The three targets set by the Nigerian Medical Association (NMA) for the country’s new health ministers to work on, namely, making primary healthcare sustainable, interfacing with other ministries to achieve better health and encouraging federal government to increase health budget, if implemented, will go a long way at resolving the lingering crisis in Nigeria’s healthcare delivery.
The association highlighted the target areas as it prepares for its second National Health Summit in November, the first of which gave rise to proposals that led to the National Health Act. NMA president, Dr Francis Faduyile, told a press conference in Abuja, “The major problem is for us to be able to have a sustainable primary health care. It is beyond the ministry of health but it is primarily state.
“We expect the new ministers to work with states to ensure states increase funding to ensure primary health centres are functional. If primary health care is good, the pressure will reduce on the secondary and tertiary systems.”
Former minister of state for health Osagie Ehanire was named early August as health minister, replacing Isaac Adewole, while Senator Adeleke Mamora is the minister of state for health. Faduyile said the new ministers must also interface with other ministries so they can work well together, noting that sustainable health care was multidimensional, with factors that cut across the purviews of other ministries, including agriculture, environment and finance.
He added that the new ministers must also encourage federal government to increase funding to health. They should also encourage the public to help increase health financing by using the National Health Insurance Scheme. President Muhammadu Buhari has been slated as special guest of honour, the United Arab Emirates health minister as panelist, Delta state governor Ifeanyi Okowa as speaker, with former head of state Yakubu Gowon to chair the opening ceremony.
In an apparent response to the NMA’s proposition, the minister of health said expanding health coverage will be his major agenda. Osagie, while briefing the media shortly after he assumed duty penultimate week alongside the minister of state for health, expressed his desire to key into the agenda of Mr. President for the health sector.
He said his main vision for the sector includes: the expansion of health coverage, particularly the primary health sector; improvement in the quality of medicare in hospitals; improving the indices in health security in the country, among others.
On his part, the minister of state promised that the ministry would work in synergy with all relevant stakeholders to move the sector forward. To achieve these, Mamora said, “We must change certain things by working together with the agencies”.
It is instructive that while presenting the 2019 budget to the National Assembly last year, President Buhari revealed that the health ministry and the defence ministry jointly have the highest recurrent expenditure. Both ministries are expected to pay salaries and overheads totalling N62 billion in 2019.
A key element of the budgetary allocation for health is the one per cent of the Consolidated Revenue Fund amounting to N51.22 billion which has been earmarked for the Basic Health Care Provision Fund.
Speaking on the health sector, the president said health is an important part of his government’s aspirations for human capital development and pledged he will continue to strive to make Nigerians healthy and happy. But these lofty ambitions were not reflected by the government’s budgetary allocation for health which is less than two per cent of the total budget.
Furthermore. while health is among the top 12 ministries with the highest budget allocation, it ranked in the bottom half. In 2019, the federal government’s expenditure for health includes major investments in vaccination, which will gulp a total of N24.75 billion for the Global Vaccine Alliance, Gavi, and the Global Fund, rising from the N3.5 billion that was set aside for the same purpose in 2018.
Another obvious component of the health budget is the provision for the establishment of cancer treatment centers in nine federal government-owned teaching hospitals – University of Benin Teaching Hospital (UBTH), University of Ilorin Teaching Hospital (UITH), Ahmadu Bello University Teaching Hospital (ABUTH), University of Maiduguri Teaching Hospital (UMTH), Obafemi Awolowo University Teaching Hospital (OAUTH), University of Nigeria Teaching Hospital (UNTH), University of Port Harcourt Teaching Hospital (UPTH), Federal Medical Center (FMC) Owerri, and FMC Abeokuta.
There is no doubt that Nigeria’s health sector has over the years been bedeviled by many factors with successive administrations lacking the political will to tackle these challenges. Some of the problems of the sector include inadequate health facilities and structures, poor management of human resources, inequitable and unsustainable health care financing, skewed economic and political relations, corruption, illiteracy, decreased government spending on health, absence of integrated system for disease prevention, surveillance and treatment, inadequate access to health care, shortage of essential drugs and supplies, etc.
We, therefore, urge the Buhari administration to walk its talk on improving the health sector, particularly ensuring the pragmatic implementation of theNational Health Policy which was formulated in 1988 and subsequently reviewed in 1996, 2004 and 2016. The ranking of Nigeria by the World Health Organisation (WHO) at the 187th position out of 190 countries amongst the worst in the world is embarrassing and must be redressed.
