OrderPaperToday – As humanity marks World Health Day on April 7, countries around the world use the symbolism of the occasion to appraise their health delivery systems and shape things up for better impact.
In Nigeria, like many other nations, world health day must necessarily be discussed within the context of the global coronavirus pandemic. Following the easing of the lockdown restrictions across the country, the pandemic has created the perfect storm that runs the risk of worsening many of the already poor health services in Nigeria.
The COVID-19 outbreak has brought in some much-needed emergency funding in the health sector. Nigeria has been struggling with some of the worse health indicators ranging from maternal mortality rate which stand at 512 per 100, 000 live births, infant mortality at 67 per 1,000 live birth of children 1 years of age, according to the National Bureau of Statistics (NBS) in a data released in the last quarter of 2020.
When the coronavirus outbreak started in Nigeria, many of the existing health issues took a temporary back seat as the country grappled with the pandemic response. This has been to the detriment of basic healthcare provision, especially as stipulated by the Basic Health Care Provision Fund (BHCPF) enacted some years ago.
A fund and its drawbacks…
According to the chairman, senate committee on healthcare services, Sen. Ibrahim Oloriegbe (APC, Kwara), leading the debate on the bill on the floor of the Senate in November 2020, stated that “the BHCPF is a national- and state-level mechanism that aims to extend health insurance coverage and provide a range of free services beyond the public and formal private sectors to the country’s most vulnerable groups, particularly pregnant women, children under five years old, persons with disabilities, the elderly, and people in the informal sector with little access and ability to pay for primary healthcare”.
In terms of implementation, many analysts believe this Fund has a considerable long way to go. However, the Federal Capitol Territory (FCT) took a major step toward universal health coverage with the passage of two previously stymied bills. Once signed into law, the two bills will open the door for the FCT to access the Basic Health Care Provision Fund (BHCPF).
One of the bills, sponsored by Oloriegbe is seeking to establish a commission that will ensure provision and effective regulation of health insurance schemes and access to the fund is expected to increase access to insurance and health services and reduce maternal and under-five mortality rates and household financial hardship resulting from medical costs.
Israel Omono of Affordable Healthcare for All Initiative, a civil society organization, speaking with our Correspondent in Abuja, said that “the passage of these bills will improve access to quality healthcare for residents of the FCT. The State Health Insurance bill will address financial barriers to assessing healthcare, especially among the poor; while the Primary Health Care Board bill is aimed at improving access to quality care at the primary healthcare level, thus reducing the stress and demand on secondary healthcare facilities.”
He continued: “With approved funding under the 2018 national budget, momentum around the BHCPF increased significantly last year. Health reform has steadily advanced as individual states secure the systems and legal backing needed to access the fund.
“More than 180 million Nigerians are still paying out-of-pocket to access medical services, forcing households and individuals in incur high rate of health expenditure, thereby, further increasing the level of poverty.”
Gaping gap on health insurance…
According to a report presented during a public hearing organized by Senate Committee on Health recently, the Nigerian Health Insurance Scheme (NHIS) rate of coverage has remained low more than 15 years of establishment, managing to cover only civil servants and their dependents which is less than 5% of the population (2.8 million Nigerians). Only about four million Nigerians have any form of health insurance.
Senator Oloriegbe has also proposed a bill to repeal the National Health Insurance Scheme Act, CAP N44, LFN 2004, and to enact the “National Health Insurance Commission Bill, 2019 (SB 65).” Among the ills the bill seeks to cure includes that “the role of the state in the current NHIS is not stated. And the new bill would ensure states are allowed to set up their health insurance schemes, subsidized pools and enforce individual and employer mandates.
“Section 39 (1) mandates HMO organisation to perform such roles as may be assigned to it by the State Health schemes including but not limited to the role of the third-party administrator.”
Tinubu’s motion on PHCs…
Another legislative intervention on the health sector in recent times is a motion in the upper chamber of the Nigerian National Assembly sponsored by Senator Oluremi Tinubu (APC, Lagos Central) and 106 other Senators which called for increase in the budgetary allocation for Primary Health Care (PHC) services in Nigeria.
It was revealed in the motion that the Federal Government has ignored the existing and underfunded PHCs and continues to build more across the country without any plan for sustaining and equipping them.
Sen. Oluremi pointed out that the secondary and tertiary health care facilities are burdened with treating common ailments that could have been handled at a PHC Centre.
In adopting the motion, the Senate directed the Ministry of Health at Federal and State levels to encourage medical technological innovation in primary health facilities.
Recall that in January 2017, President Muhammadu Buhari flagged off a scheme to revitalize about 10, 000 PHCs across Nigeria.
Recall also that American businessman and Co-founder of Bill and Melinda Gates Foundation, Bill Gates, had in 2017 described Nigerian’s primary healthcare system as broken. He followed up with that not long ago when he asked Nigeria to focus on fixing the health system rather than invest billions of dollars in covid-19 vaccines.
This year’s occasion of world health day offers a good opportunity for sober reflection by the authorities to map out concrete steps to fix service delivery in the sector just as SERAP, a CSO group urged recently.
Reporting by Ojochenemi Blessing