The recent national roll out of the Basic Healthcare Provisions Fund in Osogbo by the federal government has now brought to reality the long awaited implementation of President Muhammadu Buhari’s signature health programme, ‘Huwe’. Martins Ifijeh reports
Just over a year ago, precisely April 12, 2018 during the second THISDAY Healthcare Policy Dialogue, the federal government launched the logo and beneficiary identification card for the Basic Health Care Provision Fund (BHCPF) in Abuja which signalled the beginning of a brand new programme for the Nigerian healthcare sector.
Barely 34 days after, the National Assembly took a step further and earmarked N55.17 billion in the national budget as the one per cent consolidated revenue fund for the funding of BHCPF.
That was the first time since the passage of the National Health Act in 2014, that the federal government has earmarked funds for the BHCPF.
But between that earmarking of the fund and now, the world, including development partners, healthcare stakeholders, the World Health Organisation, and most importantly Nigerians had their fingers crossed, to see if government would toe the same path of unfulfilled promises it was known for in the past.
To them, the scenario that plays out in the couple of months after all the aforementioned processes will determine whether or not the Nigerian government was serious about implementing the programme or not.
But the federal government didn’t go the way the average Nigerian or international watchers would think it to go. Last Friday it defied the odds to start the national roll out of the funds beginning with Osun State.
What BHCPF Means to Nigerians
The BHCPF is an additional fund outside the healthcare allocation in the national annual budget to address basic healthcare needs of Nigerians. In the 2018 budget, it was put at N57.17 billion for primary healthcare strengthening and service delivery, which mobilises additional resources from the government of Nigeria and development partners to improve the delivery of essential basic health services to Nigerians.
According to the Special Technical Adviser to the Minister of Health, Dr. Oyebanji Filani, the BHCPF will pay for a modest benefit package of health services which currently comprises prenatal, delivery, and post-natal care, as well as family planning services for all mothers in rural areas of Nigeria and also cover the cost of high- impact child health interventions.
He said it will also allow such services to be delivered by accredited private and public facilities that will be reimbursed for services delivered.
“In recognition that Primary Health Centres (PHCs) hardly ever receive any operational costs to cover their expenses, publicly owned PHCs will be provided with operating budgets,” he said.
According to the mandate in the National Health Act, 50 per cent of the BHCPF is allocated to the National Health Insurance Scheme (NHIS) “gateway”, 45 per cent through the NPHCDA “gateway”, and five per cent is set aside to deal with emergencies under the Emergency Medical Treatment (EMT) “gateway”.
Under the NPHCDA gateway, direct cash transfers are provided to public primary health facilities, while under the NHIS gateway accredited public and private facilities are paid for delivering Basic Minimum Package of Heath Services (BMPHS).
Filani said the design of the BHCPF provides an opportunity for channeling resources directly to public PHCs in the NPHCDA gateway, whilst the NHIS gateway provides an opportunity to incorporate the private sector through the accreditation of private providers in the NHIS gateway.
National Roll-out in Osun
Speaking during the first national roll out in Osogbo last weekend, the Minister of Health, Prof. Isaac Adewole said under the BHCPF, also known as ‘Huwe’ which in Ebira language means ‘Life’, this first roll out will ensure Osun gets fund worth N916 million over the next nine months from the roll out date.
He said the programme, which will be done under the primary healthcare facilities in the state covers antenatal care, child delivery care (including caesarian section) and free immunisation for pregnant women; free immunisation, treatment for malaria, measles, pneumonia, dysentery and malnutrition for children below five years; and free family planning services, treatment for malaria, and screening for diabetes and hypertension for all adults.
Adewole said: “From Osun State, we will be heading to Niger, Katsina and Abia in the coming weeks and then continue to 17 other states, including the federal capital territory (FCT) afterwards.”
In his remark, Osun State Governor, Adegboyega Oyetola said that his administration will continue to do whatever it takes to ensure the safety of his people.
Oyetola stressed that ”a cardinal objective of my administration is the provision of healthcare, which should be adequate, qualitative and equitable. In line with this, we have commenced the revitalisation of nine general hospitals and 332 healthcare centres, one in each ward.“
He said part of the state’s drive for equitable health provision was the health insurance scheme whose implementation will start this month. “Under the scheme, government will contribute its counterpart funds while also taking care of the vulnerable in the society. Workers’ Unions are expected to play their own role as stakeholders. We are positive that the implementation of this holistic approach shall deliver quality and adequate healthcare to our people,” he added.
On the approach to be used in the roll out, Adewole said it is consistent with the broader national goals as espoused in the Economic Recovery and Growth Plan (ERGP).
“We have long laid the foundation for what we are launching today. As a government, we are mindful that our success depends on our ability to transform non-renewable (and often volatile) natural capital into productive wealth by investing more in human capital.
“Yet slow progress on poverty reduction, health outcomes, literacy, and governance challenges threaten our development. As you may know, 70 per cent of total health expenditure in Nigeria is borne out of pocket. This is far higher than the globally acceptable rate of 30-40 per cent and remains a barrier to accessing care. Our administration is committed to reversing this ugly situation and promoting shared prosperity,” he added.
Reversing Poor Health Indices
He said with the flag off of Huwe, he was convinced that the country’s health sector will drastically improve.
He also added, “I am positive that Huwe will help reverse the poor health indices in the country. I am also hopeful that death during childbirth will be a thing of the past; and our children will no longer have to die as a result of vaccine preventable diseases or other common ailments. Also, access to health care will not be limited because of not having money to pay.”
Equity in Disbursement
Adewole said to ensure equity in the disbursement of funds, the federal government has allocated resources per state based on the incidence of poverty and also on a per capita basis, adding that this guarantees that the BHCPF will help reduce inequality and improve access to healthcare.
“This sum will cover the payment for the management of 270,000 women with normal deliveries, 763,000 under five childhood illnesses or 572,000 cases of malaria. In addition, 332 public sector facilities will become truly functional as a result of the program,” he emphasised.
Meanwhile, the Officer in Charge of World Health Organisation Nigeria office, Dr Clement Peter said the fund would help make the state healthier, and ensure improvement in the country’s healthcare narrative.