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Breaking The Vicious Cycle In The Nigerian Health Sector By Abdullahi Sadiq
Date Posted: 01/May/2018
Nigerian health workers have been embroiled in a dirty inter professional rivalry that culminates in recurrent strikes in the sector. The last is the ongoing strike action embarked upon by the members of Joint Health Sector Unions(JOHESU),the umbrella body of all other health workers apart from doctors.
Strike actions generally result in colossal loss of lives and revenue. The worst hit by it are Nigerian masses who couldn’t afford the services of private health care providers. The crisis in Nigerian health sector has lingered and hardly do we have strike-free year. At the moment,a vicious cycle has been set in motion in Nigerian health sector where resolution of JOHESU strike leads to emergence of doctors’ strikes and Vice versa. 
The years 2013 -2015 were the worst in the recent times for Nigerian health sector. There were 6 strikes between 2013-2014 by both JOHESU and doctors. The most pernicious was the sacking of 16000 residents doctors(although recalled two weeks after) at hit of Ebola outbreak. The workers were mired in the power tussle and rivalry while the patient,the main reasons they were employed is allowed to suffer untold hardship.
I had the opportunity of working during my fellowship training in Bangladesh ,a developing country like Nigeria. What I saw was a complete opposite of what is happening in our country. I saw the practical definition of teamwork where everything is about the patients and health workers operate harmoniously with each other. No wonder they have far better health indices than us. It’s gospel truth that nothing good comes out of crisis-ridden system. 
Therefore not a surprise when WHO ranked our health 178th out of 200 in the world.Although the crisis in the sector spans across the three tiers of government, it is interesting to know that  state health facilities are hardly closed down by heath workers despite the relatively low remuneration.This goes to show that there is something fundamentally wrong with the system in federal health institutions. 
The federal health workers comparatively receive fatter salaries with less workload and better working environment than state workers yet they down tool more frequently.It is a case of more money,more problems.Anytime federal health workers declare strike,state workers are the ones at the receiving end as most patients retire to them while the strikers are lavishing at their respective homes.
The professional rivalry creeps into personal relationships at workplace where the health personnel in some occasions engaged in verbal and sometimes even physical abuse.
The root causes include power tussle for the control of health institutions,pay disparity and envy. Anything done for doctors must be replicated for JOHESU and vice versa.I am yet to see anybody going on strike for poor conditions of service or demanding better equipment or quality service for patients.It is always about one allowance or the other. It is only in Nigeria that health workers close hospital and proceed on strike without making provisions for emergency services.
There are other problems bedeviling Nigerian sector including inadequate manpower, poorly trained manpower,poor and outdated equipments but none of the aforementioned worth the wrath of strikers.Salary hike will never solve the problem of health workers as long as the fundamental issues have not been resolved. Between Obansanjo and Yaradua/Goodluck administrations, the heath workers and of course other federal workers witnessed evolution of salary scale from  GL scale through CONTISS and finally CONMESS /CONHESS.
The problem of the health sector can’t be properly digested in isolation. It has to be discussed in the context of the bigger picture of Nigeria where virtually every sector is barely existing.From the economy,public service,corruption and education where decay is a common denominator to all the sectors. 
We have group of people working together without vision and no system in place to monitor performance.The government bureaucratic bottlenecks as well as the inefficiency of public service had glaringly manifested in the sector and retard any meaningful progress.
There have been many attempts by successive administrations to curtail the situation.Various high powered committees were formed to unearth the root cause of the crisis eating deeply into the fabric of the sector but the solution doesn’t seem to be in sight.
In my own opinion, we need a holistic approach to the problem. The recurrent strikes can be halted if we go back to the basics. Every employee should have a detailed jobs description at the point of employment and assigned a pathway for career progression.No trespassing should be allowed.
The government should not be in a rush to sign any unrealistic demands by health union in an attempt to cajole them into suspending a strike.The recalcitrant strike is a product of previous such agreements and unrealistic negotiations.
The Nigerian health sector should also operate in accordance with international best practices.It is incontestable fact that doctors are the leaders of health team although they can’t work without the other professionals. Similar arrangement is available in the judiciary,university system and engineering profession. Lastly the health workers should as a matter of urgency devise a novel means of pressing home their demand not via strike actions.
I pray that resolution of this strike will not be a reason for another strike.The vicious cycle has to be broken.
By Abdullahi Sadiq

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