Despite its good intentions, the National Health Act has gone unimplemented since it was signed into law by the previous administration.It is therefore remarkable that the National Assembly in the 2018 Appropriation Act has for the first time on Wednesday, 16th of May, appropriated a sum of N57.150 billion for the Basic Health Care Provision Fund (BHCPF).
This additional money will be used to deliver a basic minimum package of services for all Nigerians.
According to Henri Onyemachi, CEO, Redbridge Healthcare Group, “I think it is a good start. We are not there yet. The Abuja Declaration or Agreement under the auspices of the WHO, states that the national budgetary allocation to healthcare should be 15%. I am not sure how this 1% of CRF matches up but I am happy that the present government has shown good intentions towards this grossly underfunded sector. Let us wait to see the implementation and accountability.”
Echoing the same line of thought is Maymunah Yusuf Kadiri, a Consultant Neuro-Psychiatrist and CEO, Pinnacle Medical Services Limited.In her words, “It is indeed an exciting time for Nigeria”.Signing the 1% into law is a welcome development. It means the Primary Health Care Centres (PHC) will be better equipped and there will be no need for people to head to Tertiary Institutions for minor cases. If you go to various PHCs, it’s either they are understaffed or equipment’s are not available.”
“This initiative will also encourage employment and hopefully, there should no longer be the challenges in payment of salaries. One challenge we have as a country is implementation. If this is implemented, then I can say that there is indeed hope for the health sector in Nigeria.”
Several countries have achieved universal health care (UHC) through prioritising funding of health and implementation of reforms notably Turkey in addition to countries like Mexico, Thailand, Kenya, Ghana to name a few.
Turkey successfully introduced health system changes and provided its citizens with the right to health to achieve universal health coverage, which helped to address inequities in financing, health service access, and health outcomes.
With what it has achieved in the last two decades, it is almost unbelievable that Turkey began its journey in 2003 with the implementation of the Health Transformation Program (HTP) designed around the Basic Health Law.
This led to changes in health system functions which were implemented systematically over a 10-year period.
Needless to mention that fifteen years after Turkey has achieved UHC through the HTP, improved population health and wellbeing now provides remarkable possibilities for increases in Economic growth.
Giving his view on how Nigeria has fared in comparison to the listed countries Olumide Okunola, Senior Health Specialist IFC/ World Bank said “On the contrary, the Government of Nigeria has invested so little resources in health over the last two decades compared to countries of similar economic status. A situation that has led to stalled improvements in infant and under-5 mortality rates, the total fertility rate (TFR) has not changed in 25 years, and the nutritional status of poor children has worsened over the last 13 years.
Analysis from the World Bank indicates that only 10 percent of the poorest Nigerian children are immunized using Penta3 as compared to 28 percent in Chad and 52 percent in Niger.
Remarkably, despite having a lower GDP per capita than Nigeria, “countries like Ghana and Kenya spend considerably more on publicly funded healthcare,” Olumide revealed.
Speaking exclusively to BusinessDay, after the positive move by the National Assembly, the Chairman Senate Committee on Health, Senator Tejuoso confirmed that the leadership of the National Assembly led by Senate President Bukola Saraki had insisted that the committees on Appropriation/Finance protect the budget line for the BHCPF in the 2018 budget.
“Nigeria accounts for 10% of the world’s maternal mortality and 8% for infant mortality. These statistics are unacceptable for a nation like ours. This is why, the National Assembly passed the 2018 budget with the stipulation that 1% of the Consolidated Revenue Fund (CRF) must be used to fund healthcare across the nation in the Basic Health Care Provision Fund (BHCPF). We promised, and we have delivered,” Bukola Saraki, The Senate President said, adding that “This is a happy day for those of us who come from the medical profession because this 1% budget towards healthcare will go a long way in helping to build a healthier nation. On behalf of all medical professionals, I want to thank the National Assembly for this.”
Still in his interview with BusinessDay, Tejuoso admits the process was rough but worth it. In his words, “I am a first time senator and it was a miracle being a Chairman of a grade ‘A’ committee. When I got in, I asked myself, how do we move forward? What is the most important aspect of our laws that can make a major difference in the health sector in Nigeria and I realised that this bill, though passed in 2014 needed to be implemented.”
“There are countries that are not as rich as Nigeria and were part of the Abuja 2001 declaration, where they all agreed that 15% of each country’s budget must be assigned to the health sector; this was about 17 years ago. All the countries getting close to the agreed percentage have their health indices relatively good so it means health success is subject to funding,” Tejuoso said.
For Tejuoso, it therefore means there was no need to re-invent the will but to implement it because after the declaration, Nigeria never achieved even up to 5% and in 2014, the 1% was agreed into law as a minimum contribution while other donors also contributed. He therefore stated that it wasn’t okay to solicit for funds internationally while Nigeria hadn’t fulfilled our 1%. According to him, “How do we ask for money when we ourselves aren’t putting anything in? I began the discussion with my colleagues in the Senate, it wasn’t easy at all. I was very passionate about the implementation because I am first and foremost, a medical Doctor before being the Chairman of the committee, health is key to life.”
KEMI AJUMOBI
