school without immunization, rewarding parents for deworming their children, public awareness programs on the need for mosquito nets and cleaner environments should be introduced. Australia for example has established a new policy of cutting parents off their benefit package on refusal to immunize their children. Additionally, a school-based deworming experiment in Kenya, performed at a cost of only $0.5c per child, was reported to reduce both the rate of infection and school absenteeism by 25%.

Institutions themselves also need a boost. Public sector providers are saddled with poor human and material resources, while private sector health facilities, although of better quality, are not affordable to most Nigerians. With the private sec-tor providing 60% of Nigeria’s total health care service, its role in fostering access to care cannot be ignored. However, they must ensure affordability of health care packages. In a bid to encourage new and affordable private hospitals, funding options and loan pack-ages should be de-signed for the sector. The Central Bank of Nigeria has set up a Real Sector Support Facility fund in a bid to encourage start-ups and expansion of businesses, including private hospitals. Un-fortunately, attention has remained focused on agriculture and manufacturing value chains with service sub-sectors ignored. Proper regulation of available fund facilities to ensure efficient management of the funds is required for the benefit of the health sector.

In conclusion, growth would remain artificial with no real value if not felt by the aver-age person. Public health investments would yield development returns in the long term. Beyond financing, the Nigerian health sector needs policies that are encompassing and ad-dresses key issues. In place of broad based health policies, the Nigerian government needs to consider policies that are tailor-made for the poor. Private sector facilities while augmenting efforts of the government should provide affordable and quality health care services. The development of the country hinges on the contributions of its dynamic human capital population. A poor and unhealthy population is not able to make significant contributions to economic activities and growth.
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