Its 2 am, I’m the medical officer on call, I just attended to an elderly man who presented with acute urinary retention secondary to prostatic hyperplasia. He would benefit from surgery. However, he cannot afford care at the private hospital I work.
He has no health insurance, not even the largely inefficient health insurance provided by the National Health Insurance Scheme (NHIS). So following emergency therapy, which is free as stipulated by the new healthcare bill, I watched with an aching heart as he took his leave. Consequently, his options for surgical intervention are limited to the healthcare public sector, where overpopulated waiting rooms and overworked, under motivated staff await him.
The current state of public sector healthcare in Nigeria is a result of poor general management, gross mismanagement of funds, depreciating infrastructure and emigration of health workers as a consequence of poor incentives. As a result, health inequality, inadequacy of skilled staff, poor access to healthcare in the rural areas and a dysfunctional national health insurance scheme plague the system. High patient load and poverty of innovation and technological aid, further constrains the efficiency of this sector. Recently, a new health bill was signed into law in 2014, to tackle these and more issues.
The demand for healthcare is high. Accordingly, quality private healthcare is to a great extent unaffordable for the less privileged, as well as the middle class. The emergence of health management organisations and the increasing popularity of private sector health insurance have favoured the financial growth of the private sector over the last 5 years. Compulsory health insurance of company staff has made healthcare more accessible to the middle class. The technicalities of the HMOHealthcare Provider relationship, are currently driving a demand for appropriately educated administrators and hospital managers. Prior to this, most facilities are managed by