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Universal Health Coverage – Nigeria Intensifying Her Strategic Plans

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The National Health Insurance Scheme was set up to ensure that every Nigerian has access to good health care services without let or hindrance, and to protect families from the financial hardship of huge medical bills. Recently, the second National Strategic Health Development Plan (NSHDP) and the Basic Healthcare Provisions Fund (BHCPF) was launched by the Federal Government in Abuja. According to the Minister of Budget and National Planning, Sen. Udoma Udo Udoma who represented President Muhammadu Buhari on the occasion, said the second National Strategic Health Development Plan as approved by the Federal Executive Council on Sept. 5, 2018, is the health sector’s plan leading to attaining universal health coverage for all Nigerians. But how equipped are the strategic plans on ground to be able to achieve the desired results in no distant time? PharmaTimes Editor, MORGAN NWANGUMA writes.

Nigeria’s healthcare services have not been in the best of forms for a long while. Going by the recent health development indicators available, there is no gain saying that achieving the much desired Universal Health Coverage for the country is still some good distance away.

The recent WHO report on the country’s healthcare situation means that a lot still needs to be done. With Nigeria recording some of the worst indices on maternal, newborn and child health, nutrition status, human capital development and disease prevention, there seems to be an uphill task for the federal government in trying to achieve full coverage.

According to WHO life expectancy at birth m/f as at 2016 stood at 55/56, while the nation’s medical doctors-patient ratio in 2018 stood at one doctor to 6,000 patients compared to India’s 1:2,083 and the US, 1:500. But with the launch of the second National Strategic Health Development Plan (NSHDP) and the Basic Healthcare Provisions Fund (BHCPF), the Federal Government may just be beaming a ray of hope in the direction of healthcare services, leading to a better implementation of the National Health Insurance Scheme (NHIS) in the nation. In the light of the Fund which was launched recently by President Muhammadu Buhari, there is now a greater need for the country to advance rapidly in the direction of attaining Universal Health Coverage (UHC). Nigeria majorly lags behind in giving her citizens the required health care coverage due to the lack of political will to do what is right for the greater majority of the population.

ISSUES MILITATING AGAINST FULL COVERAGE Poor funding The African Heads of State meeting in Abuja 2001 declared that a minimum of 15 per cent of the total budget of each country be devoted to healthcare. But so far the reality on ground has been a far cry from this prescription. Experts and observers alike have over the years identified poor funding of the health sector as a major factor working against the success of the project. Coupled with this is the fact that the greater majority of the people are impoverished; human capacity building in order to buoy up the income per capita will go a long way.

Emigration of experts, poor remuneration Another obstacle experts have identified is that of mass emigration of healthcare experts to Europe and America. On the average, more than fifty per cent of graduates from the medical schools in the land want to go abroad in search of greener pastures. Thus poor remuneration in the health care services as in most sectors, is leading to brain drain and thereby hampering the system. Also, an important issue to note is the long standing unhealthy rivalry among the different professional bodies that work in the health sector, aside the recurrent industrial actions. The recent JOHESU strike vis-a-vis the imbroglio with the Nigerian Medical Association is still fresh in our memories. Other obstacles confronting the full implementation of the National Health Insurance Scheme (NHIS) as well as militating against the actualisation of a Universal Health Coverage for the nation according to experts include: drug insecurity, abuse and misuse; as well as the issue of quacks engaging in the various professions along the value chain.

FUNDING THE DEVELOPMENT PLAN The development plan that is right now in place is expected to cover the five year planning period (2018 – 2022), and guarantee that the health sector nay health standards of every Nigerian is appreciably enhanced by applying the 5 strategic pillars, and in the given 15 priority areas. The planned pillars for the road map will – ensure a healthy atmosphere so that the targeted objectives in the health sector generally can be achieved; Improvement in the way and manner vital health services are deployed; fortifying the health systems as well as securing them in times of crises and urgent situations, and funding health services in general. And conversely, the BHCPF is a fund set aside to furnish the citizenry with the essential healthcare needs. Last year (2018) the federal government budget made provisions for it using one per cent of the Consolidated Revenue Fund in the tune of N55.7 billion.

This of course, has been complemented by funding from development partners such as – the World Bank’s Global Financing Facility, and the Bill and Melinda Gates Foundation. The Minister of Health, Prof. Isaac Adewole speaking, stated that the programme is already on, adding that the Buhari administration has already commenced the release of N57.15 billion made for the fund among others.

“This fund means Nigerians will be entitled to free antenatal care, free delivery, and free caesarian sessions. It also covers for diabetes and hypertension screening, as well as free treatment for malaria and tuberculosis tests,” he stated. “We are particularly happy for this launch because this will benefit poor Nigerians who are quite disadvantaged. The health indicator for the rich in Nigeria is not different from what is seen in developed countries. So this will go a long way in improving the healthcare of poor Nigerians, and by extension improve human capital development. “We have worked on the national health policy, developed the national health strategic plan and the BHCPF.

We are now starting a brand new journey to ensure we expand access to every nook and cranny of the country.” The Minister is optimistic and promised that the funds will be well managed, adding that it will be kept safe in the Central Bank of Nigeria (CBN) from where disbursements will be made to states according to their needs. Adewole said to this effect, accountability is guaranteed; it includes the fact that government has reached an agreement with the contributors to come audit the account “anytime they want.”

SETTING AGENDA FOR THE FUTURE In 2016 Nigeria narrowly missed being completely free of any form of polio infections safe for the insecurity in the North-East of the country, and so immunisation has as well been terribly hampered by insurgency. The gap left led to the re-emergence of the virus after a period of elimination. But for most partners, especially the Bill & Melinda Gates Foundation, this remains a top priority for 2019. Moving forward, experts see the need to raise the level of private sector involvement in health funding. Time has come also to intensify the role even as we seek to intensify Primary Health Care in the country – also through increased funding. Nigeria’s maternal and child health indicators are not on the favourable side given that the country still rates as the fourth highest in maternal mortality globally. In addition, raising a sustainable family size with access to basic quality health needs will automatically translate to a healthy and wealthy nation. Thus family planning issues must be given adequate attention hence the need to support the National Family Planning Blueprint through a well laid out and committed domestic funding programme for family planning. And lastly, government is gearing up to surpass its marginal gains in the year 2018 especially with the signing into law the bill or act establishing the National Centre for Disease Control (NCDC) on the 13th November of that year – by President Buhari.

To further boost its activities, the federal agency is looking to strengthening the nation’s readiness in times of epidemic outbreaks or emergencies, by setting up a number of reference laboratories at different locations. With the efforts so far made, hopes are rather high that the government is poised to drive its policies far enough to meet the Universal Health Coverage for Nigerians.

As the poor health indicators are corrected, human capital is bound to be enhanced as the partners are in a united front to make this happen. The World Bank Group and the Bill and Melinda Gates Foundation cooperating to devote as much as US $180 million towards the implementation via BHCPF, is by no means going to fast track our hitting the target. As President Muhammadu Buhari assumes a second tenure in May, health watchers and stakeholders alike are hopeful that with continuity and further implementation of these policies, the road map will even be navigated more seamlessly, leading to easy access to improved quality of health care for the generality of the masses.

By  Morgan Nwanguma

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  • […] Experts are optimistic that Nigeria and indeed the rest of the world can achieve the Universal Healt… To do that, they said the Federal Government must restructure the National Health Insurance Scheme (NHIS) as well as operate a mandatory health scheme. Besides, they insisted that the NHIS must become a true regulator supporting all states in the country and with viable collaboration from the Federal Ministry of Health (FMoH). Meanwhile, the World Health Organisation (WHO) in a report ahead of the 2019 World Health Day, with the theme “Universal Coverage: Everyone, Everywhere,” called on governments all over the world to ensure UHC by making quality health services affordable to all with three objectives of achieving it, which include ensuring everyone who needs healthcare service gets it, irrespective of their financial status, the quality of healthcare services should be good enough to improve health, as well as ensuring people who seek healthcare services should be protected from financial risk. To meet that target, the WHO yesterday said the world needed to see one billion people benefitting from UHC in the next five years. WHO Director-General, Dr. Tedros Adhanom Ghebreyesus, said although the world had made enormous progress in recent years against some of the world’s leading causes of death and disease, the WHO still has a lot to do to realise that vision. Also, Executive Director of Delta State Contributory Health Commission, Dr. Ben Nkechika, told The Guardian that Nigeria could only meet the United Nations (UN) target of UHC by 2030 if government policies are properly articulated towards achieving it with good outcomes that get to every part of the country. In another development, Indian manufacturers of medical equipment are to deliver 2,050 units of diagnostic and surgery equipment to Borno State government to furnish 25 hospitals. In a statement yesterday in Maiduguri, Special Adviser to the Governor on Communication and Strategy, Malam Isa Gusau, said the medical equipment, to be delivered this week, were secured at discounted prices and of German standards for use in any hospital. According to him, the Commissioner for Health, Dr. Salisu Kwayabura, co-ordinated and supervised the selection of the medical equipment and negotiations before deliveries to Nigerian […]

  • Hey, how’s it going?

    I want to pass along some very important news that everyone needs to hear!

    In December of 2017, Donald Trump made history by recognizing Jerusalem as the captial of Israel. Why is this big news? Because by this the Jewish people of Israel are now able to press forward in bringing about the Third Temple prophesied in the Bible.

    The Jewish people deny Jesus as their Messiah and have stated that their Messiah has been identified and is waiting to be revealed. They say this man will rule the world under a one world religion called “spiritualism”.

    They even printed a coin to raise money for the Temple with Donald Trumps face on the front and with king Cyrus'(who built the second Temple) behind him. On the back of the coin is an image of the third Temple.

    The Bible says this false Messiah who seats himself in the Third Temple will be thee antichrist that will bring about the Great Tribulation, though the Jewish people believe he will bring about world peace. It will be a false peace for a period of time. You can watch interviews of Jewish Rabbi’s in Israel speaking of these things. They have their plans set in place. It is only years away!

    More importantly, the power that runs the world wants to put a RFID microchip in our body making us total slaves to them. This chip matches perfectly with the Mark of the Beast in the Bible, more specifically Revelation 13:16-18:

    He causes all, both small and great, rich and poor, free and slave, to receive a mark on their right hand or on their foreheads, and that no one may buy or sell except one who has the mark or the name of the beast, or the number of his name.

    Here is wisdom. Let him who has understanding calculate the number of the beast, for it is the number of a man: His number is 666.

    Referring to the last days, this could only be speaking of a cashless society, which we have yet to see, but are heading towards. Otherwise, we could still buy or sell without the mark amongst others if physical money was still currency. RFID microchip implant technology will be the future of a one world cashless society containing digital currency. It will be implanted in the right-hand or the forehead, and we cannot buy or sell without it! We must grow strong in Jesus. AT ALL COSTS, DO NOT TAKE IT!

    Then a third angel followed them, saying with a loud voice, “If anyone worships the beast and his image, and receives his mark on his forehead or on his hand, he himself shall also drink of the wine of the wrath of God, which is poured out full strength into the cup of His indignation. He shall be tormented with fire and brimstone in the presence of the holy angels and in the presence of the Lamb. And the smoke of their torment ascends forever and ever; and they have no rest day or night, who worship the beast and his image, and whoever receives the mark of his name.” (Revelation 14:9-11).

    People have been saying the end is coming for many years, but we need two key things. One, the Third Temple, and two, the technology for a cashless society to fulfill the prophecy of the Mark of the Beast.

    VISIT http://WWW.BIBLEFREEDOM.COM TO SEE PROOF FOR THESE THINGS AND MUCH MORE! TELL YOUR FRIENDS AND FAMILY. SHARE THIS MESSAGE!

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