Health System and Medical Practice in Nigeria; historical Perpective

Health System and Medical Practice in Nigeria; historical Perspective.

The Federal Ministry of Health was established in 1946 to coordinate health service delivery throughout the country by the then colonial administration as part of a 10 year health development plan following persistent nationalist agitations by Nigerian health personnel trained overseas who were discriminated against. The colonial Government in response, tried to extend modern health and education facilities to much of the Nigerian population. This was inclusive of services provided by the Government, private companies and mission hospitals.

Prior to this time, health professionals of Nigerian descent who were trained outside Nigeria,
especially in Sierra Leone, which served as settlement for freed slaves and the United Kingdom had
emerged. The first male Nigerian medical doctor was Dr. James Beale Africanus Horton, born of Nigerian parents who were freed Ibo slaves from present-day- South Eastern Nigerian on June 1, 1830 in Gloucester village, Sierra Leone. He qualified in 1858 at Kings College London, and later obtained a doctorate at Edinburgh University. Similarly, Dr. (Mrs) Elizabeth Abimbola Awoliyi (Nee Akerele), a 1936 graduate of Medicine in Dublin, was the first female Nigerian medical practitioner. Other health professionals continued on this path till the Yaba Medical (Licentiate) School and the School of Pharmacy wereestablished in the late 1920s to train indigenous manpower. There were other significant developments in the health sector prior to independence like the passage of the Midwives ordinance and Nursing ordinance in 1930 and 1947 respectively by the then colonial administration. The three Hon. Ministers of Health before independence; Chief Samuel Akintola; 1952-1956, Chief Ayo Rosiji 1957-1959 and Alhaji Waziri Ibrahim who continued from1959 till after Independence (1961) laid the foundation for subsequent planning and execution under Dr. Moses Majekodunmi whose relatively long tenure witnessed some innovative changes,
including the setting up of the National Council on Health in 1963.

Growth in Health Infrastructure and manpower continued till during and after the Nigerian Civil War
into the Oil boom era when health began to feature more prominently in the National Development Plans. During this period, Federal Teaching Hospitals increased numerically, as compared to the situation at independence when the University College Hospital, established in 1948 was the only teaching hospital in the country. There was also a new emphasis on primary healthcare, in keeping with the Alma Ata declaration of 1978, and corresponding growth in the number of professional regulatory bodies in addition to those for doctors, nurses and midwives, pharmacists and medical laboratory scientists. The global oil glut induced austerity measures and structural adjustment programme, SAP of the 1980s which slowed the pace of development in the health sector as with other sectors of the Nigerian economy. However, the next two decades witnessed an expansion of funding support to specific disease intervention programmes like those of  HIV/AIDS, Malaria and Tuberculosis control, with a corresponding increase in the involvement of nongovernmental
organizations and the private sector.

The dawn of the new millennium heralded a changing trend in health in a variety of ways. More
resources were made available to the health sector from non-conventional sources like the Global Fund for AIDS, TB & Malaria Control, and the Debt Relief Gain of the Federal Government which was channelled through the office of the Senior Special Assistant to the President (OSSAP) on Millennium DevelopmentGoals, (MDGs).The take- off of the National Health Insurance Scheme (NHIS) under President Olusegun
Obasanjo was also part of the fundamental changes in the health sector then. Nigeria has also witnessed tremendous improvement in her bid to reduce the menace of drug counterfeiting through the efforts of the National Agency for Food and Drug Administration and Control (NAFDAC) over the past 10 years to the extent she is now a model for other developing countries of the world.
However, in a bid to improve on some of our critical health indices, there was a renewed attention to
Maternal and Child Health and primary health care through the introduction of the Integrated Maternal, New born and Child Health (IMNCH) Strategy as a means of delivering the Ward Minimum Healthcare Package.

The quest to ensure a more participatory health development planning mechanism also led to the adoption of the National Strategic Health Development Plan, (NSHDP) 2010-2015 by the Federal Executive Council in 2010 to serve as a template for future investments and programmatic activities in the health sector.
The Federal Ministry of Health has indeed championed half-a- century of sustainable Health development over the past 50 years.

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