TO gauge the impact (or lack of it) of the departing regime of the President, Major General Muhammadu Buhari (retd), on the health and education sectors, consider the exodus of Nigerian doctors and nurses for better prospects abroad, the endless strikes, and shortage of medical specialists and dons. Resident doctors have just suspended a five-day ‘warning strike;’ the Academic Staff Union of Universities has given notice of more strikes ahead, while no Nigerian institution made the latest ranking of the world’s top 1,000 universities. Beyond question, Buhari’s performance in the two sectors is one of dismal failure.
Though Buhari and his party had promised to revitalise education and health when seeking office in 2014/15, alas, after eight years in office, he is leaving them in ruins.
When he was in opposition, he had lampooned the preceding Goodluck Jonathan administration over the instability in the tertiary education headlined by ASUU strikes, and dilapidated facilities, but did not resolve them in his two presidential terms. The university system lost almost an entire academic session in 2022. This was after the COVID-19 pandemic prompted a lengthy closure in 2020. Strikes also pervade the health sector, and facilities across the country remain decrepit and inadequate.
More tellingly, Buhari’s failure to salvage the health care system is reflected in his reliance on foreign medical services for his personal health care, the latest being another trip to London to see his dentist!
The sector is reeling. Apart from frequent industrial actions by health workers, it is underfunded, ill-equipped, inefficient, and understaffed. Professionals are fleeing in droves, with over 16,000 Nigerian doctors officially practising in just four countries – the United Kingdom 10,986; the United States 4,000; Canada 632; and Saudi Arabia 500. More doctors, nurses and other health specialists are arriving in those countries and several others monthly.
From a survey of 20,000 institutions worldwide, no Nigerian university made the Centre for World University Rankings’ 2023 list of the top 1,000 universities. South Africa had two in the top 300.
The education system also overwhelmed the regime. Industrial disputes and academic strikes in higher institutions remained recurring decimals. Cumulatively, strikes by ASUU during his tenure, according to a report, amounted to 670 days – about one year and 10 months.
Despite claims by the Minister of Education, Adamu Adamu, that “Buhari has expended a total of N6.3 trillion on capital and recurrent expenditure in the education sector in the last seven years,” his highest yearly budgetary allocation to education in eight years (being the N1.08 trillion allocated for 2023), is still a far cry from the minimum recommendation of UNESCO.
Defiantly, the regime claims successes in both sectors. Among others, it says it injected over N2 trillion into tertiary institutions, N264 billion in matching grants for basic education professional training for teachers in the states, and partnered with the World Bank to support skills acquisition in the states and for federal technical colleges.
In the health sector, it cited the passage of legislation on basic health provision, disease control, and cancer treatment, and the upgrade of some federal tertiary institutions.
These were obviously not enough to reverse the decay. On Buhari’s watch, the number of out-of-school children increased from 10.5 million to 13.5 million, and then to 20 million according to a September 2022 report by UNESCO. This rubbishes the regime’s claim of having reduced the figure by 3.24 million by 2020 with help from the World Bank.
Significantly, it failed to resolve the lingering contentious FG/ASUU pact on the revitalisation of universities. The 2020 Memorandum of Action agreement it renegotiated has not been honoured. Quarrels remain over the government’s Integrated Payroll and Personnel Information System used to pay public sector workers with the one developed by the academics that ASUU says is more suited for the peculiarities of the academic community, the government’s default on the promise to release funds for equipping universities, and the payment of the backlog of lecturers’ allowances.
Only the University of Ibadan and the University of Lagos were ranked in the 501-600 range of the more than 1,600 universities across 99 countries and territories surveyed in the Times Higher Education World University Rankings 2022. The Tertiary Education Trust Fund in November 2021 described the decadence and the universities’ poor global ranking as “embarrassing” and totally unacceptable.
Buhari, with the support of the compliant Ninth National Assembly, compounded the situation. At a time when the country’s higher institutions are grossly underfunded, understaffed, and lacking basic infrastructure in lecture rooms, laboratories, and halls of residence, in eight years, both created no fewer than 30 new tertiary institutions.
It is a monumental misplacement of priorities. Apart from the lack of funds and infrastructure, the National Universities Commission last year raised the alarm that the system had just 100,000 lecturers for 2.1 million students.
All military, and paramilitary services, including the police, were gifted universities, apart from mono-varsities with no thought to funding sources, staffing or intelligent needs assessment. The AcademicStaff Union of Polytechnics noted that politicians had turned to establish higher institutions to ‘constituency projects.’
The school system is still grappling with the shortage of qualified teachers hampering the implementation of the Universal Basic Education Scheme. Instead of pursuing a structured pedagogy, a coherent package of inputs that include teacher training and empowerment, his lack of grasp of the needed educational reforms made him approve and cite as an “achievement,” a 40 per cent salary increase and 65-year retirement age for teachers (up from 60) at a time or record unemployment when thousands are graduating with no jobs in sight.
Buhari’s personal health care arrangement advertises both his lacklustre performance and his unfitness for the high office he occupied. As of November 2022, a Sunday PUNCH investigation uncovered that the President had spent at least 225 days away from the country on medical trips after assuming office in 2015. Even for the ailments such as toothache, the President lost confidence in his country’s medical competency and would rather travel to London.
He made no effective attempt in eight years to build world-class medical institutions that would stop medical tourism and end the national embarrassment of Nigerian presidents frequenting foreign hospitals. The declaration by his wife, Aisha, at the inauguration of new facilities at the Presidential Villa hospital that no Nigerian leader needs to go abroad again for medical attention rings hollow.
Between 2010 and 2020, a Central Bank of Nigeria report in March 2022 revealed that Nigerians spent $11.01 billion on foreign countries’ health-related services.
Nigeria’s poor image took further battering in 2017 when the First Lady lampooned the regime, lamenting that she had to go to a “hospital owned and operated by foreigners 100 per cent” because the X-Ray machine in the Aso Rock clinic was not working. Before that, her daughter, Zahra, on her Instagram handle, had revealed that the clinic lacked “ordinary paracetamol.”
Like his predecessors, Buhari failed to honour the 2001 African Union Abuja Declaration urging member countries to allocate at least 15 per cent of their national budgets to health. Except in 2023, health received less than eight per cent of the national budget from 2016 to 2022.
Buhari leaves office with terrible health indices. Current infant mortality rate 2023 is 54.740 deaths per 1000 live births, while UNICEF stated that Nigeria records 576 maternal mortality per 100,000 live births, one of the highest in the world. Also, Nigeria, according to the 2021 World Malaria Report, accounts for the highest malaria-related deaths globally. Of the 619,000 persons killed by malaria in 2021, Nigeria accounted for 31.3 per cent.
The brain drain during the Buhari years is alarming. Between 2016 and 2022, UK immigration authorities said more than 5,500 Nigerian-trained doctors moved to the country. In 2021 alone, about 13,609 Nigerian healthcare professionals were granted working visas in the UK.
Strikes by doctors and other health workers working in Federal Government-managed hospitals culminated in the loss of more than 153 working days between 2015 and 2023.
The demands of the Nigerian Association of Resident Doctors, which centre on the provision of infrastructure in hospitals, salary increment, payment of arrears and other conditions of service, have still not been met. In the place of creative policies, the government tries strong-arm tactics, including the thuggish disruption of a recruitment exercise of doctors for Saudi Arabia, and an irrational bill at the NASS seeking to deny medical doctors practising until after five years in service.
An assessment by the quartet, ONE Campaign, National Advocates for Health, Nigeria Health Watch, and Public and Private Development Centre, on the state of primary healthcare delivery in Nigeria between 2019 and 2021 revealed that in the areas of immunisation, nutrition, and maternal health, only 19 of the 36 states and the Federal Capital Territory achieved a score of 56 per cent and above. Only 11 states have at least one functional primary healthcare per ward. There is no single world-class hospital in the country.
In fairness, the blame is not Buhari’s alone. The states and local governments are also abject failures in providing acceptable health care and educational systems at all levels and ensuring the welfare of citizens and health workers. But the regime failed to provide leadership at the national level or rally the other tiers for the task. Considering all the glaring negatives, Buhari’s meagre steps in health and education leave a poisoned chalice for his successor. His eight years have left the two sectors in disrepair and Nigerians in misery. They will not miss him.
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