ACADEMIA Letters Challenges of the Nigeria Health Care System and the Fight Against Coronavirus Rita Okoebor, Bowen University Abstract The Nigerian health care system is faced with shortage of health care workers, inadequate health facilities and equipments and massive corruption had been found to bedeviled the health care system, the little resources allocated to the health sector are most times embezzled. The study aimed at investigating the current state of the country’s health sector and how it combats the coronavirus. The conflict theoretical perspective to health and ill-health was adopted in this study. A onetime survey was adopted in this study, 60 public and private hospitals were randomly selected from the six geopolitical zones and questionnaires were administered on 3000 randomly selected respondents comprising of health workers and patients. The findings revealed that the above mentioned problems characterized almost all the health facilities investigated either at maximum or minimum degrees. It was therefore recommended, that government at a levels should as a matter of urgency give priority to the investment in the health sector and increase the coverage of the health insurance scheme. Keywords: health care system, health services, challenges, coronavirus and health disparity Background Health is an essential aspect of every society. A healthy society can be said to be a wealthy society. The government must invest considerable amount of its resources in its healthcare Academia Letters, May 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Rita Okoebor, ritaokoebor@yahoo.com Citation: Okoebor, R. (2021). Challenges of the Nigeria Health Care System and the Fight Against Coronavirus. Academia Letters, Article 854. https://doi.org/10.20935/AL854. 1 system. Primary healthcare system is the bedrock of any country’s healthcare system and any government who wishes to provide accessible health care services for her citizens must invest in it country’s primary health care system. The amount of attention that health care system attracts varies from country to country. While countries in Europe and the United States America governments tend to give greater attention and priority to their health institutions, the same cannot be said of Nigeria, as its healthcare system is in a deplorable state due to government lack of attention and corruption in the sector. (World Health Organization (WHO), 2020, Abu and Abdulahi, 2010 and Martins, 2005) Nigeria seems to have the worst health indices in the world. Infant mortality stands at 114 per 1000 live births, child mortality stands at 150 per 1000 live births, maternal mortality stands at 814 per 100,000 live births while the life expectancy of Nigeria is 52 years. (WHO, 2020, Bakare and Olubukun, 2011). The state of a country’s healthcare system determines the extent to which such country is able to deal with emergency cases of health such as an epidemic or a pandemic. The coronavirus placed a huge burden on the healthcare systems of various countries of the world even developed and high income countries were not spared. High income countries saw their healthcare systems stretched beyond their capacities to handle the number of infected people who needed healthcare. Countries in Western Europe and the United States of America were worst hit because of the high rate of their aged population, who tend to be most vulnerable group to the effect of coronavirus. If developed and high income countries’ health institutions could almost be overstretched by the effect of the coronavirus, what becomes of Nigeria, a poor country? (Kazeem, 2020 and WHO, 2020) The World Health Organization, (2020), projected Nigeria to face a great deal of challenge in her fight against coronavirus due to her high rate of poverty, weak healthcare system and the existing burden of communicable diseases in the country. The capacity of Nigeria to respond to the community spread of the coronavirus, is very poor. The existing state of her healthcare system, inadequate testing equipments, inadequate isolation centers, ventilators and other resources needed to fight the virus. The low fatality rate that had been achieved by the country is not as a result of adequacy in her healthcare system, rather, it is due to the tropical nature of the county’s climate which makes it difficult for the virus to survive under high temperature and the country’s demographic pattern that is mainly characterized by youthful population whom seem not to be vulnerable to the disease as would the aged. Academia Letters, May 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Rita Okoebor, ritaokoebor@yahoo.com Citation: Okoebor, R. (2021). Challenges of the Nigeria Health Care System and the Fight Against Coronavirus. Academia Letters, Article 854. https://doi.org/10.20935/AL854. 2 Statement of the Problem The healthcare system in Nigeria is grossly inadequate in meeting the health needs of Nigerians and combating the deadly coronavirus. Statistics from the Demographic Health Survey of Nigeria, (2020, shows that the country currently has about 33,303 general hospitals, 20, 278 primary health centers and 59 teaching hospitals and federal medical centers. Many of these health facilities are in deplorable states as they lack the needed medical equipments and personnel to functions. Onyedinefu, (2020), revealed that the number of registered doctors in Medical and Dental Council of Nigeria stands at 74,543 and the ratio of doctors to the Nigerian Population is 36.6 per 100,000, the ratio of nurses stands at 88.1 per 100,000, the ratio of midwives stands at 58.9 per 100,000, the ratio of pharmacists stands at 12 per 100,000 and other health workers were also found to be grossly inadequate and the findings also aligned with the study of Menizibeva, 2015. Eleven months after the first index case of coronavirus was discovered in Nigeria, Nigeria has only been able to test just 1,270,523 samples of coronavirus out of the estimated 200 million population and the reason for this, is as a result of gross adequacy of testing centers and testing kits. Nigeria currently can boast of only five infectious disease centers, only few of the teaching hospitals and federal medical centers have molecular laboratories where samples of coronavirus can be tested. Many states in country do not have infectious disease centers and standard laboratories to test for coronavirus, as samples from these states have to go to other nearby states for testing (Nigeria Center for Disease Control, 2020 and WHO, 2020). Inadequate availability of Personal Protective Equipments and improper training of health workers on correct ways of handling coronavirus patients led to a situation whereby many health workers got infected with the virus and some died as a result of complications from the disease (WHO, 2020). Onyedinefu, 2020, reported that handsanitizers and facemasks donated by the government, non-governmental organizations and well-meaning spirited Nigerians to hospitals were hoarded by some corrupt health care workers and were later being sold at exorbitant price to patients. Objective of the Study This study aimed at evaluating the state of the Nigerian healthcare system and its capacity to combat the coronavirus. Academia Letters, May 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Rita Okoebor, ritaokoebor@yahoo.com Citation: Okoebor, R. (2021). Challenges of the Nigeria Health Care System and the Fight Against Coronavirus. Academia Letters, Article 854. https://doi.org/10.20935/AL854. 3 The Conflict Perspective to Health and Ill-health This perspective to health posits that the problem of human health is linked with the structure of inequality that exists in a given society. It opined that health and ill-health are not randomly distributed among members of a given society rather the socioeconomic status of members of society influences their state of health. (Annandale, 2003). Methodology A onetime survey was carried out in 60 randomly selected public and private hospitals across the six geopolitical zones in the country to evaluate the state of these health care units. 120 Indepth interviews were conducted, non-participant observations were conducted and 2400 questionnaires administered on 3000 randomly selected respondents who were made up of health care workers and patients were returned. Findings Findings revealed that 90 percent of the respondents that is, 2,160 and majority of interviewees, expressed that health care facilities are inadequate and the one available are ill-equipped and also there is shortage of health care workers particularly doctors. The non-participant observations also buttressed the above mentioned challenges. Conclusion There is no doubt that the state of health of a given nation is a reflection of the level of investment of the nation’s resources in the health sector. Nigeria health institutions are fraught with great deal of decay, due to the deplorable states of the health facilities, lack of hospital equipments, supplies and health personnel. The coronavirus stretched out the health system in Nigeria due to the weakness in the sector. Recommendations 1. The government should invest considerable proportion of its Gross Domestic Products to the health sector and ensures that an effective monitoring system is put in place to ensure judicious use of the resources. Academia Letters, May 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Rita Okoebor, ritaokoebor@yahoo.com Citation: Okoebor, R. (2021). Challenges of the Nigeria Health Care System and the Fight Against Coronavirus. Academia Letters, Article 854. https://doi.org/10.20935/AL854. 4 2. The government should employ more health workers and ensure the right remuneration and good working environment be provided for them. 3. The government should increase the number of Nigerians captured in the health insurance scheme and the scheme should give priority to children, pregnant women, the poor and the vulnerable. 4. Primary healthcare be provided in every local government area of the nation and be made to function with the provision of health facilities, equipments, drugs and adequate health workers. References 1. Abu, N & Abdullahi, U. (2010). Government Expenditure and Economic Growth in Nigeria, 1970-2008; A Disaggregated Analysis. Business and Economic Journal, BEJ (4): 1-11. 2. Annandale, E. (2003). Sociology of Health andMedicine. A Critical Introduction. Cambridge: Blackwell. 3. Bakare, A.S. & Olubokun, S (2011). Health Care Expenditure and Economic Growth in Nigeria. Journal of Emerging Trends in Economics and Management Sciences JETEMS, (2): 83-87. 4. Demographic Health Survey of Nigeria, 2020 Report, Nigeria. 5. Kazeem, Y. (2020). World Economic Forum 6. Martins, G.M. (2005). On the Concept of Health Capital and the Demand for Health. Journal of Political Economy 80 (2) : 223-255 7. Menizibeva, S.W (2015). The Nigerian Health Care System Needs for Integrity Adequacy. Medical Intelligence and Surveillence 8. Manye, F. (2016) An Appraisal of National Health Insurance Scheme of Nigeria, Common Wealth Law Bulletin 32 (3): 415-427. 9. Nigeria Center for Disease Control’s Report, 2020 10. Onyedinefu, G. Business Day News Paper, March 30th 2020. 11. World Health Organization Report on Nigerians Health Indicators 2020. Academia Letters, May 2021 ©2021 by the author — Open Access — Distributed under CC BY 4.0 Corresponding Author: Rita Okoebor, ritaokoebor@yahoo.com Citation: Okoebor, R. (2021). Challenges of the Nigeria Health Care System and the Fight Against Coronavirus. Academia Letters, Article 854. https://doi.org/10.20935/AL854. 5