Nigeria’s quest to achieve Universal Health Coverage (UHC) may continue to be a mirage, until certain steps are taken to ensure that the right policies are not only put in place but also translated into actionable plans and procedures. Even among the policy makers, a lot has been said about Universal Health Coverage which the World Health Organisation (WHO), defines as a system in which everyone in a society can get the health care services they need without incurring financial hardship.
It is a system that ensures that all people are granted access to needed promotive, preventive, curative and rehabilitative health services of sufficient quality to be effective. The system also ensures that people in the process of accessing the healthcare they need, did not suffer financial hardship when paying for those services.
Unarguably, Nigeria is reputed to have some of the best policies on any given subject. However, the challenge has always been the will to translate such policies into implementable platforms that will achieve the desired goal.
Sadly, in our view, this has been the situation with the nation’s policy on UHC. Three years ago, the National Health Bill, which stakeholders believe was designed to turn around the fortunes of the health industry, was passed into law.
It is worthy of note that since then and until now, implementing that sound policy has become elusive primarily because government which enunciated the policy and transformed it into a legal document has turned lethargic at the point of providing the needed fund to enable it achieve its desired intent.
We are persuaded to recall that President Goodluck Jonathan signed the bill into law in December 2014, after six years of legislative debate and intense pressure by some civil society groups who were convinced that that it was the missing link in the nation’s effective healthcare delivery system.
It is germane to point out that the provisions of the Healthcare Act, indicate that health services for Nigerians would be transformed if the dictates of the policy are followed to the letter. Specifically, the law demands funding from the federal government with counterpart funding from state and local governments for guaranteed basic minimum health care package for all.
Part 1 Section 1(e) of this Act stipulates among other things, the Protection and Promotion of the Act so as to fulfil the rights of the people to have access to healthcare services. Article 11 specifically made provisions for Basic Healthcare Provision Fund, with not less than one per cent of Consolidated Revenue Fund to be disbursed as follows: (a) 50 per cent Basic Minimum Health Package (NHIS); (b) 20 per cent Essential Drugs and Vaccines; (c) Five per cent Laboratory Equipment and Transport; (d) 10 per cent Human Resources and (e) five per cent Emergencies.
Children below the age of five, pregnant women, the elderly and people with disabilities, according to the provisions of the law, are to receive free health care even as it requires universal acceptance of accident and other emergency cases by all health facilities, both public and private hospitals.
The Act provides for improved standards and quality of healthcare in health facilities; it curbs the use of public funds by Nigerian public office holders and civil servants seeking treatment abroad, a popular trend that sees thousands of medical tourists spending millions of dollars’ worth of taxpayer money overseas.
Disappointingly, even with the law in place, direct-out-of-pocket payment is still operational in Nigeria, with about 70 per cent of cases from household expenditure. But, with the non-implementation of the Act, Nigeria’s health system, especially at the grassroots, remains weak as evidenced by lack of coordination, dearth of resource and manpower, including drug and supplies, inadequate and decaying infrastructure, inequity in resource distribution and access to care, and very deplorable quality of care.
In spite of decades of implementing Primary Health Care and enrolment of Nigerians into the National Health Insurance Scheme (NHIS), the progress achieved is still far from being favourable, as health status indicators have remained unacceptable.
We, therefore, call on the federal government, to, as a matter of priority begin the implementation of the National Health Act so that the appalling health indices of the country would significantly improve. This must start with an appropriate funding of all processes that have to do with effective service delivery.
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