ACCOMPLISH MAGAZINE OCT 2023

The Health Sector
Dr. Mishack
Ikechukwu Akunekwe
Dr. Mishack Ikechukwu Akunekwe, FWACS, FICS, is a
medical consultant with unquenchable desire to
see the rising of a new Nigeria. He is a widely respected
burns, plastic, reconstructive and aesthetic surgeon. He
is also a researcher, publisher and a missionary doctor.
Accomplish Magazine sought his views about Nigeria’s
health sector and his responses were straight-to-thepoint.
Accomplish Magazine: As
Nigeria celebrates its 63rd
Independence Day anniversary,
what would you say are the
issues confronting real progress
in the country’s health sector?
Mishack Akunekwe: The
issues confronting real progress
in Nigeria’s health sector can
be categorised into three. These
are: infrastructural, manpower
and political will.
First, there is poor
infrastructural facilities in the
health sector. For instance,
many tertiary and secondary
health institutions have no
diagnostic tools like magnitude
resonance imaging (MRI),
computerised tomographic (CT)
scan and radio-therapeutic
machine; where they exist, they
may be in bad shape!
Poor power supply is really
hampering services in health
institutions and this has made
investigations and reagents
which require constant power
supply not achievable. It is
very cost-intensive to operate
generators in hospitals etc.,
because of the cost of diesel
and/or premium motor spirit.
Also, there are poor
infrastructural facilities in the
rural areas. For instance, lack of
electricity, poor road network,
lack of healthy and pipe-borne
water has resulted in the drift of
health workers from the rural to
the urban areas in search of a
better working conditions, thus
jeopardising the primary and
secondary health care systems.
For manpower, the doctor
to patient ratio in Nigeria is
1:5,000! This is worrisome when
it’s compared with the WHO
recommendation of 1:600. This
situation has been worsened
by the brain-drain termed “japa
syndrome” being witnessed
recently in the country.
This “japa syndrome” has
been orchestrated by poor
working conditions and
remunerations. The shortage
of manpower has made the
few available personnel to
over-labour themselves. In fact,
there have been incidences of
health personnel, especially
doctors, collapsing and dying
while on duty due to “burn out”
syndrome. When few workers do
the work meant for many within
the same specified time, believe
it or not efficiency and output
are reduced.
With regards to political will,
I’ll say that the political will to
implement the lofty laws meant
to guide the health sector
in Nigeria is lacking. There
is poor budgetary provision
to the health sector. Besides
poor budgetary provision and
allocation, the primary health
care system is not functionally
effective while the secondary
“
This “japa
syndrome”
has been
orchestrated
by poor working
conditions and
remunerations.
The shortage
of manpower
has made the
few available
personnel to
over-labour
themselves.
health care system, which is
under state government control,
is “sick” in many states, if not all.
Accomplish Magazine: How
can these challenges be
addressed?
Mishack Akunekwe: There is
need for an overhaul of facilities
in our health institutions. This
should not be left in the hands
of the government alone.
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Accomplish Magazine