Towards Universal Health Coverage In Nigeria,By Hamid Hendrix



Namadi-Sambo- 600There is renewed confidence in the management and programmes of the nation’s health sector in the last few days arising from bold indications of continuing efforts to revitalize and reposition the sector to address the numerous challenges for the benefit of the silent majority of Nigerians who depend solely on public health institutions. The success of the Presidential Summit on Universal Health Coverage in Nigeria (UHC) as encapsulated in the 2014 Declaration endorsed at the end of the summit is a positive development.
Its significance lies in the articulation of an agenda of commitment to concerted action by the federal, state and local governments to overcome the basic challenges inhibiting the effective delivery of qualitative health care to the majority of Nigerians whose dire need cannot be over-stated. By bringing together all the important stakeholders in the health sector in general and primary health care in particular to share the latest international initiatives towards fast-tracking the attainment of universal health coverage and activating a common resolve to implement adopted strategies, the UHC Summit has no doubt set the stage for impactful intervention. This was also reflected in the presidential speech to the summit delivered by VP Namadi Sambo which urged lawmakers and policy makers as key stakeholders to “work together in establishing the correct legal and policy framework to address this new drive in meeting the health needs of our people.”
The crucial aspect of the concept of universal health coverage is its focus on extending the frontiers of affordable access to primary health care in the process of which the main factors inhibiting wider availability of health care to the needy population of common people are tackled. It is worth recalling that the concept of Universal Health Coverage itself was the outcome of the resolution adopted at the 58th World Health Assembly in 2005 which called on member states ” to develop their health systems so that all people have access to services and do not suffer financial hardship paying for them”. The felt need to ensure that the nagging problem of access to health care limited by affordability is progressively resolved in favour of its teeming victims among the majority of common people is indeed a welcome expression of concern.
Prior to the adoption of the Universal Health Coverage initiative, several special interventions have been implemented in the unyielding determination of the Federal Ministry of Health, through the National Primary Health Care Development Agency, to seek innovative means of overcoming the access and affordability hurdles. These include collaboration with state health ministries in support of establishment of state primary health care development agencies, implementation of the Ward Minimum Health Care Package and increased routine immunisation coverage. The National Health Insurance Scheme(NHIS), especially with its Community Based Health Insurance Scheme, has also contributed in increasing the range of needy people coming under its programme. Strategies under the Save One Million Lives Initiative such as the Midwives Service Scheme worked to bring skilled health care workers to the rural populace.
Despite these commendable initiatives, the fact remains that a lot more has to be done in order to meet the mandated determination of President Goodluck Jonathan to ensure that 30% of the population is covered with suitable financial protection mechanisms for access to primary health care by 2015. In this context, Health Minister Onyebuchi Chukwu told the summit that making human health insurance compulsory with the processes to ensure rigorous implementation is now a priority. The Universal Health Coverage initiative was considered most appropriate in addressing the challenge of poor coverage/access to primary health care. Specifically, the UHC focuses on increasing access to primary health care, providing protection against financial risk in accessing health care and improving the health status of people.
Another unique aspect of the UHC that enhances its success is the active involvement and commitment of representatives of states and local governments to partner with the Federal Ministry of Health in adopting and implementing the UHC strategies at their respective levels as a matter of policy with support from the Federal Government. This is a significant departure from the past tendency for states and local governments to exercise discretion in adoption and implementation of national health. Towards this goal, the National Primary Health Care Development Agency has been leading the drive for higher investments by state health ministries in refurbishment and construction of primary and secondary health care facilities just as the Federal Ministry of Health has been investing in tertiary health care development.
The successful staging of the Presidential Summit on Universal Health Coverage was therefore another marvellous milestone in the relentless strive of the Federal Ministry of Health, through the National Primary Health Care Development Agency, to galvanize stakeholders and streamline their involvement in implementing strategic approaches to the delivery of quality health care services where they are needed most. The impressive turnout of all major stakeholders at the memorable UHC Presidential Summit, especially the high-powered presidential delegation led by VP Namadi Sambo, state governors, health commissioners, and local government chairmen, was a reassuring testimony to the genuineness of commitment to achieve the healthy objectives of the Universal Health Coverage initiative. Indeed, as the Executive Director of the National Primary Health Care Development Agency, Dr Ado Jimada Gana Mohammed enthused at the end of the Summit, “the UHC ,Movement has taken shape and the journey has begun”.
There is every hope that the expected outcomes of the Summit will ensure the highest level of commitment to the UHC. From the president to the governors, the Federal and State Health Ministries, members of the National Assembly and local government chairmen will empower the mobilization of all Nigerians for the creation of UHC Movement in the country and uphold the commitment by all levels of government to increase funding for health, access to financial risk protection schemes and efficient use of available funds.
HAMID HENDRIX is a journalist in Abuja

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