ANALYSIS OF KADUNA STATE 2020 PROPOSED HEALTH BUDGET

Proposed for 2020
1) Select another batch of Primary Health Centres for upgrade, refitting, equipping and provision of solar grids for their electrical needs, to be manned by some 3,000 additional health care staff PHCDA plans to employ.
2) Complete the 300-bed specialist hospital at the Millennium City that has been under construction since 2009;
3) To improve health outcomes for our people, we shall continue to upgrade the primary health sector, bringing more equipment, expanding the coverage of our immunisation programme, recruiting health professionals and working to reduce infant and maternal mortality.
4) State Primary Health Care Development Amendment (or re-enactment) Bill to update the PHCDA/PHCUOR law that this Honourable House graciously enacted in September 2015, paving way for influx of coordinated donor support to our immunisation and primary healthcare programmes.

Financing Universal Health Coverage in Africa: Nigeria’s comparative experience

The Partnership for Advocacy in Child & Family Health at Scale, PACFaH@Scale (PAS), is a social accountability project which aims to strengthen the capacity of Nigerian Civil Society Organisations at the national and state levels. The project aims to hold decision-makers (in the executive and legislature) to account to comply with commitments in child and family health, policies (laws); financial obligations and to bring down regulatory and administrative barriers to effective and efficient service delivery. PAS is anchored by the development Research and Projects Centre (dRPC) and implemented by a coalition of 23 indigenous health NGOs and professional associations. The project is also supported by 2 government partners working to develop champions with the executive and legislature.

Premium Times National Health Dialogue Communique

A communique issued at the end of a two-day conference with the theme “Universal Health Coverage: The Role of State and Non-state Actors in the Healthcare Funding and Support” organised by Premium Times, Premium Times Centre for Investigative Journalism, PACFaH@Scale, development Research & Projects Centre, Project PinkBlue, International Society of Media in Public Health, Nigeria Sovereign Investment Authority and Nigeria Governors Forum. 

Preamble

In line with the United Nations’ Sustainable Development Goal (SDG) 3, which emphasises the need for Universal Health Coverage (UHC) and healthcare funding in Nigeria. PREMIUM TIMES and its partners organised this year’s National Health Dialogue with the theme: “Universal Health Coverage: The Role of State and Non-State Actors in Healthcare Funding and Support”. The dialogue, which is second in the series, attracted experts, policymakers, media, and civil society organisations.

The Vice President of Nigeria, Professor Yemi Osinbajo, represented by his Chief Personal Physician, Dr. Nicholas Audiferren, declared the event open.  Keynote and opening speeches were delivered Dr. Waziri Dogo-Muhammad, Former Executive Secretary National Health Insurance Scheme; Alhaji (Dr) Abubakar Shehu Abubakar III, the Emir of Gombe; and Dr Chiedo Nwankwo of the Paul H. Nitze School of Advanced International Studies, John Hopkins University, USA. Various experts also spoke at different sessions and panels in the course of the two-days.

At the end of the two-day Dialogue, participants made the following observations and recommendations:

OBSERVATIONS

  1. Participants describe the dialogue as needful and commendable opportunity for a multi-stakeholder conversation on the Nigerian healthcare system. They commended Premium Times and its partners for convoking the event.
  2. Absence of sufficient funding/ weak funding model: The Nigerian government has consistently under budgeted for the Health sector. The 2018 budget, for example, allocated only 3.8% of budgetary allocation to health. The 1% consolidated fund for Basic Health Care Provision Fund (BHCPF) lacks 100% releases with so many gaps as to who benefits from health insurance.
  3. There is failure of the NHIS to capture citizens in the informal sector
  4. Population overgrowth: Nigeria is estimated to be 200 million and projected to double that figure in 25 years. Family planning programs which are the best way to control population growth is frustrated by poor funding.
  5. Absence of data: The Health sector suffers a fate that troubles almost all sectors of the economy, lack of data. Initiatives and programmes are not data-driven and thus almost bound to fail. Lack of sufficient data leads to a lack of adequate information and as such, poor quality health delivery to the people.
  6. High leadership turnover: Leadership changes in Nigeria almost automatically means truncation of initiatives and programmes, no matter how laudable
  7. Corruption: Corruption does not spare the healthcare system, as seen in many scandals in the sector over the years.
  8. Poor policy implementation: Policies are poorly understood and poorly implemented to the detriment of expected outcomes and results.
  9. Strikes: The sector is poorly funded and health workers often have to resort to incessant strikes to get the attention of stakeholders.
  10. Weak or non-existent collaboration among the tiers of government and intra/inter ministry and agency: The federal, state and local governments often haggle over whose responsibility healthcare is and the agencies overseeing the health sector work independently of each other often leading to poor, inconsistent policy design and implementation.
  11. Poor knowledge about health insurance schemes, benefits and operations by citizens.

RECOMMENDATIONS

  1. Increased budgetary allocation to healthcare with intent of attaining Universal Health Coverage by 2030.
  2. Decentralization of the National Health Insurance Scheme to improve its functionality and bridge inequality in access to healthcare.
  3. Additional funding for the Implementation of the Basic Healthcare Provision Fund (BHCPF).1% consolidated funding for the BHCPF should be supported by international partners and the private sector.
  4. Increased capacity building of PHCDA workers and HMOs in identifying simple cancer signs and symptoms in other to attend to patients.
  5. Free cancer screening and subsidized rates for cancer drugs and treatment such that even the poor can afford without any financial implication.
  6. Create advocacy around causes of cancer and the Basic Health Care fund provisions to the cancer patients
  7. Tax should be placed on tobacco, champagne bearing in mind that in no time, revenue generated from oil will become very low to sustain the implementation of UHC in the country.
  8. CSOs must work towards ensuring that universal basic health care is made a top priority in the political agenda of parties during elections, which later will be enforced when they come into power.
  9. Strong advocacy for state-level implementation of the NHIS backed by constitutional provisions.
  10. Political commitment from the president and governors is important to the success of the universal health coverage. Both federal and state government must interact with clear understanding of the insurance scheme and what role each has to perform for maximum results to be achieved.
  11. Engagement of traditional rulers as advocates of the scheme will impact on participation.
  12. Non-state actors should be engaged as stakeholders to critique and contribute to policy design and implementation of the scheme.
  13. The media must employ ensure storytelling technique backed by sufficient evidence to showcase, advocate and for accountability. Data collection and harmonisation must be done such that both the supply and demand sides benefit from it.
  14. Nigeria and Africa must make a case for health in politics, especially during election period as was done in Ghana and the public must actively participate in holding the ruling government in power on delivering on its promises.
  15. Autonomy should be given to primary health centres as this will help them to meet daily expenses that are likely to hamper effective service delivery.

You can contact us info@premiumtimesng.com with the title “National Health Dialogue”.

RI: NPHCDA to partner with NCWS

Women groups are crucial partners in Nigeria’s quest for improved routine immunization coverage, family planning and other healthcare delivery challenges. Executive Director of the National Primary Healthcare Development Agency (NPHCDA), Dr Shuaib Faisal stated this when he received the National President of The National Council for Women Societies (NCWS), Dr Laraba Gloria Shoda in his office.

The visit is part of ongoing advocacy engagement organized by the umbrella body of women societies in Nigeria, working with the development Research and Project Centre’s under the Partnership for Advocacy in child and family health At Scale (PACFaH@Scale) project.

Dr. Faisal Shuaib commended the NCWS for the visit, pledging to do everything possible to assist the association in its quest to stamp out polio in the country. He said,  “As far as I am concerned, we are partners in progress. We have had a long history of collaboration with the NCWS, from Polio Eradication to Family Planning and so on.”
“So, today is just another vista in our long history of deep collaborations with your organization, but particularly with women in Nigeria, either as an individual or as a platform…I want to assure you that we will continue to work with you at NPHCDA,” Dr Shuaib said. He further said   immunization is a right of the child and that a lot needs to be done to ensure that children get needed vaccines. In addition, the Executive Director noted that the observations made  by the NCWS through its leaders who had addressed him earlier were being looked into, following increased funding of the agency through the Basic Health Care Provision Fund.
“There are number of observations that have been made that relate to the weak primary health care system. We are aware of these challenges as a result of many years of neglect of the primary health care space.
“But in the last two years, Mr. President has approved the Basic Health Care Provision Fund, which is one percent of the consolidated revenue fund towards strengthening primary health care. So, some of the issues that you’ve raised towards inadequate or absence of management tools, inadequate training, inactivation of the village health committees and wards health committees, inadequate and lack of manpower will soon be a thing of the past because the Basic Health Care Provision Fund is targeted at addressing these gaps in the primary health care system.
“I want to assure you, without making any empty promises that we are here to work with you. It’s a good thing that we’ve already established a rapport with the program manager,” he stated.
Earlier, National President, NCWS, Dr. Gloria Laraba Shoda, had said the purpose of the visit was to disseminate the result of the “recently conducted a one-day high-level consultative meeting with 14 CSOs and CSOs networks working on routine immunization (RI) with the executive director.
“Analysis of the post-test administered on this CSOs/CSOs networks showed that a low percentage of women voices are captured in routine immunization advocacy.
Mrs. Laraba Shoda highlighted factors that have boosted primary health care services in the country and issues preventing the nation from being proud of quality primary health care system.
She sought the representation of NCWS in the National Emergency Routine Immunization Coordination Centre (NERICC), which the NPHCDA’s boss said he would look into.
She added: “We will be holding a one-day dialogue in November with all the relevant stakeholders of the GAVI transition plan development to discuss the possibilities of increasing domestic resource mobilization post-GAVI, review plan implementation of the GAVI transition of 2018 – 2028 till date and discuss indicators for developing RI scorecards. She expressed that this was a medium to officially invite NPHCDA to provide technical support for this important event.”
Addressing the meeting, Programme Manager, National Emergency Routine Immunization Coordination Centre, NERICC, Dr Bassey Okposen, expressed joy over the support from the NCWS.
“I’m very happy that they have outlets in all the 774 LGAs. They are our mothers and they understand the system very well…It happened that we met at a time like this when we are doing many things that require your usual support,” he said.
He explained further that the group would be needed for the success of the NPHCDA’s upcoming routine immunization in northern and southern parts of the country.
NCWS – Nigeria is a non-governmental, non-profit-making, a non-political, non-ethnic and non-religious organization founded in 1958 and incorporated in 1965. It has its branches in the 36 states and also in FCT and chapters in all the 774 local government areas in Nigeria with more than 250 women affiliates.
The group is the umbrella body for women organizations’ in Nigeria and her major role is to coordinate activities of women organizations to achieve their various goals and aspirations.
NCWS in partnership with PAS (NCWS-PAS) is working on routine immunization as an issue area on the PACFaH@Scale project. The PACFaH@Scale project (PAS) is a social accountability project which aims at national and state level to hold decision-makers in the executive and legislature to account to comply with commitments in the child and family health policies, law and financial obligations to bring down regulatory and administrative barriers to effective and efficient service delivery.

Pictures from the advocacy visit to the ED NPHCDA and the NERICC Team by NCWS-PAS

Major Takeaways from the 2019 National Health Dialogue

At the 2019 National Health Dialogue, Nigerians and foreign participants converged in Abuja to re-echo the demand for Nigeria to achieve Universal Health coverage by the year 2030. What were the major talking points? Click the link  below summarizing the major takeaways from the National dialogue organized by the Premium Times Newspapers, Project Pinkblue, Nigerian Governors Forum and the development Research and Projects Center’s Partnership for Advocacy in child and family health at scale (PACFaH@Scale)

Click here to read

You can also read the NHD Communiqué here

Photos from the two day National Health Dialogue conference organized by Premium Times in partnership with dRPC and other stakeholders

Top Health Officials from Lagos and Niger States join Stakeholders to discuss the future of healthcare in Nigeria

Top government officials working in child and reproductive health in Lagos and Niger states join numerous other stakeholders to discuss the future of healthcare in Nigeria at the 2019 Future of Health Conference series in Abuja. The series, organized by the Nigeria Health Watch (A BMGF Grantee), in collaboration with the development Research and Projects Centre (dRPC), under the Partnership for child and family health At Scale (PACFaH@Scale), remain a platform where the hopes and aspirations of Nigerians for their health sector are articulated. Annually, the conference brings together participants, speakers and partners agitating to find solutions to the challenges in the health sector, pushing for policy action to ensure that all Nigerians have access to quality and affordable healthcare.

The government officials from both states – Lagos and Niger – are Mrs. Halima Muhammed of the Integrated Management of Childhood Illness (IMCI) in Niger state, Mrs. Ummul Khair Nauro from the Integrated Case Management Centre, Niger state, Mrs. Okanlawon Juliana, the Coordinator, Lagos state Reproductive Health Unit, and Mr. Adenekan Ibiwunmi, State Coordinator, Lagos State Child Survival Strategy Unit.

The one-day event brought numerous stakeholders from the length and breadth of Nigeria’s health sector to brainstorm and explore the latest trends in healthcare quality improvement. The stakeholders discussed new ways of looking at the safety of healthcare, such as efforts to improve safety in delivering healthcare, standards and the critical importance of patient-centered care.

Read for more details here

Pictures from the Future of Health Conference organized by Nigeria Health Watch in partnership with dRPC-PAS and other development partners

The Nigeria Association of Nurses and Midwives Tasks the National Assembly on proportionate allocation to Health

Kano state NANNM Chairman, Comrade Bello Sa’id during a press conference on the 2020 Health Budget at the 2019 Delegates Conference in Kano   

The Nigeria Association of Nurses and Midwives (NANNM) Kano state, has raised concerns over the capacity of the proposed 2020 health budget by the federal government of Nigeria to address the health needs of almost 200 million Nigerians. The concerns were raised by the Chairman of the Association, Comrade Bello Nuraddeen Sa’id during the 2019 quadrennial state delegate conference held in Kano state in collaboration with the Partnership for Advocacy in Child and Family Health at scale PAS Project (PACFaH@Scale) on October 17, 2019.

In his welcome remark to declare open the conference, the Chairman stated that the 2020 budget proposal on the  health sector was only 4.14%, adding that it is less than what was allocated in 2019. He disclosed that despite increase in Nigeria’s population, the health budget on capital expenditure is being reduced annually. Similarly, He expressed dismay with the pattern of non-release and return to treasury of public funds meant for the health sector attributing the nonchalant attitude to gross mismanagement and poor foresight of health managers.

Comrade Sa’id also gave an example of the year 2018 budgetary allocation, where he said the capital allocation to the health sector was N141.62 billion. However, the amount released was only N21.62 billion which stands at a mere 15.3% of the capital expenditure for the health sector. The chairman noted that out of the N21.62 billion released, only N13.35 billion which is 9.4%, was utilised while the sum of N8.27 billion had to be returned to the treasury. He called on stakeholders to demand more funding to be allocated to the health sector considering the rising population. This is in addition to timely release of funds to enable the country achieve the set goals of improving the health status of its citizens.

The state delegate conference is conducted after every four years in the month of October. It is an event where all the members of the Association meet to discuss issues and elect new executives that will run the affairs of the association for the next four years and it is carried out in all the states of the federation.

This year, the activity was held in Kano state in collaboration with Partnership for Advocacy in Child and Family Health at scale PAS Project (PACFaH@Scale). The conference’s highest priority was budget allocation to the health sector.

The delegate conference was attended nurses, midwives, government officials, business men and women, labor unions, professional bodies/associations, those in the academic community s and the Media.

Traditional and Religious leaders demand roles in Universal Healthcare Delivery

Traditional and religious leaders in Nigeria came together for a 1-day policy dialogue, to demand a role in healthcare delivery as the solution to the poor state of Universal healthcare delivery in the country. Led by the Sultan of Sokoto, His Eminence, Sultan Muhammdu Sa’ad Abubakar, MNI, CON, the traditional and religious leaders  made this demand  at a policy dialogue on “Funding Universal Healthcare Delivery in Nigeria: Integrating the perspectives of Traditional and Religious Institutions”, organized by the National Institute for Policy and Strategic Studies (NIPSS) in collaboration with the development Research and Projects Centre (dRPC) under the Partnership for Advocacy in child and family health At Scale (PACFaH@Scale) on Thursday, 24 October 2019.

The event was designed to collate the perspective of traditional and religious leaders on ways to improve healthcare delivery and how to achieve UHC in Nigeria as part of the course 41 of the Senior Executive Course of the National Institute. According to the Sultan, for primary healthcare to make an impact and succeed in Nigeria, religious and traditional leaders should be carried along, as they are close to the grassroots and can easily mobilize their subjects and advise the government on how to address the myriad of health challenges of their subjects. He also pointed out that religious leaders and traditional rulers are in the best position to solve most of the problems associated with healthcare delivery in the country. “We should encourage the government to set up real healthcare centres. This will reduce medical tourism”, he said.

In his Welcome address at the occasion, the Director-General of the National Institute, Professor Habu Galadima, emphasized the purpose of the Policy Dialogue – an important platform – to get the perspectives of traditional and religious leaders on funding universal healthcare delivery in the country. Professor Galadima noted that the perspectives from the religious and traditional rulers will form part of recommendations that will be offered to government at the Annual Presidential Parley with Mr. President by Participants of the Senior Executive Course later in the year.

The Gbong Gwom Jos, HRM, Da Jacob Gyang Buba, CON, Chief Host of the event, also emphasized the essential role of traditional and religious leaders in the policy process, noting that the policy dialogue is an important forum for which NIPSS must be commended.

On his part, the Olu of Warri, Ogiame Ikenwoli, tasked participants of the Senior Executive Course (SEC) 41 of NIPSS not to limit their research work to the cities, stressing that they should find time for the rural people and hear their plight as regards accessing primary healthcare in their locality.

The Policy Dialogue was attended by eminent traditional rulers and religious leaders including the Sultan of Sokoto, His Eminence, Sultan Muhammadu Sa’ad Abubakar, mni, CON; the Gbong Gwom Jos, His Royal Majesty Da Jacob Gyang Buba, CON; the Olu of Warri, Ogiame Ikenwoli; and Emir of Shonga, Dr. Halitu Ndanusa Yahaya. Others were Emir of Uba, Alhaji Ali Ibn Ismail Mamza II; Reverend Samson Olasupo Ayokunle President of CAN (represented); and Dr Khalid Abubakar Aliyu, Secretary-General of JNI.

Photos of traditional and religious leaders in the policy dialogue event organized by NIPSS-PAS

Senate, Society of Public Health Professionals of Nigeria Partner to Expand Healthcare through Primary Health Care

Public Health Professionals in Nigeria are collaborating with the Committee on Primary Healthcare and Communicable Diseases of the Senate of Nigeria to provide 70% of the health needs of Nigerians by ensuring a workable, effective and efficient Primary healthcare system in the country.

This commitment was reached when the Society of Public Health Professionals of Nigeria (SPHPN), with the collaboration of the development Research and Projects Centre (dRPC), under the Partnership for Advocacy in child and family health At Scale (PACFaH@Scale) paid an advocacy visit to the Chairman of the Senate Committee on Primary Healthcare and Communicable Diseases, Senator Chukwuka Utazi.

The objectives of the Advocacy visit is to present the report from the scoping mission, conducted on the activity of PHCUOR at the national level (NPHCDA) and also to advocate for separate budget line for PHCOUR activities. to the Senate Committee Chairman, Senator Chukwuma Utazi on PHC and Communicable Diseases. This is especially in terms of collaborating with the work of the relevant Committees of the NASS, to express the Society’s recognition and appreciation of the concurrence of the objectives of SPHPN and the mandate of the Committee. The advocacy visit was to assure the Committee of the willingness and capability of the Society to continue to collaborate in fulfilling their shared objectives. Finally, the advocacy visits also aimed to proffer recommendations for reforming the PHC policies in Nigeria

In his presentation during the visit, the Association’s National President, Professor MC Asuzu, who was represented by the President of the Abuja chapter of the Association, Dr Tolu Fakeye (Project Director, SPHPN-PAS) handed over the 120-page findings of the association on the status of primary health care system in Nigeria.

In the report, the association charged the senate to reposition the primary healthcare services in the country, to place it on the pedestrian, to solve the demand for quality health. The report also calls for sustainable funding of the primary healthcare in Nigeria through searching for alternative domestic resource financing, review the minimum service package and an improvement of the human resources for health if the country is to achieve universal health coverage by 2030.

The association challenged the Senate Committee on Primary Healthcare and Communicable Diseases to tackle the persistent incidence of underutilization of budgetary funds by MDAs.

In his response, the Chairman, Senate Committee on Primary Healthcare and Communicable Diseases, Senator Chukwuka Utazi declared that the senate is open to any collaboration that will provide 70% of Nigerians with the needed healthcare coverage, adding that it is only when the PHC is effective that Nigeria can be said to be on its way to achieving UHC by 2030.

Senator Utazi added that the National Assembly would explore avenues for taking needed corrective measures through legislation and oversight activities to reform the PHC policy and inject new ideas as being proposed by the association to optimize the PHC system in the country.

Senator Utazu promised that his committee will push for legislative action that could result in improved budget allocations, release and utilization of funds especially in favour of primary health care programs and communicable diseases in Nigeria.

SPHPN-PAS members in group photograph with Senate Committee Chairman on PHC and Communicable Diseases