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100 days and Health Sector; Bottom-up Advocacy

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It is difficult to keep track of how each of the 36 executive governors spent his 100 days in office which was marked on Saturday 5th September 2015 and it is even more difficult to know if health sector has featured among their celebrations. I was in Bauchi on that Saturday 5th September 2015 and witnessed the official launching of Governor M A Abubakar’s 5 point health agenda tagged ‘Lafiya Garkuwa’ meaning ‘Health is Shield’. The launching of the agenda and a visit to a primary health care clinic were the main business of the 100 days celebration.

Iam thrilled to report it here because Iam of the opinion that other governors could equally do the same as in doing that may spark off national scale up including the federal government.

The 5 Point Health Agenda of his Excellency the Executive Governor of Bauchi State are as follows;

  1. “Strengthening Primary Health Care including Routine Immunization and     Reproductive, Maternal, Newborn and Child Health Services
  2. Access to quality and cost effective essential and live saving drugs including consumables and laboratory services
  3. Motivation, retention and re-training of frontline health workers for effective and quality service delivery
  4. Improving funding to health sector through innovative financing mechanisms, accountability and transparency
  5. Demand creation via health education, awareness creation and strategic communication”

Which governor will not be interested in the above 5 point health agenda? The answer is none. If Bauchi State Government and other governors will provide adequate funding in line with the above, I preempt a remarkable progress in Nigeria in effective and efficient quality health care delivery system.

Just like I wrote in my previous article Health Sector as we inch towards 1st 100 days of PMB’, the essence of 100 days commentary isn’t about evaluating success but it serves as a marker to ask questions regarding what are Mr. President and our 36 governors steps and actions being taken to revamp the health sector in line campaign promises and party manifestos.

The government of President Buhari through its transition committee report and APC policy dialogue recommendations itemized the following as the ‘100 Day Covenant’

  1. “Introduce a well-managed and properly funded healthcare delivery system
  2. Free healthcare for children (less than 12) and free treatment for infectious diseases
  3. Introduce and disseminate national healthy living program to improve life expectancy
  4. Raise health practitioner ratio
  5. Encourage active health investment and partnership programs
  6. Perform baseline study to clarify current situation and identify potential efficiency gains
  7. Define relevant KPIs for healthcare agenda and set up mechanism for monitoring results; leadership of key institutions to be held accountable for results
  8. Find funding for strategic vaccination programs such as polio eradication
  9. Identify healthcare best practices across states and determine best way to share findings.”

We should as citizens ask questions if some of the itemized agenda are achieved or plan to be implemented by the Buhari’s administration and equally go round to document what each governor has promised and what he has done or plan to do as we marked the 1st 100 days..

An excerpt from the APC dialogue revealed that “Nigeria’s healthcare sector is in need of reform. Lackluster infrastructure, inequality in access to services, poor medical personnel training and equipment, rampant corruption and failure to pass and implement crucial reforms has resulted in Nigeria’s healthcare system lagging behind among most countries on key health indicators and negatively impacting Nigeria’s potential growth. As a first initiative, improving access, accuracy and availability of health related data is required to establish a baseline for target setting and results tracking. Active engagement of states and local Government areas (LGAs) for reforms will be crucial to ensure effective implementation.”

The agenda number 5 among the 5 point health agenda of Bauchi State says “Improving funding to health sector through innovative financing mechanisms, accountability and transparency”. This is worth emphasizing that with the dwindling financial resources in the entire country, we have to look within and re-strategies and introduce innovative ways of mobilizing financial resources as well as efficient spending.

The Government Spending Watch 2015 Report titled ‘Financing the Sustainable Development Goals’ stresses the need for dramatic improvement in effectiveness of financing. It also made a strong recommendation for greater transparency, especially of data on spending and revenue/aid in budget-related documents. It also observed that budget transparency makes tracking MDG spending and financing more feasible, by encouraging governments to improve the quality and details of their data.

I will conclude by saying that we should encourage advocacy that starts from the states and move up to the federal level and try to influence the governors to implement agreed agendas that have the potential of catalyzing more actions in the entire country.

We should remember that in line with the demographic health survey of 2013 “health outcomes of Nigeria’s population are poor compared to other countries with comparable (and fewer) human and natural resources. One in every 170 births in Nigeria leads to the mother’s death. One in every 15 Nigerian children die before reaching age one, and one in every eight do not survive to their fifth birthday and nearly all of these deaths can be prevented”.

It is time for political agendas and actions.

1st published in Daily Trust Newspaper of 8th Sept 2015 by Dr Aminu Magashi Publisher Health Reporters (healthweekly@yahoo.com)  


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