Health care: Universal coverage tops demands from Tinubu government

Calls for holistic actions to strengthen the healthcare sector in widening access to improved quality of care are growing ahead of the inauguration of the next president.

Bola Tinubu, the president-elect, would be inheriting decades of failed promises to shore up national funding for health to at least 15 percent of the annual national budget.

He would acquire a primary healthcare system that is largely decrepit, general hospitals that are short-staffed and of poor capacity, and teaching hospitals that are badly hit by unabated exit of essential health workers out of the country.

Tinubu would come into power having roughly 90 percent of the population overburdened by out-of-pocket expenditure, a sad reality that manifests more when treating chronic illnesses with exorbitant cost of treatment.

Stakeholders, worried about the chances of having another four years with low progress in health indicators, have charged the president-elect to focus on strengthening healthcare systems, promoting preventive healthcare, and ensuring access to essential medicines and skilled healthcare professionals.

Pamela Ajayi, president of Healthcare Federation of Nigeria (HFN), said the issue of funding should be tackled with a comprehensive approach that combines government effort with private sector potential.

“The government needs to allocate sufficient funds to the healthcare sector by increasing public sector expenditure in healthcare from the current 8 percent to 15 percent in compliance with the Abuja declaration of 2001,” she told BusinessDay.

Ajayi, who also chairs the board of Bridge Clinic, said the policy draft on incentivising the healthcare industry still needs to be signed to increase private sector investment while the national health insurance coverage should be effectively extended to all Nigerians.

“The prime intention of the NHIA Act of May 19, 2022 is to eliminate once and for all, the problem of out-of-pocket expenditure. Hopefully, when the NHIA Act is fully implemented, all healthcare in Nigeria will be through the avenue of mandatory and obligatory health insurance. No one should need to bring out money to access Healthcare except for a few co-payments,” she said.

Hammering on the need for advancing universal health coverage in Nigeria, Zakari Osheku, executive director of Primary Healthcare Initiative, said during an advocacy that a field assessment by the organisation showed that some of the enrollees under the basic health care provision fund were confronted health facilities without basic provision for drugs.

He said while political leadership is key, private sector engagement is also necessary in an era when about 50 percent of people depend on private sector for their health pursuit.

For Leke Oshuniyi, chairman of the Health and Managed Care Association of Nigeria (HMCAN), a professional body of health insurance practitioners, the economy of a country also has a reflection on healthcare. If a country is rich and can provide social amenities like water, electricity good drainage, roads, it automatically improves health, he said.

“Our GDP needs to grow at seven or eight percent per annum for a period of 20 years. This must start now with the incoming administration. NHIA has estimated 2.5 million while private insurers cover about five million. The rest are still uncovered.”

Apart from health financing solutions, stakeholders expect Tinubu to prioritise skilled healthcare workforce. They want the new government to develop and retain skilled healthcare professionals, and encourage the return from the diaspora. They are seeking adequate compensation and motivation to ensure health workers to stay and work in the country, especially in rural areas where the need is vast.

On healthcare infrastructure and technology, Nigeria needs to focus on more effective utilisation of existing healthcare infrastructure through rehabilitation, or public-private partnerships to ensure they are equipped with modern medical equipment and technology.

“The use of digital health technology, including electronic health records, telemedicine, and mobile health applications, will help improve healthcare access and quality in Nigeria. These technologies help improve health outcomes by enabling remote consultations, facilitating the tracking of patients, and improving access to health information,” the HFN president added.

Demands for access to essential medicines are also rising, considering how key it is to achieve health security and the successful treatment and management of diseases.

According to some stakeholders, the challenges experienced during the COVID-19 pandemic have shown that Nigeria needs to focus on the local production of affordable, high-quality medicines to ensure it is always available to the public.

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