It will be almost impossible for Nigeria to achieve Universal Health Coverage (UHC) by 2030 if the Primary Health Care (PHC) system is not improved and if health insurance remains voluntary.
This was the main talking point Tuesday when the National Institute for Policy and Strategic Studies (NIPPS) met with experts, partners and stakeholders to proffer solutions to challenges hindering Nigeria’s progress towards achieving UHC.
Tagged ‘NIPPS study tour visit to DRPC-PAS’, the event which held in Abuja was organised by NIPPS and the Development Research and Project Centre (DRPC).
To achieve UHC, Paul Basinga, Country Director, Bill and Melinda Gates Foundation, suggested that Nigeria needs to build a strong PHC system.
“It has to be a top priority for the federal and state governments,” Mr Basinga told journalists during tea break at the study tour.
“There is need for a reform so as to have a viable PHC system with enough finance flowing down to the facilities that will be located in the right places with adequate human resources, equipment and drugs.”
Unsettling challenge
A viable and people (grassroot) oriented PHC system is key in achieving UHC, according to the World Health Organisation (WHO).
In Nigeria, there have been concerted efforts but the PHC system is dogged by multiple challenges.
This is largely because billions of naira reportedly spent over the decades on health facilities by government at different levels was mismanaged.
Again, there is an element of misplaced priority. While thousands of PHCs lie waste, government has continued to build more across the country without any plan for sustaining and equipping them.
Only about 20 per cent of the 30,000 public PHCs in the country is fully functional, a recent survey by a nongovernmental body, CISLAC, said.
President Muhammadu Buhari, in January 2017, flagged-off a scheme to revitalise about 10,000 PHCs across Nigeria.
But more than a year later, investigation found that very little work had been done.
Last year, American businessman and co-founder of Bill and Melinda Gates Foundation, Bill Gates during a visit to the country, described as ‘broken’, Nigeria’s primary healthcare system.
“The Gates foundation is working with the government to implement the Basic Health Care Provision Fund (BHCPF) to boost service delivery in PHCs. As a matter of fact, we have provided money for it,” Mr Basinga said on Tuesday.
“We are the first donor to put money in BHCPF. We put two million dollars on the table to really allow government to speed up implementation and then we think that it’s a long term strategy which will allow money to flow from the CBN account down to the facilities.
“We have signed an MOU with the government for them to really meet their commitments to buy vaccines and we have committed for the next five years, 75 million dollars to put into the BHCPF if the government is to achieve their commitment on funding their vaccines.”
Health Financing
Nigeria must make health insurance compulsory to achieve UHC, says health expert, Obioma Obikezie.
“Currently, only civil servants are covered in the NHIS and their contribution is too lean to give us UHC.”
Enyantu Ifenne, the chairperson of Nigeria’s Health Insurance Scheme (NHIS), during her presentation at the event described the current structure of the scheme as the “critical part of the problem” which hinders progress in the health sector.
“This is 14 years after the scheme was set up and have only five per cent coverage. At that rate, it will take up to 280 years to achieve universal coverage. Its cynical!”
She further cited Rwanda as an example of countries that achieved maximum coverage by making health insurance compulsory.
“About 70 per cent of the Nigerian population are in the informal sector so that is the more reason health insurance should be made compulsory.
“Despite the fact that Nigeria has a teeming population of vulnerable groups including women and children, there is no provision in the current NHIS act and guideline that covers them.”
Mrs Ifenne urged the NIPPS delegation to adopt relevant models which ensure maximum and compulsory coverage of the Nigerian population and present same to the president.
UHC by 2030 – the part NIPPS will play
NIPPS is Nigeria’s policy formation center for bureaucrats, private sector leaders, army officers, medium-rank and senior civil servants. It was founded in 1979.
Many policymakers in Nigeria have attended the NIPSS. Notable among them include ex-military dictator, Ibrahim Babangida, and Nuhu Ribadu, a former anti-corruption chief.
Each year, the institute develops a policy plan for the country. It reports directly to the office of the president and is supervised by the vice president.
This year, NIPPS has a mandate of charting a roadmap that will help the country achieve UHC through better funding mechanism.
“At the end of this study tour, we will come up with recommendations and strategies that will be conveyed to the president as a pathway to achieving UHC,” D. L Sanda, Leader of the NIPPS delegation said.
The event is coming barely a month after NIPPS and DRPC led the Nigerian delegation for the Africa Health Agenda International Conference 2019 (AHAIC) which held in Rwanda.
The conference was centred on how African countries can achieve UHC by 2030.
