Legislations on critical health policies that could have enhanced access to better care and expanded the Universal Health Coverage for Nigerians have continued to suffer in the National Assembly.
Data compiled by BusinessDay show that bills older than a decade have been circumventing cycles of reintroductions without substantial effort to enable them become law.
The National Drug Control Bill, National Mental Health Bill and Bill on the Establishment of Cancer Registry are key among several pending bills that can directly impact Nigerians’ health outcome.
If they had been passed, evidence-based treatment and rehabilitation services for affected Nigerians could have been enhanced, while funding could have improved data collection and research on the growing detection of cancer.
“For too long, non-assent to these bills in the health system has resulted to increased health care costs and slowed access to care for patients,” a government source told BusinessDay, noting that assent to these bills is an important step to fix the already weakened health sector.
“It will correct the balance by promoting faster resolutions in the sector, patient care, safety and quality improvements, and health information technology systems and policies that would help improve care and outcomes,” said the source.
The policy on mental health was first formulated in 1991 to foster advocacy, prevention, treatment and rehabilitation. The Bill protects the rights of persons with mental disorders, ensures equal access to treatment and care, discourages stigma and discrimination and sets standards for psychiatric practice in Nigeria.
It also makes provisions for access to mental healthcare services, treatment, accreditation of professional and facilities, law enforcements and other judicial protection for people with mental illness.
In 2003, Ibiabuye Martyns-Yellowe and Dalhatu Tafida, both senators, re-introduced the Bill for the Establishment of Mental Health Act, but the Bill was withdrawn in April 2009.
Again in March 2013, the bill was re-introduced to the National Assembly by Samuel Adejare and Solomon Olamilekan Adeola, both senators. Yet, it remained in limbo.
“I think the delay of the National Mental Health Bill is due to general apathy from the legislature. The bill has been promoted by the psychiatric association of Nigeria but it has not seen the light of day,” said Richard Adebayo, a consultant psychiatrist/clinical psychologist at Federal Neuropsychiatric Hospital, Yaba, Lagos.
But while Nigeria has dilly-dallied, other countries have made progress.
Seventeen years ago, South Africa upgraded and assented to its Mental Health Care Act by replacing the Mental Health Act of 1973, ushering in improved psychiatry practise. Likewise Egypt in April 2009 adopted the “Law for the Care of Mental Patients”.
Nigeria has also delayed in the amendment of the National Health Insurance Act, amendment of the National Primary Health Care Development Agency Act, and amendment of the Pharmaceutical Council of Nigeria Establishment Act.
Other bills suffering the same fate are the Institute of Healthcare Management of Nigeria Establishment Bill and Certified Council of Allied Dental Health Professionals (Establishment) Bill.
The disposition of government towards these bills has been of concern to some stakeholders in the health sector who have been advocating that just as economic development is a function of improved regulatory frameworks and policies, so is concrete implementation of policies on performance of health systems in maternal mortality and high disease burden, among others.
In 2011, SA formally established its National Cancer Registry (NCR) under regulation 380 of the National Health Act, giving impetus to cancer surveillance. The legislation makes reporting all confirmed cancer diagnoses to the registry obligatory and mandates the NCR to implement population-based cancer registration in South Africa.
With renewed support, the registry’s data processing has moved to electronic reporting of pathology data from laboratories, with its database warehousing over 1·2 million cancer records and about 80,000 new cases added each year.
But despite graduating from having just three to 284 registries, Nigeria only managed to capture approximately 6,452 cases yearly from 18 states as of 2013.
“The major challenge of the registries is lack of funding and continuous training of registry staff. In Nigeria, clinical and population-based research studies in oncology aren’t well developed,” the National Cancer Control Plan states.
ANTHONIA OBOKOH & TEMITAYO AYETOTO
