Policy Conundrum in Nigeria: A Close-up on the Health Sector

Brief analysis of the persistent failure of the Nigerian government to formulate society-oriented policies, and the lack of political will to implement those already formed. It focuses on the health sector and the appalling human developmental indices from it as a showcase of the policy conundrum in Nigeria.The growth, advancement and sustainable development of a people depend on the policy that guides them. Public Policy can briefly be described as government’s definite plan of action regarding the welfare and the general wellbeing of its citizenry.

Nigerian’s public policy has been evolving since after independence. However, there remain several gaps that have made the Nigerian public policy a fiasco.

While the Nigerian public policy claim to be rational, responsive and possess clear goals and methods, the reality on ground reveals that the policy is largely not feasible, not always backed with enabling laws and structure, and not always followed up with implementation actions. The result is that the public policy of Nigeria does not embody the general welfare of the society, but that of the powerful few. Hence, those who continue to lose out are the majority while the gains rest with the powerful minority, or the upper class in the social stratification of the society.

During the decades of the military junta in Nigeria, several decrees were passed, like the now infamous decree 2 of 1984 [that allowed citizens to be detained endlessly without bail or trial, many notable citizens dying in that process] which only benefited one group- the dictators of Nigeria. It was never legitimized and was never duly enacted. Those military decrees only served as the dictator’s instruments for tyranny and oppression of the innocent citizens, and it was a powerful blockade on those who may have attempted to question government’s actions and inactions.

The Nigerian public policy has a lot of aspects that are not feasible. For example, there is usually a time lag between budget draft and passing at the National Assembly and it’s hardly ever fully implemented. Several national projects, like the Green revolution, the Structural adjustment Program, Mass Mobilization for self reliance, the vision 2010, the Privatization policy, Education for all by Year 2000, the National integrated power project, the electoral reform policy and countless others which held promises all went down, and died naturally, either due to poor implementation or follow-up by succeeding administrations. This lack of continuity has led to the policies all slowing down before reaching full throttle. Now we have the 7-Point Agenda and before Nigerians could get into the sense of it, there is the vision 2020!

It is obvious therefore, that Nigeria does not suffer from policy enactment. No. The nation is blessed with abundant human and natural resources, and she has produced renowned policy makers and technocrats. However, the bane of the Nigerian public policy has been implementation and policy administration. Until the entire policy system is overhauled, and care is taken to ensure adequate follow-up and monitoring and implementation of policies, the vicious cycle of poor policies with its consequent negative effects on national growth and development will continue to plague the Nigerian state, and the health care, economic, social and infrastructural development will continue to stutter and decay.

The national indices of Nigeria are shocking. Nigeria ranks 158th out of 177 countries as indicated by the UNDP at the end of 2008 human development index report; the life expectancy is 46.5, which is one of the poorest in Africa; gross domestic product per capita is USD 792.31; less than half of the populace has access to safe water (48%). According to the State of the World Children report recently released by UNICEF in 2009, about 778 newborn babies die daily in Nigeria. 1 woman die every 10 minutes from pregnancy complication and (or) childbirth; and Nigeria is ranked as the second highest contributor to the number of maternal deaths worldwide, second only to the Democratic Republic of Congo. [And if you think about all the political crises, wars and economic distress the DRC has faced over the past ten years, would you not wonder why it is Nigeria that is second to the DRC?] The average Nigerian lives on less than USD 2 daily. About 80% of the populations are farmers, yet these subsistent farmers have not, and cannot claim ownership of farmlands due to the land tenure systems and land laws in Nigeria. The large percentage of these farmers still lives in rural areas devoid of basic amenities like water, motorable roads, electricity and adequate shelter. Yet, Nigeria is the most populous black nation on earth, with about 150 million people. Is this how to be the "Giant of Africa"?
This state of decay can be traced to one source- corruption and bad policy administration in Nigeria.

Can Nigeria survive? It looks grim at the moment. Take a look at the Millennium Development Goals. See the priority attention given to poverty eradication, basic education, sustainable development and public health related issues like maternal and child mortality, and eradication of infectious diseases like malaria and pandemics like HIV/AIDS. Is there any nation that can attempt to attain these lofty goals without a well thought out, well consummated and implemented national policy? The answer is obvious.

Now, also take a look at the framework for the future development of Africa, encapsulated in the legal document known as the New Partnership for Africa’s Development (NEPAD). It can be summarized as a calculated attempt to uplift Africa as a State out of the shackles of poverty, illiteracy and disease, and empower the African economy, thereby leading to capacity building and sustainable development. Can Nigeria attain this? Not without a feasible and all encompassing national policy project at least.

Now, look at Mr. President’s 7-Point Agenda, which is the policy blueprint for the present administration. Lofty on paper; not uncommon among Nigerian leaders. But can it be implemented? Can the nation move forward when only 40% of the annual budget is expended and the remaining 60% unaccounted for? Can the nation move forward when, on the 17th of February, 2009, after hearing the UNICEF’s State of the World Children report about Nigeria, the First-Lady of the federal republic orders a fresh survey to be carried out and reject a document that should be sobering enough to cause a national policy savage mission? Really, can Nigeria move forward?

For Nigeria to survive, and live the dream of her founding fathers, then radical re-evaluation of the Nigerian policy is needed, and the sooner the better. For now, it is but a quagmire. By Nosayaba Osazuwa-Peters