Over the past 10 years, Nigerians have spent the sum of $11.01 billion on health-related services abroad. This is according to a review of the Central Bank’s balance of payment data.
It is important to evaluate the effect of the huge capital flight recorded by Nigeria over the years, as it goes a long way in determining the level of our foreign reserve viz-a-viz exchange rate. Hence, Nairametrics presents the second edition of the Nigerian BOP review series. You may read the previous report on foreign education expenditure here.
According to the data, Nigerians spent $11.01 billion on health expenses abroad between 2011 and the first quarter of 2021, recording the highest in 2019 with $2.56 billion foreign health expenses, and the least in 2016 at $17 million.
Quality health is a fundamental right of all Nigerian citizens and a basic necessity for survival and productivity. This makes the health sector a crucial component of the economy; one that ideally, should attract massive investment. Unfortunately, Nigeria’s health sector bleeds from multiple besetting problems, one of which is underfunding. Averagely, the sector has received 4.72% of the country’s fiscal budget in the last 10 years.
Although wealthy Nigerians are both willing and financially capable of seeking quality healthcare services abroad, it is costing the nation a small fortune and further compounding the FX pressures that Nigeria grapples with. While Nigeria records significant capital flight to fund health-related services abroad, it records no inflow for reciprocal services in Nigeria as the nation’s health sector leaves much to be desired in terms of service delivery, availability of adequate medical infrastructure and sufficiency of skilled professionals.
Nigeria’s healthcare problem
According to the Nigerian Sovereign Investment Authority (NSIA), Nigerians spend an average of $1 billion annually on medical tourism for a range of healthcare needs. 60% is reported to be across four key specialities: oncology, orthopaedics, nephrology, and cardiology.
A PwC survey of Nigerians found that more than 90% of respondents associated advanced healthcare delivered in Nigeria with “low quality.” Each new report of poor clinical care has reinforced the belief among the population that Nigerian healthcare is substandard and should be avoided whenever an alternative can be found.
In terms of contribution to economic growth, Nigeria’s health sector, valued at N484.76 billion in real terms as of 2020, only accounted for a meagre 0.69% of the economy.
A cursory look at the country’s budget allocation to the health sector revealed that only 4.05% of the national budget was allocated to the federal ministry of health in 2021, 76% of which was budgeted for recurrent expenditure, while capital expenditure took the remaining 24%.
The data also shows a systematic decline in the proportion of allocations to the health sector over the past 10 years, as it declined from 5.58% in 2011 and 6.03% in 2012 to 4.05% in 2021.
Source: CBN, Budget office, NM Research
While Nigeria’s healthcare system continues to record massive drawbacks, countless Nigerian citizens are excelling in the medical profession abroad. Two cases in point are Nigerian-born medical doctor, Professor Iyalla Elvis Peterside who was named as one of America’s best physicians for the year 2020 by the U.S National Consumer Advisory Board. Similarly, Dr Onyema Ogbuagu a U.S-based and Nigerian born doctor was one of the scientists who discovered the Pfizer vaccine for the covid-19 disease.
Why do Nigerians go abroad for healthcare?
In 2019, Nigeria’s health minister, Osagie Ehanire while representing President Buhari at the second National Health Summit of the Nigerian Medical Association (NMA) faulted the poor attitude of health workers across the country stating that it is a major reason for the growing culture of seeking medical care abroad.
He opined that Nigerians have lost confidence in the country’s health system because of the poor service delivery in Nigerian hospitals. Despite alluding to the fact that lack of equipment and medical technical expertise has contributed to the capital flight, he admitted that the attitude flaws of healthcare practitioners contribute the most.
“If we must be honest to ourselves, we must admit that even more than lack of equipment and medical technical expertise, poor housekeeping and sanitation and often poor and disrespectful attitude of health workers and also a perceived lack of confidentiality are damaging the image and reputation of the health system and also the public confidence in it,” he said.
Earlier this year also, Senator Aishatu Dahiru Ahmed representing Adamawa Central at the red chamber cited under-funding, weak facilities and infrastructure, poor motivation of health workers, low budget, weak accountability, conflicts with the political structure of the states and industrial strike actions as major problems bedevilling the Nigerian health sector.
She also mentioned that an average of 20,000 Nigerians travel each year to India for medical-related services due to the absence of a solid healthcare system at home.
In a chat with a Nigerian healthcare worker, Mrs Emilola Eniodunmo, she addressed the lack of adequate facilities and low morale on the part of the health workers as a major reason for the poor delivery of healthcare services in the country.
She, however, stated that there are good healthcare service providers in the country, for patients who can afford premium care.
“In some notable private hospitals in Nigeria and even state-owned hospitals, we have executive rooms for patients, VIP treatment room, where special treatment is being given to patients for the right amount,” she said.
She also stated that the dearth of modern medical equipment and technical expertise to manage certain severe disease conditions was a major reason for patients’ choice of seeking medical help outside the country.
Meanwhile, according to the Global Health Workforce Alliance of the World Health Organisation, Nigeria’s healthcare service sector is affected by a number of factors, including:
- Lack of public and private sector coordination;
- Commercial pressures in the private sector that lead to poor quality work;
- Work environments that contribute to low motivation, less-than-optimal productivity, high attrition – especially in rural areas; and
- Lack of planning based on staffing projection needs, resulting in an overproduction of some categories of health workers at the expense of others.
Evidently, Nigeria’s healthcare sector needs adequate funding to compete with its counterparts abroad and attract foreign investments and patronage. Besides this, the nation also needs to incentivise the medical profession to stymie the ongoing brain drain in the sector as it is no secret that Nigerian medical professionals are leaving the country in droves to seek better working conditions abroad.