President of the National Postgraduate Medical College of Nigeria, Professor Akin Osibogun, has said the commercialisation of faith has led many quack pastors to deny many patients access to timely treatment.
The former Chief Medical Director of the Lagos University Teaching Hospital said this has led to many avoidable deaths.
He warned that the sin theory of disease has become a major challenge to the delivery of modern healthcare services in Nigeria.
Osibogun, a Professor of Public Health at the College of Medicine, University of Lagos, spoke at the 2023 Scientific Conference of the Medical Guild, Lagos, themed: ‘Optimising Health Services for Nigerians in the 21ST Century.’
Medical Guild, Lagos is the association of doctors working with Lagos State, in general hospitals & Lagos State University Teaching Hospital, Ikeja.
Osibogun cautioned that if the activities of the commercial pastors are not checked, it would continue to lead to poor patient outcomes and continue to increase the disease burden in the country.
The consultant public health physician said, “Without belittling the role of faith in our well-being, I dare say that the commercialisation of faith has led many quack pastors to deny many sick patients the treatment that could have helped them.“The sin theory of disease poses a great challenge to the delivery of modern healthcare services.
“We should note that the use of incantations, counter-spells, bloodletting, scarifications, etc is continuing practices in many communities even in Nigeria with serious implications including loss of critical appropriate intervention time.
“Other implications are the introduction of agents of sepsis, outright haemorrhaging, and death.“From all accounts, it would appear that the earliest medicine men were sorcerers, magicians, and spiritualists with some of their descendants persisting till today.”
Speaking on the challenges confronting healthcare delivery in Nigeria, the former LUTH boss identified poor financing and the inefficient use of resources as major problems.
“ Total health expenditure per capita in Nigeria is a meager $97 compared to roughly $4,000 in Europe and $8,500 in the United States. General analysis of global data shows that the more a country spends on health per capita, the better the health outcomes.
“Our fund pooling mechanisms are currently weak and inadequate. Up to 70 percent of our current total health expenditure is from out-of-pocket. In general, from global data, the more prominent OOP is in a country’s health financing mechanism, the poorer the health outcome.
“Third, even with our low level of health expenditure, we are inefficient spenders with our health outcomes being worse than those of a country like Senegal spending less than half of what we are spending”, he explained.
On advancing the health of Nigerians in the 21st Century, he said: “From our national experience, government bureaucracy and inefficiencies make quality delivery of services often difficult. The future of quality delivery of services is largely in private provision and government regulation of services.
“Financing availability will require investments in health infrastructure, equipment, pharmaceutics, and consumables as well the pre-service and in-service development of human capital. Availability addresses the supply side of the problem.”
Osibogun said advancing the health of Nigerians would require intersectoral collaboration between private organisations and the government.
He also said government bureaucracy and inefficiencies make quality delivery of services difficult, adding that the future of quality delivery of services is largely in private provision and government regulation of services.
On the way forward, the professor recommended, “To address the demand side of the problem and ensure that citizens have access to needed health services, then we must look for fair financing mechanisms, particularly those that protect citizens against catastrophic health expenditure. Catastrophic health expenditure sends individuals, families, and communities into spiraling poverty.
“If we are ever going to lift our people out of poverty, we must address their health and access to health services. A mechanism that can help in achieving this must be fair in fund pooling and health risk sharing. Either a general tax mechanism or a dedicated tax mechanism in the form of mandatory health insurance can be a fair fund pooling mechanism.
“Whichever of the two pooling mechanisms is adopted, our next concern will be the quality delivery of health services. In my opinion, the best fund disbursement mechanism to promote quality delivery of health services will be a pay-for-performance mechanism in which providers are paid based on both quantity and quality of services provided.”
