As Survey Exposes Huge Deficit in Access to Healthcare, Informal Workers Call on Govt to Upscale Investment in Health Facilities


INFORMAL sector workers in Nigeria have called for more active government investment in the provision of healthcare facilities, especially in poor communities across the country in order to enhance access of the poor to quality health services.

The workers made the call on Tuesday during the presentation of the report of a survey on access to health involving informal workers from different parts of the country.

Workers who participated in the survey were drawn from the Federation of Informal Workers of Nigeria (FIWON), Professional E-hailing Drivers and Private Owners Association (PEDPA, National Union of Textile, Garment and Tailoring Workers of Nigeria (NUTGWTWN), and National Union of Professional App-based Workers (NUPAWF).

The survey report noted that “informal sector workers who participated in the focus group discussion expressed the need for more government involvement in the provision of more health facilities, hospitals and clinics in poor communities.”

The report also noted that the private sector dominated health insurance systems are also obviously not working for informal sector workers because not only that most of them are not able to afford the premiums but also that informal workers are excluded from health insurance scheme benefits.

The report, in addition to the above, pointed out that government-mediated community healthcare schemes are also poorly implemented with some of the workers complaining of “…being given only paracetamol.”

Respondents in the survey, the report said, recommend, in addition to increased government investment in healthcare facilities, also canvassed “for provision of subsidised drugs in the public hospitals to reduce the widespread incidence of abuse of drugs, use of fake and adulterated drugs and widespread patronage of unregulated and poorly standardized traditional medicines.”

The survey, coordinated by the Organisation of Trade Unions of West Africa (OTUWA) in collaboration with the American Solidarity Center, found that 78% of the 509 participant informal workers spread across six cities of Kaduna, Lagos, Abeokuta, Oshogbo, Owerri and Port Harcourt reported not being able to afford healthcare services.

“Most of the respondents, 78%, reported not being able to afford healthcare services and in the few occasions they had to patronize the hospitals, most pay cash.

“Over 67% of the respondents actually claim to pay out of pocket. 22% reported depending solely on local herbs while most also reported using local herbs and/or traditional medical therapies for most common ailment; resorting to the hospitals only when situations get very critical.

“74% of the respondents actually reported having been denied medical treatment because of inability to pay while over 90% of the respondents admitted that they have had to go to work despite being very sick on several occasions in their working lives due to the necessity to earn some money for food and basic sustenance and the inability to pay for medical treatment,” the report reveals.

On the situation of informal workers under the covid-19 pandemic lockdown; the report states, among other things, that “66% of the respondents reported that access to healthcare services during the COVID-19 lockdown was very poor while 21 per cent reported access to have been fair demonstrating some level of social differentiation among the survey population and informal workers generally.

“39% of the respondents reported reduced earnings during the lockdown while 13% reported having actually lost their jobs. 9% of the respondents reported having experienced harassments.”

The occasion, which was used to launch a media and advocacy campaign on the theme: “#Healthcare is A Human Right” so as to draw attention to the plight of informal workers due to their lack of social protection coverage, is set to commence advocacy visits to key government functionaries including the Federal Ministry of Labour and Employment, National Assembly, National Health Insurance Scheme (NHIS), and other health-related agencies beginning from Wednesday, August 11, 2021.

Speaking at the presentation of the report, Comrade Gbenga Komolafe, General Secretary of FIWON, stressed that social protection is key to not only the health of informal sector workers but that of the entire working people.

According to Comrade Komolafe, it is in the context of the relevance of social protection to workers that the ILO designed various instruments to guarantee good and quality healthcare for children who lost their parents in the course of work.

He said the campaign under the theme of #Healthcare is a Human Right is a compelling advocacy for all workers, especially informal workers. “We must wake up and demand for our rights because if we don’t, we will not get it.”

According to Comrade Komolafe, social protection didn’t just happen in developed economies; “workers fought for it, workers fought for their rights. Countless workers suffered death, incarceration; they didn’t come on a platter of gold.” He said while sections of the Nigerian constitution guaranteed healthcare, among other things, as a right, it must be fought for, be demanded before it can be enjoyed.

While stating that though traditional medicine may have its values in the healthcare system, Comrade Komolafe called for its proper regulation to tame is dangerous tendencies. “It may be effective but it can also be dangerous if not regulated,” he said of traditional medicine.

Speaking earlier, Comrade John Odah, OTUWA’s Executive Secretary, stated that though the survey on accessibility of healthcare for informal sector workers was conducted in six West African countries – Ghana, The Gambia, Liberia, Nigeria, Senegal and Sierra Leone – the report being presented was that on Nigeria’s informal sector workers.

According to Comrade Odah, the Covid-19 pandemic has effectively deconstructed the wrong notion by the ruling elite in Nigeria that they can ignore the healthcare sector since they and their families can easily be flown out for treatment.

“One thing that Covid-19 has thrown up is that if it is not possible for the poor to get quality treatment, it is also not possible for the rich to get quality treatment since they cannot fly out due to covid restrictions. If the poor are not treated, they too are not secure; they are at risk,” he said, as he gave a brief background to the rationale for the introduction of social protection after World War II.

While stating that the findings of the report is staggering, Odah commended the unions that participated in the survey as he assured that the report will be submitted to government agencies so that they can use it as a guide in their intervention on the very poor state of healthcare delivery system.

The event received solidarity messages from NLC, represented by Comrade Ismail Bello, Acting General Secretary, and TUC, represented by Comrade Nuhu Toro, Deputy Secretary General.


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