Reasons for Poor Access to Healthcare for the Majority in Nigeria

Abstract

Access to healthcare services in Nigeria remains problematic for the majority. This essay, based on desk review and interviews with organizers of medical outreach, focuses on the influence of power and wealth on access. It also discusses the emerging phenomenon of medical outreach and its limitations. The findings show that hitherto free public medical services have been commercialized and now institute user fees, which have become a precondition for access. In most instances, money is demanded upfront and those unable to pay are tumed away and, in rare cases, provided services but must settle all bills before discharge. The current situation has been facilitated by health sector reforms which require fee-for-service in a context of growing poverty and where the National Health Insurance Scheme reaches only three million. Some of the excluded rely on informal sector such as patent medicine shops and medical outreach provided by benefactors. But while the majority who are poor and/or have no privileges attached to office are left to their devices, the powerful and the rich access special facilities within Nigeria and/or abroad. The situation indicates grave implications because health targets and the battle against identified challenges like maternal and infant mortality cannot be won without universal health access. It is recommended that the challenge is ensuring universal health coverage for all, irrespective of socio-economic status.