“My administration will provide a strong political leadership, accountability and transparency in the health sector as health is fundamental to national development. We will strive to reverse the unfortunate trend of unacceptable maternal and under-five deaths due to preventable diseases by investing in both preventive and curative medicine and by working with state and local governments, development partners and civil society organizations to improve human resources for health and ensure essential live saving drugs are available in all our facilities 24 hours a day and 7 days a week. We are also committed to improving the fiscal space for health as we are aware of the challenges of adequate funding for Routine Immunization and what is needed for the final push to eradicate Polio in Nigeria. We will engage all interested stakeholders including the private sector to innovatively improve health care financing via public-private partnership and mobilizing more domestic resources. We should utilize funding from international development partners as complimentary not the main source of funding for our health sector. I am also committed to the full implementation of the recently signed National Health Act which provides a framework for reforming the health sector. Nigeria will take its leadership position in leading other African countries in providing innovative solutions to the myriad health problems in Nigeria and Africa in general. This we will achieve by meaningful engagement of African heads of states and international players at ECOWAS, African Union, World Health Assembly and United Nations.” This was President Buhari in my dream speaking on May 29th, 2015 during his inaugural speech at eagle square in Abuja. While it is a dream but it is not impossible for the President to say the above. The reader might remember the article that I published on these pages ‘Why the Health Sector must engage Buhari’s Transition Committee? -http: //healthreporters.info/2015/05/06/why-the-health-sector-must-engage-buharis-transition-committee/’. In that article I opined that “there is palpable anger and disappointment within the Nigeria’s health sector over the choice of the membership of the 19 member President elect Buhari Transition Committee. A senior colleague retorted that the 19 member committee is devoid of even a single health worker or health NGO or development worker.”
Iam happy to report that the health sector via national civil society organizations had formerly made a presentation to the President elect Buhari Committee on Tuesday 12th May 2015 in Abuja. I led a delegation of 5 and we had a good interaction with the committee and were excited that our presentation had coincided with the presentation of Dr Muhammad Ali Pate a former state minister of health. His paper “Creating a More Responsive Health System to deliver a Better Health Care to Nigerians” was brilliant. Analyzing his paper will be a discussion of another day but I was happy that we both agreed on almost all the problems bedeviling the health sector and what should be done to address the yearning of Nigerian. Permit me to provide few lines from the technical working paper that we presented.
The Situation in Nigeria
Nigeria’s Maternal Mortality Ratio (MMR) is 576 maternal deaths per 100,000 live births (NDHS 2013) which isn’t significantly different from the ratio reported in the 2008 NDHS of 545/100,000. It has gone up rather than slowed down. Other relevant indicators to help better understanding of the situation are; antenatal care coverage for at least one visit is 60.6% and for four or more visits is 51.5%. These percentages signify that almost half of the women population are disenfranchised.
Routine Immunization; Nigeria has recorded significant progress in reducing childhood mortality, and vaccines have been a significant contributor. However these gain can be reverse due to inadequate domestic funding to finance vaccine procurement.
HIV/AIDS; Nigeria has an estimated 3.5 million people living with HIV, one of the highest numbers of infected people in the world. Nigeria has over 600,000 people living with HIV/AIDS that are supposed to be on regular drugs; majority can’t afford these services.
Population and Development; Population growth and the opportunity of demographic dividend is another issue that the in-coming government cannot shy away from, not least because it is a health issue that has far-reaching and cross-cutting effects, especially on the national economy and overall wellbeing of Nigerians.
Some recommendations for consideration by Transition Committee;
- Improving fiscal space for health sector; Nigeria should increase its domestic resources for health through enhanced revenue collection and allocation, re-prioritization where relevant, and innovative financing. It should spend its 5% of GDP to health and attend $86 per capita spending on health.
- Full implementation of the National Health Act; For the Act to be fully implemented, it requires the political will of the new government to allocate and appropriate the 1% annually and to ensure timely release of funds as enshrined in the Act. An estimate of about N34 billion annually is required to implement the National Health Act.
- Strengthening Service Delivery & Quality of Care; the best practice of service delivery that delivers quality of service is focused on making health care service accessible, affordable, available, and technologically sound as a right for every citizen.
- Essential and life-saving commodities; The availability and accessibility of essential and life-saving commodities is strongly advocated for the actualization of all commitments made by the Nigerian government, including commitments made at the London Family Planning Summit of 2012 as well as United Nations Commission on Live Saving Commodities.
- Polio eradication; Nigeria need to interrupt all poliovirus transmission by mid-2015 and maintain certification-level surveillance standards through 2018 and secure domestic financing commitments for polio eradication in 2016 at 2015 levels (i.e., $80 million).
1st published in Daily Trust Newspaper of 19th May 2014 by Dr Aminu Magashi Publisher Health Reporters (healthweekly@yahoo.com)
