As THISDAY prepares for its third series of Healthcare Policy Dialogue, with a focus on states and emergency medicine, Martins Ifijeh examines how this can bring healthcare closer to Nigerians

When Paulo Coehlo, in his book, The Alchemist, made the now famous quote, “Everything that happens twice will surely happen a third time,” he probably had THISDAY in mind. The newspaper is planning to host the third edition of its healthcare policy dialogue in Abuja.

The first, which focused on Healthcare Financing in Nigeria, in March this year, brought together under one roof, stakeholders in the health sector, policy makers, politicians, development partners, and concerned Nigerians to chat a better model for financing healthcare in the country.

Nigeria has for decades been known for giving little attention to funding of the health sector, an attitude that has seemed to make the country one of the worst places on earth in terms of healthcare.

The second summit brought together the number one medical doctor in the world, Director-General of the World Health Organisation (WHO), Dr. Tedros Ghebreyesus, and high powered delegates from the World Bank, governors, the National Assembly, development partners, healthcare stakeholders, and the general public. They tried to chart a way forward for achieving universal health coverage in the country. This time, a direct impact of the dialogue resulted in the inclusion of one per cent consolidated revenue for funding the Basic Health Care Provisions Fund (BHCPF) in the 2018 national budget, which amounted to N57 billion.

Buoyed by the successes recorded at the last two high powered policy dialogues in March and April this year, THISDAY is now set to hold a broader edition, with a focus on two areas: ‘High performing states in healthcare and emergency medicine in Nigeria’.

The summit is themed “Funding Healthcare for All, Why States Matter,” and “Emergency Medicine: Need for Action. This third edition will highlight the role of states in achieving UHC, identify high performing states, and showcase the importance of emergency medicine in tackling primary and secondary healthcare issues in Nigeria.

The measure these, the Save One Million Lives (SOML) Programme performance index is one of the tools used in measuring high performing states in the country. The SOML is an establishment of the federal government which aims to support states in the improvement of health outcomes in their various states. Under the programme, the federal government, in 2017, gave $1.5 million to each of the 36 states for healthcare interventions.

Among the key states already identified using the performance index are Zamfara, Adamawa, Cross River, Federal Capital Territory, which are best improved states with overall improvement in key Maternal, Newborn and Child Health indicators. Lagos and Anambra are best improved states in terms of immunisation. Others are Delta and Akwa Ibom

According to THISDAY Board of Directors, the set of verifiable and objective indicators provided by the newspaper’s Healthcare Dialogue Team and the SOML initiative programme were used in determining star states in the six geo political zones.

The board said the poor health outcome recorded in Nigeria, are chiefly because priority has not been given to the basic healthcare needs of Nigerians, adding that for any country to effectively achieve UHC, all levels of government must be involved.

“States and local governments are very critical to achieving UHC, but only few states have charged ahead with increased budgetary allocation of financing to primary healthcare and expansion of coverage of essential priority interventions. Most states in Nigeria are yet to put in place the required accountability and governance framework required to change the tide for improved health outcomes. However, some states have differentiated themselves and are making efforts towards a better healthcare,” the board said.

The board also said with an effective emergency medicine in Nigeria, accident prevention will be strengthened; pre-hospital transport care will be addressed, while hospital stabilisation and treatment will be more effective.
THISDAY said it was for these reasons it is holding the high powered summit in partnership with the Federal Ministry of Health, World Bank, and a host of development partners.

The summit will bring together the presidency, members of the federal executive council, governors, commissioners for health, national and state primary healthcare development agencies, high level dignitaries from the public and private sector, stakeholders and members of the public.

Sharing his thoughts on the summit, the Minister of Health, Prof. Isaac Adewole, who described THISDAY as a star in repositioning healthcare in Nigeria following its interest for a better healthcare, said the dialogue will help emphasise the role of states as primary healthcare providers.

He said while the federal government has given a fixed grant of $1.5 million to each state under the SOML last year, he believed this event will provide a platform to know what has been done with the fund, and help in comparing states for a healthy competition.

The minister said, “We intend to give the states more money for healthcare interventions, but knowing what they have done with the one already given is important. States are very key to addressing healthcare in the country, but many states have been relaxed, thinking the federal will take care of their problems.

“I think the issue started when there was so much ‘money’ around. At that time, the federal government created an impression that they could do it alone, so states relaxed thinking the federal will take care of the problem. But to me, it does not represent the reality on ground. Federal does not have the human and financial resources, so it is time states play active role. The people in the states are primarily indigenes of that state before they are indigenes of Nigeria.”

He said this era of cooperation will help in strengthening healthcare, and will make states viable partners in healthcare delivery in the country.

The minister, who likened the federal government to the roof of a house, said the states were like the walls of a building, while the local government is the foundation.

“So we will be deceiving ourselves if we put a golden roof up without good foundation and good walls. We must strengthen all levels of healthcare, and this dialogue is a step in the right direction to achieving that,” he said.