Procuring health care services in Nigeria could be quite expensive, and for people with certain conditions such as cancer, kidney and fertility challenges, the burden becomes almost unbearable.
This is more so when payment is done out of pocket and not through any insurance cover such as the National Health Insurance Scheme (NHIS).
This has varying consequence for the patients, their families and even employers as the impact is felt at different levels of relationships. This is expected to worsen this year as hospitals, pressed by rising cost of drugs and other supplies, are increasing the fees charged to patients.
For hospitals, many lose money when patients, after getting treatment, are unable to pay their bills. Nigeria’s minimum wage is N18,000, whereas roughly 95 percent of the citizens have to make out-of-pocket payment to meet their health needs. This leaves just about 5 percent of Nigerians covered by any form of health insurance.
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“We have lost so much from our earned income paying for our mother’s medical bills and treatment. To worsen it all is the pressure from the long queue for treatment, and every time there is a sad story of the radiotherapy machine breaking down,” said Ikechi, whose 58-year-old mother has breast cancer.
Ikechi’s mother (name withheld) was diagnosed with breast cancer on her right breast in 2012, and it had to be surgically cut off that same year.
Since the surgery, Ikechi said, the family has been taking her to the clinic for check-ups, spending on drugs and some treatment therapies.
“We believed that the cancer had been cured. However, at a point in 2018, she started developing pains again from the breast to the waist, six years after the surgery was done. We went to another hospital and a CT-scan was carried out in August. The doctor said the result shows that the cancer has spread all over and it is eating her up,” he said.
“When we took our mother home, after the results confirming that the cancer has spread, it took us two months as a family to discuss how to raise more money to continue her treatment, because we had spent so much in the last few years. Between the months of September till now we have spent not less than 1.5 million naira,” he said.
Cancer is responsible for 3 percent of total mortality in Nigeria, which translates to about 72,000 deaths per annum, according to the World Health Organisation.
“Cancer treatment has always been expensive for the patients and their families and is yet to be covered by the National Health Insurance Scheme (NHIS),” said Francis Abayomi Durosinmi-Etti, consultant, clinical oncologist and chairman of National Programme on Cancer Management in Nigeria.
Durosinmi- Etti said the cost of cancer treatment is high, which is why patients need urgent assistance.
“If the country finds a means of getting the money, whether through the NHIS or even some other means of support, then patients can get treatment at a proper price and also service will be kept going,” he added.
Just as it is for cancer treatment, kidney and fertility treatments are also paid out of pocket. Recently, BusinessDay reported that more Nigerian families are turning to the In-vitro fertilisation (IVF), procedure leading to a boom in a market valued at over N17 billion.
Between 5,000 and 10,000 couples turn to the procedure every year at an average cost of N1,706,000 for full procedure, which puts the market at N17 billion yearly. This is according to submissions by practitioners at the seventh International Conference on Fertility and Reproductive Health held in Lagos in 2017.
“There are about 12 million infertile persons in Nigeria,” noted Faye Iketubosin, president, Association for Fertility and Reproductive Health (AFRH).
Similarly, it is estimated that the incidence of kidney disease in Nigeria is 100 per 1,000,000 population every year and seeking treatment through renal dialysis, patients will have to pay between N30,000 and N50,000 per session.
“Getting this dialysis has become a problem due to the huge cost involved and lack of nephrologists in the country,” said Ebun Bamgboye, president, Nigerian Association of Nephrology (NAN), at the commemoration of the 2018 World Kidney Day.
“Each patient needs about three sessions per week which is almost N100,000 per week and about N400,000 per month. Not many Nigerians can afford this and the National Health Insurance Scheme (NHIS) covers just three sessions of the dialysis,” he said.
Tayo Lawal, medical director, Gbagada General Hospital, Lagos, said in an interview with BusinessDay that when the kidney fails automatically, the end point will be to have kidney transplant and that comes to N13 million currently, which is not an easy sum for most Nigerians to afford.
Umar Sanda, president, Healthcare Providers Association of Nigeria (HCPAN), believes that mandatory health insurance in Nigeria is “the only way forward for the health sector in the country”.
“This will reduce all price indices and many people will have access to quality health care. It will enable Nigerians to access care in the hospital without the fear of paying out of pocket. When you are on the health insurance scheme, it means you have prepared yourself for any unforeseen health issues, because your health insurance will take care of it when you are sick,” Sanda said.
ANTHONIA OBOKOH
