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Establishing A Medical Diagnostic Centre in Nigeria; The Opportunities.

Nigeria is a West African country with a population of about one hundred and seventy – five million (175,000,000), which is likely to increase to two hundred and seventeen million (217,000,000) by 2025. It is also the biggest economy in the whole of Africa, driven mainly by oil & gas and attracts loads of foreign direct investment each year.
It is also likely to emerge as the one of the top twenty (20) economies by 2020 and as the fourth most populous country by 2050. In nominal terms, the size of its economy was $594 billion ($1.058 trillion in PPP terms) last year. In 2014, it clocked a GDP growth rate of close to 7.5% and this is likely to increase in the times to come, provided the country enjoys a period of relative political stability.

According to a 2015 BMI report, there were an estimated 3,534 hospitals in 2014, 950 of which were in the public sector. These included 54 federal tertiary hospitals comprising 20 teaching hospitals, 22 federal medical centers, three national orthopedic hospitals, the National Eye Centre, the National ENT Centre and 7 psychiatric hospitals, which are overseen by the Hospital Services Department of the Federal Ministry of Health (FMOH).

The private sector is the dominant provider of care in many areas, accounting for the greater part of secondary care facilities. In 2005, the FMOH estimated that there were around 9,000 private health facilities, but information on their location and the level of care provided was patchy. Private health facilities are thought to include around 2,600 private hospitals and clinics.

Nigeria had an estimated 134,000 hospital beds in 2014, equal to 0.8 per thousand populations, which is well below the rate for the African region. The number of hospital beds is estimated to have grown at a compound annual growth rate (CAGR) of 3.8 percent since 2009, slightly higher than population growth but at an insufficiently high rate to have a significant impact on the population bed ratio.

Health services in the country are unsafe, low quality, and inaccessible to majority of people. The healthcare market in Nigeria is presently grossly underdeveloped and does not meet the local need, but the landscape is changing pretty rapidly. Most of the healthcare infrastructure is confined to major urban centres with people living in urban areas getting four times as much access to healthcare as those living in the rural areas. The private health sector is highly fragmented, consisting of many small medical facilities that are owned by medical professionals. Most hospitals in the private sector have less than 50 beds with minimal facilities.

According to the World Health Organization (WHO), the Sub-Saharan region, where Nigeria is located, alone accounts for 11 percent of the world’s population and yet bears 24 % of the global disease burden, and commands less than 1% of the global health expenditure.

Nigerian healthcare system is, in principle, decentralized into a three-tiered structure with responsibilities at federal, state and local government levels. The local governments manage the local dispensaries (primary healthcare), the State Ministries of Health (SMOH) manage various General Hospitals (secondary healthcare) and the role of Federal Ministries of Health (FMOH) is confined to framing of policies and management of Teaching Hospitals and Federal Medical Centres (tertiary healthcare). National Health Insurance Scheme (NHIS) launched with great fanfare in May 1990 has not made any impact with poor country wide penetration of less than 4%.

There is gross shortage of doctors, nurses and other clinical and non-clinical staff, the important link in the healthcare value chain. The salaries too are not attractive enough for good talent. Brain drain is therefore a major issue with a large number of doctors, nurses and paramedical staff leaving the Nigerian shores for better opportunities outside, mainly to the US & Europe.

Demand for diagnostic related equipment and technologies such as Magnetic Resonance Imaging (MRI), Computed Tomography scan (CT), Digital X-Ray, Ultrasound, Mammography, ultrasound scans, as well as anesthesia kits and mortuary equipment have increased significantly since the introduction of the National Strategic Health Development Plan (NSHDP).

According to the Registrar of the Medical Laboratory Science Council (MLSC), Prof. Anthony Emeribe, there are over 10,000 medical laboratories in the country. Unfortunately, most of them operate below global standards. Even worse, only a meagre 3,000 medical laboratories are said to be in the council’s national database.

Medical practitioners have spoken out against the deplorable state of medical facilities across the country which have continued to have counterproductive results in diagnosis and patient care and management.

Diagnostics forms a critical input for medical treatment. It comprises of two major fields: Laboratory Diagnostics and Imaging. In Ekiti state, 60 – 70 per cent of medical treatments are based on laboratory diagnostic tests, thus making it one of the most indispensable segments in the healthcare industry.

According to research report, the diagnostic services market is expected to continue growing at 8.5% for next five years. This growth is likely to be driven by improving healthcare facilities, medical diagnostic and pathological laboratories, private-public projects, and the health insurance sector. Moreover, with the rise in health consciousness in the society and the rising burden of chronic diseases, the market would also experience growth.

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