Giant Step towards Achieving Universal Health Coverage

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The recent launch of the second National Strategic Health Development Plan and the Basic Healthcare Provisions Fund has inched Nigeria closer towards achieving Universal Health Coverage. Martins Ifijeh writes

In a sector often known for churning out some of the worst indices on maternal, newborn and child health, nutrition status, human capital development and disease prevention, there seems to be a glimmer of hope with the launch of the second National Strategic Health Development Plan (NSHDP) and the Basic Healthcare Provisions Fund (BHCPF).

The launch, which was done by President Muhammadu Buhari in Abuja last Tuesday, has again brought to the fore the need for Nigeria to move speedily towards achieving Universal Health Coverage (UHC) as several grounds have been lost due to lack of political will to address issues around the health of citizens.

Funding Healthcare
On specifics, the second NSHDP is the country’s five years policy road map from 2018 to 2022 that would ensure overall improvement of the health of Nigerians through five strategic pillars and 15 priority areas. The pillars include enabling environment for attainment of health sector goals, increased utilisation of essential package of health services, strengthening health systems and protection from health emergencies as well as health financing.

On the other hand, the BHCPF is a fund allocation to cater for the basic healthcare needs of all Nigerians. In the 2018 budget, the federal government allocated one per cent of the Consolidated Revenue Fund, amounting to N55.17, to drive it. Development partners like the Global Financing Facility of the World Bank and the Bill and Melinda Gates Foundation (BMGF) have also contributed to the purse.

While the two programmes by the federal government will no doubt move Nigeria towards achieving UHC through provision of basic and quality healthcare to Nigerians, the official roll out done by Buhari has put concrete steps on ground to ensure every Nigerian, especially the poor, truly access healthcare the way they should.
As a collective effort to address Nigeria’s poor healthcare indices and improve human capital development, the Nigerian government, the World Bank Group and the Bill and Melinda Gates Foundation have jointly committed $180 million to fund Universal Health Coverage through BHCPF.

Speaking during the launch, the Minister of Health, Prof. Isaac Adewale said with the funds already on ground, the implementation of the programme has kicked off.
Adewale said the federal government has started the release of its allocated N57.15 billion for the fund, while the World Bank’s Global Finance Facility has released N$20 million, and the BMGF has released $1.5 million out of the $2 million it pledged.

He said: ‘This fund means Nigerians will be entitled to free antenatal care, free delivery, and free caesarian sessions. It also covers for diabetes and hypertension screening, as well as free treatment for malaria and tuberculosis tests.

“We are particularly happy for this launch because this will benefit poor Nigerians who are quite disadvantaged. The health indicator for the rich in Nigeria is not different from what is seen in developed countries. So this will go a long way in improving the healthcare of poor Nigerians, and by extension improve human capital development.

“We have worked on the national health policy, developed the national health strategic plan and the BHCPF. We are now starting a brand new journey to ensure we expand access to every nook and cranny of the country.”
He assured Nigerians that the funds will not be mismanaged, as it will be sent directly to the Central Bank of Nigeria (CBN), where they will be disbursed to states where they are needed.
“To ensure accountability, we have also agreed with our contributors that they can audit the account anytime they want,” he added.

Health as Top Priority
Launching the fund, Buhari said one of his cardinal promises was to make health of Nigerians top priority, adding that it was time to focus more on the people living in rural areas. Buhari who was represented by the Minister for Budget and Planning, Senator Udoma Udo Udoma, said the launch of both BHCPF and the Second National Strategic Health Development Plan (2018-2022) was part of the health sector’s agenda to achieve universal health coverage.
He said: “I had in January, 2017, also flagged off the Primary Health Care Revitalisation Programme in Kuchingoro to kick-start the plan of having 10,000 functional primary healthcare facilities with at least one functional health facility in every political ward in the country.

“Our effort at revitalising the PHCs is to ensure that quality basic healthcare service is delivered to majority of Nigerians irrespective of their location in the country. We shall focus more on the people living in the rural areas and the vulnerable population in our society such as women, children under five years of age and the elderly in collaboration with national and international partners.

“One of the main objectives of our Economic Recovery and Growth Plan is investing in our people. Our administration in recognition of this, provided N55 billion, the one per cent CRF to cater for the BHCPF in fulfillment of the National Health Act, 2014.

“International partners such as the World Bank, Bill and Melinda Gates Foundation, and USAID are also contributing to the Fund. The brand name for this programme is “HUWE” meaning life.”

According to him, the BHCPF will provide the sustainable fiscal space healthcare and will increase the human capital base of our economy. “We must recognise that UHC is a destination and Nigeria is putting in place processes to achieve it. I am told that very strict accountability and transparency mechanisms have been put in place to ensure there is no corruption in the use of the funds. The first phase of the roll out is what we are launching here today in the six states and the FCT. All other states will benefit from the fund as they fulfill the laid down criteria for accessing the fund.”

He also emphasised that providing quality, affordable healthcare to Nigerians devoid of financial hardship was in alignment with the agenda of the All Progressives Congress (APC), adding that they promised to provide succor to the poor while at the same time providing for all other segments of the society.

He said: “I am aware that out of pocket payment for health constitute over 70 per cent of total health expenditure in Nigeria. Our vision is to reverse this ugly situation and promote shared prosperity. The two main game changers for achieving Universal Health Coverage is a functioning Primary Health Care System and a mandatory Universal Health Insurance Scheme.”

He also said the government was providing money through the Saving One Million Lives Performance for Result Initiative to states to improve their performance on health. “The presentation of the cheques here to high performing states today is a testament of our resolve to improve the health indices in our country and encourage competitiveness among the states by paying for performance.”

The six beneficiary states are Niger, Osun, Abia, Katsina, Edo, Yobe and the Federal Capital Territory.

World Bank Involvement
Giving his keynote speech, the Country Director, World Bank, Nigeria, Rachid Benmassaoud, said the launch of the fund was a step in the right direction, adding that with the latest World Bank Human Capital Index recently released, Nigeria needs to do more to improve the health and nutrition of its people as part of plans to change the human capital narrative.

Benmassaoud, who was represented by the Senior Water Supply and Sanitation Specialist, World Bank, Khairy Al-Jamal said: “I am particularly glad that the BHCPF and the Second National Strategic Health Development Plan will help in moving Nigeria towards universal health coverage.

“One thing is key, the accountability framework of this scheme is strong, so we are optimistic that this will help improve health indices in Nigeria,” he said