The Minister of Health, Prof Isaac Adewole, has blamed the poor state of healthcare facilities in Nigeria on the failure of some state governments.

Briefing lawmakers on the abysmal state of tertiary institutions in the country, on Tuesday, May 21, 2019, Adewole accused states of "abandoning" primary and secondary healthcare development in their areas for the Federal Government.

According to the Minister, fourteen states in Nigeria have shown no interest in the basic healthcare provision fund meant to improve primary health facilities in their areas.

Nigeria’s Minister of Health, Prof Isaac Adewole, says State have abandoned healthcare development for the Federal Government.
Nigeria’s Minister of Health, Prof Isaac Adewole, says State have abandoned healthcare development for the Federal Government.

“As of today, 14 states are yet to show interest in the basic health care provision fund and because senators represent the entire country, I want to quickly seek your permission to list the 14 states that are yet to register – Kebbi, Jigawa, Akwa Ibom, Cross River, Gombe, Rivers, Borno, Zamfara, Ondo, Benue, Taraba, Nasarawa, Ogun and Sokoto," he said.

Nigerias overcrowded tertiary healthcare system

While appreciating the National Assembly for the passage of the basic healthcare fund, Adewole said tertiary health institutions in Nigeria have become overcrowded due to the neglect of primary and secondary healthcare systems by the States.

"We have 22 teaching hospitals in the country, 20 federal medical centres and 17 specialist hospitals all over the country under the direct purview of the federal government. Most states also have teaching hospitals to provide tertiary care," he said.

"The teaching hospitals by design constitute the apex of healthcare in any country and for us in Nigeria they represent the topmost and by design they are expected to receive referrals and manage complicated cases.

"For them to function, they depend on primary healthcare centres and functional secondary healthcare centres. When these two levels of care are functioning 90 percent of ailments can be taken care of at primary and secondary healthcare centres. Only 10 percent of Nigerians who require care will need to go to a tertiary institution. 

"However, over the last couple of years, we have a major challenge, the healthcare system can be described as a pyramid. The primary care centre at the base, secondary at the middle and tertiary at the tip. 

"The problem we have is that the foundation is bad (primary healthcare), the wall is weak (secondary) and we are only concerned about the roof (tertiary). 

"Going by media reports, Nigerians have no confidence in primary and secondary, everybody will go to a teaching hospital.

“What we have through your support and I must commend you for approving the healthcare basic fund, it is a game changer. We have spent almost a year developing the guideline and over the last weeks, we have started a roll-out and as at the last count, 22 states have registered for the basic healthcare provision fund.

“What we have done with the fund is to structure it in a way that money will flow from central bank to the primary healthcare facilities bypassing all obstacles. Last week, we succeeded in moving out funds from central bank to the agencies and from the agencies, it will go to the primary healthcare."

While noting that most tertiary health facilities lack access to water and power supply, the Minister called for partnership between state governments and international organisations like Red Cross.

The minister also reacted to queries from lawmakers who wondered why Nigerian hospitals "are in bad state" despite "huge funding" of the health sector.