The Critical Role of Healthcare Professionals in Shaping Health Policies Across Africa

Cheetahs Policy institute

Cheetahs Policy institute

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Healthcare professionals are central to the formulation and implementation of effective health policies. As frontline workers, they experience firsthand the challenges within healthcare systems and understand the needs of patients and communities. Despite their critical role, many African countries, including Nigeria, have historically failed to integrate healthcare professionals into policy decision-making processes, hindering the development of comprehensive and effective health policies.

In Nigeria, the exclusion of healthcare professionals from policy formulation remains a significant barrier to progress. While the country grapples with a shortage of health workers, inadequate infrastructure, and a rising disease burden, healthcare professionals are rarely given a seat at the policymaking table. Decisions regarding healthcare are often made by bureaucrats and politicians with little consultation from those working within the system. For example, the National Health Act of 2014, which aimed to establish a framework for universal health coverage, faced significant implementation challenges due to minimal input from healthcare professionals during its development. Additionally, the Nigerian Medical Association (NMA) has repeatedly highlighted the lack of meaningful engagement with doctors and other health workers in discussions around health sector reforms, including workforce retention and funding allocations.

The lack of representation contributes to policies that fail to address the root causes of healthcare inefficiencies. For instance, Nigeria’s ongoing brain drain crisis, where thousands of doctors and nurses leave the country annually for better opportunities abroad, is exacerbated by poor working conditions and low wages. Policies aimed at retaining healthcare workers often miss the mark because they are crafted without the insights of the professionals most affected. This exclusion perpetuates systemic challenges, leaving Nigeria’s healthcare system overburdened and underfunded.

Rwanda, on the other hand, provides a strong example of how healthcare professionals can be effectively integrated into policymaking processes. The Rwandan government has consistently involved doctors, nurses, and public health experts in the development of its health strategies, resulting in transformative outcomes. One notable example is Rwanda’s Community-Based Health Insurance (CBHI) policy, which has dramatically increased healthcare access across the country. The policy was crafted with significant input from healthcare professionals, who provided insights into operational challenges and proposed pragmatic solutions. Their involvement ensured the policy was not only comprehensive but also implementable within the constraints of Rwanda’s healthcare infrastructure. Today, over 90% of Rwandans are covered by the CBHI, demonstrating the power of inclusive policymaking .

The exclusion of healthcare professionals from policymaking does not only affect the quality of policies but also significantly influences how resources are allocated to the health sector in national budgets. Historically, Nigeria’s budget allocation to healthcare has been alarmingly low, often falling short of the 15% target agreed upon by African Union (AU) member states under the Abuja Declaration in 2001. Over the years, this underfunding has directly contributed to poor healthcare infrastructure, insufficient medical equipment, low salaries for health workers, and inadequate training programs.

For instance, in 2022, the Federal Government allocated just 4.3% of its national budget to the health sector, which translated to approximately ₦1.08 trillion out of a total ₦17.13 trillion. This amounted to a meager ₦3,453 per citizen for healthcare, barely enough to cover the treatment of common illnesses like malaria. Despite the slightly higher allocation of 4.64% in the 2024 budget, the actual value of this allocation has been eroded by the severe depreciation of the naira, with the exchange rate now exceeding ₦1,650 per US dollar. Adjusted for inflation and currency devaluation, the health sector’s purchasing power has declined, making it unlikely that the increased allocation will significantly improve healthcare delivery.

The likelihood of repeating past mistakes in budget allocation is high if healthcare professionals remain excluded from policy formulation and implementation. With the 2024 budget allocating approximately ₦1.34 trillion to the Ministry of Health, each citizen is entitled to roughly ₦6,289 for healthcare services. However, this allocation still falls significantly short of the AU’s 15% target, which would have amounted to ₦4.3 trillion in the 2024 fiscal year. Additionally, the purchasing power of this allocation is undermined by the soaring inflation rate and the depreciation of the naira .

If healthcare professionals were actively involved in the budgeting process, they could highlight the inefficiencies of previous allocations and advocate for strategic investments. For example, funds could be directed toward reducing the cost of medical supplies, expanding training programs for healthcare workers, and implementing policies that retain talent. These measures would address systemic challenges and ensure a higher return on investment for healthcare spending.

Healthcare professionals hold the key to transforming Africa’s healthcare systems. Their inclusion in policymaking, particularly in budgetary processes, will ensure resource allocation aligns with real-world needs. By learning from Rwanda’s inclusive approach and addressing the gaps in Nigeria’s health sector, policymakers can create systems that work for all citizens. The road to better healthcare begins with collaboration, transparency, and accountability—a journey Nigeria must embark on with urgency.

Awaje Caleb

Awaje Caleb

Awaje Caleb is the Director of Research and Innovations at Cheetahs Policy Institute. With a background in pharmacy and project management, Caleb leads cutting-edge research and drives innovative policy solutions to address critical societal issues.