Investing in Health; A must for Politicians

On 24^th February 2015 in Abuja I co-facilitated a press conference under the platform of Partnership for Advocay in Child and Family Health (PACFaH) , a coalition of 7 civil socieity organisations dedicated to improving  Nigeria’s Maternal, Newborn and Child Health. I was thrilled that day looking at the quality of news coverage that trailed the event in electronic, print and online media. That day and subsequent days the health messages were out in many media outfits. In my introduction I informed the media that  “as you are all aware, political parties and their aspirants have been traversing the length and breadth of Nigeria to canvas for the votes of the populace during the 2015 General Elections. With the postponement of the elections from the initial date of February 14 to March 28, PACFaH coalition considers it critical that priority health issues affecting women and children are adequately given priority in the political agenda.”

Also reiterated that “being a non-partisan coalition of CSOs, we wish to state that irrespective of whichever political party that wins in the general election, we expect governments at Federal, State and LGA levels to fulfil their policy commitments on improving the state of child and family health in Nigeria.”

What were the health issues raised ?

1. There are huge funding gaps in the provision of key MNCH interventions and even where funds are available, there are unnecessary delays in the approval, release and utilization of budgetary allocation to child and family health in Nigeria.
2. Nigeria’s poor performance with Maternal, Newborn and Child Health (MNCH) has been made worse by huge inequalities/disparities between geopolitical zones in the country.
3. Nigeria is off-track in meeting the MDGs targets for Maternal, Newborn and Child Health (MNCH) for 2015, and the country’s health indices continue to be unacceptably poor. Nigeria’s 2015 target for MDG4 (Under-5 mortality) is 70 deaths per 1,000 live-births; while for Maternal Mortality Ratio (MMR) it is 250 deaths per 100,000 live-births and can’t be achieved.
4. Nigeria’s poor MNCH status is underlined by an overarching poor governance and stewardship responsibility for health, especially at the Primary Health Care level.
5. 2013 NDHS figures show that the contraceptive prevalence rate (CPR) for Nigeria was just 15%. While availability of FP services at health facilities may have improved in the last 2-3 years, this has not been matched by improved service quality and increased demand especially at the community level where women from poor households with low education abound. The low utilization of FP services is worse in North East and North West where the utilization is less than 1% according to the 2013 NDHS figures. The Nigerian government in 2010 made commitments to release US$3 million annually for the procurement of FP commodities, and later at the London Summit in 2012 made an additional commitment of US $ 8.35 million annually over the next four years for reproductive health commodities including contraceptives. However, the government has not fulfilled the respective commitments to fund these services.

6. While Nigeria has in recent years made progress in local food production, the poor nutritional status of Nigerian children has been a major concern to the coalition. For instance, 37% of children under age five in Nigeria are classified as stunted. This rate is the highest in sub-Saharan Africa and second in the world.
7. In 2013, about 3 million children under age 5 years died globally, 51.8% of them from infectious causes with Nigeria being one of the countries with the highest number of deaths. In Nigeria most of the deaths are caused by malaria and pneumonia with pneumonia as the single infectious and preventable disease with the highest mortality. The NDHS 2013 have identified five issues as important risk factors for Childhood Pneumonia and they are malnutrition, low birth weight, non–exclusive breastfeeding, solid fuel use, crowding (7 or more persons sharing the same household) in a household, in addition to zinc deficiency, measles and poor hygiene especially lack of hand washing culture.
8. The Coalition in addition wish to call on the Government to revise the National Treatment Guidelines with Amoxicillin (dispersible tablet) adopted as first line of treatment for Childhood Pneumonia by 2016 as well as increase buy-in and support for Zinc and oral rehydration solution (ORS) as treatment for Childhood Diarrhea.
9. It is commendable that Nigeria as at the end of December 2014 achieved 87% reduction of the Wild Polio Virus Type 1 (WPV1) burden and 78% reduction in geographic spread of the virus with only 6 confirmed WPV1 in 2 states recorded in 2014 compared to 50 cases in 9 states for the same period in 2013. Notwithstanding these successes, the government need not relent on its efforts until the country is certified as Polio-free.
10. With the rebasing of Nigeria’s economy and reclassification as a Medium Income Country, our continued dependence on donor agencies for the funding of our nation’s immunization programme will no longer be feasible.

We concluded by calling on political parties, their candidates and the general population to ensure that priority health issues are brought to the realm of public discourse before, during and after the 2015 general elections. We also recommended a paradigm shift from building more hospitals and clinics to strengthening health systems that are necessary for providing affordable, accessible and equitable healthcare services which are democratic dividends for the populace who voted politicians to various offices.

 1st published in Daily Trust Newspaper of  3rd March 2015 by  Dr Aminu Magashi Publisher Health Reporters (healthweekly@yahoo.com)