Nigeria’s journey to Universal Health Coverage slow- Ehanire


By Doosuur Iwambe

The minister of health Dr Osagie Ehanire has admitted that Nigeria’s journey to Universal Health Coverage, (UHC) has been slow.

Speaking during the 2022 National Health Dialogue organised by the Centre for Journalism Innovation and Development (CJID) in collaboration with PREMIUM TIMES, Dr Ehanire however noted that remarkable milestones have been achieved.

Represented by the Director, Primary Health Care System Development, National Primary Healthcare Development Agency, NPHCDA, the minister disclosed that with heightened efforts to revitalize and strengthen PHC system, Nigeria is moving closer to attaining UHC, DailyTimesNGR gathered.

Identifying the challenges affecting the advancement of PHC system, the minister listed limited funds, dilapidated infrastructure, weak referral systems, shortage and mal-distribution of healthcare workers as some of the challenges.

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“Several challenges have bedeviled the Nigerian Primary Healthcare System. Some challenges are the shortage and maldistribution of healthcare workers, dilapidated infrastructure, and weak referral systems.

“However, limited financing for the primary healthcare system stands out as a factor that has significantly limited the advancement of our primary healthcare system. National Health Account reports published over the past decade indicate that expenditure on primary healthcare has been sub-optimal, with significant spending on curative healthcare.

“The inadequacy in funding for the primary healthcare system has negatively impacted the delivery of services such as immunization and maternal and child health services”, he said.

Dr Ehanire who further disclosed that the theme of the dialogue: “Role of State and Non-State Actors in Primary Healthcare Financing” was apt said, everyone has a role to play financing primary healthcare in Nigeria.

“The private sector, civil society organizations, non-governmental organizations, the media, faith-based organizations, trade unions, professional organizations, academia, community groups and private citizens alike can all contribute to financing primary healthcare in Nigeria.

“To strengthen the primary healthcare system, the Federal Government of Nigeria has continued to make efforts to improve the proportion of resources allocated to the primary healthcare system.

“The Basic Health Care Provision Fund has been a game changer and resulted in increased financing for the primary healthcare system through the different gateways.

“Efforts from agencies like the National Primary Health Care Development Agency and the National Health Insurance Authority have contributed towards financing Primary Healthcare in Nigeria.

“Guided by data from the National Health Account Reports, which indicate astronomically high out-pocket expenditure for healthcare, the Government of Nigeria determined that it would provide more resources for health, hoping for a significant reduction in out-of-pocket spending and more funding for priorities such as primary healthcare”, Ehanire added.

The World Health Organisation, WHO in their goodwill message decry shortage of funding for health.

Quoting the National Health Account, the global health body said, it had estimated that 16.6% of the Current Health Expenditure is from Government (Federal, State, and LGA), 11.8% is from Development Partners while 3.6% is from Insurance.

This it disclosed leaves the remaining 70.5% of health care spending in Nigeria including primary healthcare to households who pay out-of-pocket with catastrophic potentials.

In addition, it is important to note that 61.4% of health spending in Nigeria is on communicable diseases such as Malaria (36.2%), HIV and other STDs (10.4%), Tuberculosis (5.5%) and vaccine preventable diseases (4.7%).

According to the WHO Representative in Nigeria, Dr. Walter Kazadi Mulombo, considering the above, the task of ensuring that all citizens have access to the quality healthcare they need without falling into poverty is a deliberate political decision and in a large federal nation like Nigeria.

He said that this would depend on how the governments at the different tiers complement themselves but most importantly collaborate with non-state actors including the private sector.

He added that non-State Actors are integral partners towards ensuring that no one experiences financial hardship and unmet needs.

“Non-State Actors have therefore been integral partners towards ensuring that no one experiences financial hardship and unmet needs.

“Protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because unexpected illness requires them to use up their life savings, sell assets, or borrow – destroying their futures and often those of their children.

“Although COVID-19 pandemic revealed global fractures in all systems with far-reaching consequences even in sectors beyond health, it however has provided clear opportunities to demonstrate the importance of health not only as a social service but a key enabler of economic development of any nation, reaffirming that health is wealth. Indeed, COVID proved that meaningful investment of non-state actors such as CACOVID in Nigeria can significantly strengthen the hand of government in accomplishing huge milestones.

The pivotal roles played by local and international non-state actors including foundations like (Dangote, BMGF, CHAI, PharmAccess, Pathfinder, etc) in the establishment and functioning of key health financing mechanisms such as the Basic Healthcare Provision Fund, Global Fund, GAVI, COVAX, etc cannot be over-emphasized. These mechanisms are very instrumental in guaranteeing access to lifesaving PHC services to millions of Nigerians”, he added.

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