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.
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:
- 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.
- 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.
- There is failure of the NHIS to capture citizens in the informal sector
- 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.
- 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.
- High leadership turnover: Leadership changes in Nigeria almost automatically means truncation of initiatives and programmes, no matter how laudable
- Corruption: Corruption does not spare the healthcare system, as seen in many scandals in the sector over the years.
- Poor policy implementation: Policies are poorly understood and poorly implemented to the detriment of expected outcomes and results.
- Strikes: The sector is poorly funded and health workers often have to resort to incessant strikes to get the attention of stakeholders.
- 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.
- Poor knowledge about health insurance schemes, benefits and operations by citizens.
- Increased budgetary allocation to healthcare with intent of attaining Universal Health Coverage by 2030.
- Decentralization of the National Health Insurance Scheme to improve its functionality and bridge inequality in access to healthcare.
- 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.
- Increased capacity building of PHCDA workers and HMOs in identifying simple cancer signs and symptoms in other to attend to patients.
- Free cancer screening and subsidized rates for cancer drugs and treatment such that even the poor can afford without any financial implication.
- Create advocacy around causes of cancer and the Basic Health Care fund provisions to the cancer patients
- 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.
- 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.
- Strong advocacy for state-level implementation of the NHIS backed by constitutional provisions.
- 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.
- Engagement of traditional rulers as advocates of the scheme will impact on participation.
- Non-state actors should be engaged as stakeholders to critique and contribute to policy design and implementation of the scheme.
- 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.
- 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.
- 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.
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