Nigeria is currently in search of a workable approach to achieve Universal Health Coverage (UHC) and tackling issues around financial barriers, low doctor-patient ratio, infrastructure, clinical governance, quality of care and transparency in the health sector.
Universal health coverage, (UHC), is an aspiration by a country, like Nigeria, to provide her people with affordable quality healthcare. In Nigeria, this will entail ensuring everyone has access to healthcare – this could be via public or private health services.
Experts say universal healthcare is about elaborating equitable and affordable healthcare noting that in order to create a catalytic process within the system, the country needs to focus on tackling key issues and not more with measurable goals and targets.
These experts further said that for Nigeria to achieve universal health coverage to deliver substantial health, economic and political benefits across populations, healthcare should be considered as a human right and no one should be denied access to healthcare due to financial reasons, gender reasons, issues related to geographical barriers or any other issues which might create a barrier to healthcare access.
“Improving transparency in disbursements could be tying budget disbursements to specific healthcare results or outputs from a hospital or health facility with clear repercussions if they are not met, that is performance-based disbursements,” Chibuzo Opara, Co-CEO DrugStoc Nigeria.
Opara said circling back to the issue of financial access to healthcare. “The first thing to note is there is no free healthcare in the world. Someone always foots the bill.”
“There should be an agreement and a commitment between citizens and decision-makers on where the country places universal healthcare among other important priorities,” he said.
Recently at the 2019 National Health Dialogue, Yemi Osinbajo, Vice president of Nigeria stated that the federal government cannot adequately provide health care services to over 200 million Nigerians but said an effective National Health Insurance Scheme (NHIS) remains the best option in achieving universal health coverage (UHC) for all and addressing funding challenges.
Nigeria’s target is to achieve UHC by 2030 which is the third goal of the Sustainable Development Goals (SDGs)
As part of efforts to achieve UHC, the country has been to set of guidelines defining the basis for Administration, Disbursement, Monitoring and Financial Management (ADMFM) through the Basic Healthcare Provision Fund (BHCPF, “The Fund”).
The guidelines address urgent interventions put in place to tackle persistent and emerging causes of population mortality in Nigeria including Maternal Mortality, Perinatal Mortality and Road Traffic Injuries (RTIs).
Doyin Odubanjo, chairman, Association of Public Health Physicians of Nigeria, Lagos Chapter said making health insurance mandatory as some states have started in the country, is expected to benefit all Nigerians and will as well serve to improve the country’s economy when more people are healthy.
“Government should be responsible for the accountability of the health providers for service delivery and it must be monitored to ensure the providers deliver quality healthcare services at the end of the day,” Odubajo said.
Nigeria’s primary, secondary and tertiary institutes are beset by challenges, although PHC facilities are the people’s first point of contact with the health system, insufficient service delivery, overburdened clinics with long queues, and poor quality of services has resulted in many people avoiding PHC facilities and going straight to hospital outpatient departments where services are perceived to be better.
Since the establishment of the National Health Insurance Scheme (NHIS) in 200, only about five percent of Nigerians are covered.
Opara said improving the quantum and scope of healthcare services. Quality is very important on so many levels simply because once quality is improved it has one of those long-lasting and catalytic effects on a system leading to cheaper and more effective care in the long term.
“A crucial point to effect system change is holding individuals and entities accountable and measuring the impact of interventions and activities in the healthcare sector.
“For far too long we have been concerned with just how much money and inputs go into the healthcare sector, that is how much in salaries, or what items are being procured, with too little attention paid to measuring outputs and outcomes of the system,” he said.
Opara added that decision-makers and healthcare providers need to be held accountable for health outcomes stating that governance and transparency are quite crucial.
“They will serve to manage our lean resources effectively in addition to attracting the necessary private sector funding to plug the gaps in the fiscal space for healthcare,” he said.
ANTHONIA OBOKOH
