The future of health in Nigeria

Abstract

In a letter in today's issue, Seye Abimbola and colleagues highlight the health effects of the 6 year Boko Haram insurgency in Nigeria. The militant group now controls three states in the northeast of the country. Maternal and child mortality are worse in these states than in the rest of Nigeria, there are fears about undetected polio cases, and more than 980 000 people are internally displaced. Conditions are dire for the internally displaced population who live in informal and formal camps with minimum access to health care and other basic needs, such as food and clean water. This overlooked health crisis deserves urgent attention from the Nigerian Government and international agencies. The health situation throughout Nigeria also needs better leadership. Africa's most populous country (177 155 754 people) has many unsatisfactory health indicators: life expectancy at birth is just 53 years for men and 55 years for women; mortality for children younger than 5 years is 124 per 1000 livebirths; the maternal mortality ratio is 560 per 100 000 livebirths; the HIV prevalence is 2030 per 100 000 people; the tuberculosis prevalence is 161 per 100 000 people; and the incidence of malaria is 28 710 per 100 000 people. A presidential election is scheduled for March 28 after being postponed for 6 weeks because of the Boko Haram insurgency and related security issues. 14 candidates, including Presidential incumbent Goodluck Jonathan, are standing. Jonathan has been applauded for signing the National Health Bill, which aims to provide access to basic health-care services, into law in December last year. This is a great achievement but it came late: more than 3 years after Jonathan took office and 4 years after the bill was first passed by the National Assembly. His main challenger is Muhammadu Buhari, who led Nigeria for 20 months in the 1980s after a military coup—months that were marked by widespread political arrests. Neither of the candidate's campaigns has focused on health. Whoever wins the election can make amends for this omission by ensuring that the implementation of the National Health Bill is a priority during their term in office. Such a move should certainly help to improve Nigeria's poor health indicators. Boko Haram insurgency: implications for public healthNigeria has been involved in a 6 year conflict with the group Boko Haram, responsible for many attacks, the most widely reported being the kidnap of 276 school girls in April, 2014. Boko Haram currently controls an area the size of Belgium across three states in northeast Nigeria: Adamawa, Borno, and Yobe. Health indices, such as maternal and child mortality are worst in the northeast region compared with elsewhere in Nigeria.1 The substantial gains Nigeria has made to control polio might be lost if these issues of health care are not urgently addressed in northeast Nigeria. Full-Text PDF