Mrs. Foluke Adams had been ill for sometime. She took her medications religiously, still her condition got worse. She had been to four hospitals but did not get any better. As a result of this, her family decided to send her abroad to seek treatment. All efforts to revive her eventually hit the snag when a few weeks later Foluke died.  Her medical results revealed that she had been suffering from cancer which was not detected early enough by the time she was flown abroad.

There was little or nothing the doctors could do. The question everyone kept asking was how come none of the hospitals she visited before travelling detected it?

Foluke is not the only one who had had to pay for such an expensive price for the deplorable state of health care in Nigeria. Several Nigerians have been victims, irrespective of their status.

This signifies that the health sector remains one of the most underdeveloped in Nigeria's economy. Despite the huge fund being pumped into the sector, it has yet to record any significant growth. The situation does not augur well for the economy that is plagued by high incidence of malaria, tuberculosis, and poliomyelitis which is common among children.

With a population of about 140 million (census 2006) it is only normal to have a high demand for adequate health care in Nigeria. True as that maybe, it is sad to know that there aren't enough facilities, personnel and investment to meet this demand. Going by a health sector statistics which put the number of doctors at 34,923 with a density ratio of about 0.28 per 100 Nigerian, 210,006 nurses with a density ratio of about 1.70 per 1000 Nigerians and 6,444 pharmacists with a density of about 0.05 per 1,000 Nigerian, it is glaring that the health service sector is grossly understaffed.

The revised health policy document shows that preventable diseases account for 70 percent of Nigeria's disease burden followed by poverty which is also a major problem. The same report revealed that our maternal mortality rate of 1 percent is "one of the highest in the world," some of our health indicators, such as the under-5 and adult mortality rates are higher than the average for sub-Saharan Africa.

Health care providers
The health sector is operated by both the public and the private sectors with the public sector divided into two; namely health care delivery and pharmaceuticals. The health service delivery is further divided into primary, secondary and tertiary levels with government as the dominant player. Others are NGOs and private medical practitioners.  Pharmaceutical companies include, May&Baker, DN Meyers, Glaxo Smithkline,

Evans Medicals and others.
Due to the inability of the government alone to effectively manage the health sector, other private institutions have come on board to compensate for the effort of the government. This includes banks such as Oceanic Health Management, and other Health Management Organizations (HMOs). But this has not also brought the desired result as many Nigerians who cannot afford the services of the private medical institutions still do not have access to quality health care thereby leaving a large percentage of the population uncatered for.

Will the HMOs deliver?
While some believe that the establishment of HMOs will boost the performance of the health sector, other experts disagree on the basis that the health management organization scheme put in place by the National Health Insurance Scheme may not translate to anything regarding the original plan for which they were set up. They argue that HMOs rather than focus on providing quality health care for all members of the society irrespective of their level now focus on corporate bodies and Nigerians on the high income scale, denying others on the lower income scale access to health care. It is believed that these setbacks are as a result of under-investment and neglect of responsibility by the Nigerian government.

Challenges facing the health sector
Basic challenges besetting the sector include shortage of personnel, obsolete equipment, poor power and water supply, poor remuneration for government health workers, corruption and low investment among others. Mrs Oluremi Soile of the Nursing services department of the Ogun state health management board, while speaking on the challenges facing the Nigerian nurses in a keynote address delivered at the last annual Nurses week of National association of Nigerian Nurses and Midwives (NANNM) held recently at LUTH, explained that these factors remain a hindrance to quality health care delivery in Nigeria.

Consequences
Soile added that the consequences of these challenges have been a steady migration of qualified nurses and doctors to more advanced economies with higher remuneration and better working conditions. These challenges have affected the attitude of health workers in Nigeria who struggle to deliver in spite of the difficulties. The lack of modern medical equipment has resulted in loss of lives in cases where the real causes of the illness are not ascertained on time till the victim dies.

Lack of research has led to intellectual dearth, and as a result our medical system does not measure up to international standards. Rather companies rebrand generic products and little is done about researching into new areas, this encourages importation from more advanced nations and puts extra burden on the economy. However, these challenges can be overcome by healthy investment in the health care service sector.

Areas to invest in
  Diagnostics - Dr Lawal, General Medical Adviser for UACN, puts it this way, “for me diagnostics is the future of health care investment in Nigeria.” According to him, the ability to detect illnesses and nip them in the bud before they can cause more damage was key to solving a lot of health related problems in Nigeria. Diagnostics involves thorough examination of the body to detect signs and symptoms of diseases that are still budding. It requires using sophisticated machines designed for this purpose. Some of these machines can cost from N3 million and above each.

Investors must ensure they get new ones because second-hand machines do not last and are dangerous. This will also solve the problem of ignorance, incorrect analysis, treatments and save the patient a lot of money. Instead of spending money to buy drugs which are not needed, all it may require may just be a change in life style depending on the result of the diagnosis.

Pharmaceuticals according to Dr, Idris Iris, Lagos state commissioner for Health, Nigeria's pharmaceutical industry was small. He say it caters for only about 50 to 70 % of the nation's drug need. This makes Nigeria largely dependent on importation. To curb this, the federal government has banned a number of drugs to encourage local production. You can find investment opportunities in local drug production, sourcing and supplying its raw materials some of which are agro related. Other avenues to making money lie in distribution, retailing and supplying pharmaceuticals, such as hospital equipment, syringes,  and hospital beds among others.

  Research and development - This will yield viable investment contrary to the opinion of some experts who do not believe it will. This is because medicine thrives on research given that the latest and outstanding discoveries in medicine have emerged through research. In Nigeria, researchers are making findings on local herbs and roots which are effective in curing certain diseases. They manufacture these drugs in small quantities with NAFDAC approval and sell locally because they lack funds for large scale production and marketing. Medical practitioners in developed countries are beginning to further research on herbs as alternative medicine. Nigeria can do the same.

At the last world health congress on traditional medicine held in Beijing, China and attended by health representatives from over 70 countries, major discussion was on how to make traditional medicine more available. This is on the premise that health practitioners all over the world have begun to identify traditional medicine as an alternative for western medicine. Revenue for traditional medicine in Europe in 2003 and 2004 reached 3 billion euros about $3.28. The same can be achieved in Nigeria through investment in research.
  Spas and wellness centres - These are becoming an alternative source of treatment for some illnesses. Now some hospitals have spas attached to them to assist in treating stress related illnesses and enhance the general well being of patients but some Spas also operate independently.
   Nursing homes - There are hardly any special care centres specially created for the elderly in our society as most hospitals and health centres attend to a mix of all age brackets together. Nursing homes are not common in Nigeria where most people send their parents to the village without adequate provision for good health care. Some are practically abandoned with little or no visits from or to the city. Such lonely treatment can hasten their journey to the grave. Demand for nursing homes is high especially among the middle and high income earners whose busy schedules afford them little time at home; but it is also quiet because it is not popular. Investing in this venture requires professional health care practitioners with experience in this area. You determine how much you want to pay as salaries, the type of property you need, facilities, and other materials which will give you an idea of how much is needed. Your location for this sort of project is quiet vital.
  The stock market - Investing in health care companies quoted on the stock exchange. This is a passive but equally effective way to invest in the health care sector. You can do this by buying stocks of such companies.

Why invest in health care ?
A growing population- Nigeria's population and economy is among the fastest growing in Africa and the world. If the current population of Nigeria does not have access to quality health care, it might be facing a disaster in the coming years if there are no more investments in the sector to support the growing population. We believe that the rise in population will stimulate demand which is currently inadequate.

A ready market-Many Nigerians travel abroad for as little as a checkup. This will change if they can find the same quality of service here in Nigeria. There is a ready market for quality health care at all levels, the primary, secondary and tertiary health care.
Demand - The demand for quality health care at all levels is overwhelming. The importance of good health care to a nation cannot be overemphasized.  Every sector in health care has great opportunities and demand is stable.
Government policy  the government policy which includes ban on importation of some drugs is a plus for investors. This will stimulate local production and investment and also create trust in locally manufactured products.
Turnover  rate of turnover is relatively high as a result of sustainable demand, but your area of investment is a determining factor
Major investments have continued in drug manufacturing, alternative medicine, rebranding, general pharmaceuticals and other aforementioned areas.
Capital - This depends on the scale of investment you are considering. However, you could consider funding from banks, partnership with other interested bodies and even the government. We advise that you do a feasibility study before you go in.
The health sector has a lot of untapped investment opportunities with promising returns. With an annual growth rate of 6% cumulating to about four million people a year, you cannot go wrong investing in Nigeria's health sector.