Healthcare funding: 1% game changer?

National Health Act (NHActs)
The National Health Act, enacted in 2014 to provide a framework for regulation, development and management of a National Health System and lay down standards for rendering health services and related matters in the country, set aside one per cent of Consolidated Revenue Fund as Basic Healthcare Provision Fund.

The move is expected to address the funding gaps in the health sector which is faced with a myriad of problems resulting in the high mortality rate recorded in the country.

The Act states that one percent of consolidated revenue of the country be made available to provide basic healthcare services to all Nigerians, especially the poor.

It also stated that 50 per cent of the revenue be given to the National Health Insurance Scheme (NHIS) as basic minimum health package, while 45% of the funds be given to the National Primary Health Care Development Agency (NPHCDA), for provision of essential drugs and vaccines, Laboratory equipment and Logistics and also for human resources. The other five percent is to be given to the federal ministry of health for emergency medical treatment.

Speaking recently in Abuja to mark the World Health Day, the Minister of State for Health, Dr. Osagie Ehanire said, “Operationalisation of the Act, as a step towards Universal Health Coverage (UHC), is expected to support physical and financial access to healthcare by aiding revamping of neighborhood PHC Centres and solving Human Resource for Health challenges, for a basic healthcare package that includes free antenatal and postnatal care, free immunisation service and free treatment of children under the age of 5.

“Healthcare delivery quality is expected to improve significantly with more Value for Money, Transparency and Accountability. Appropriate payment exemption schemes are to be determined by the National Council on Health to provide access to the vulnerable.”

Implementation of one per cent Consolidated Revenue Fund (CRF) for the Basic Health Care Provision Fund (BHCPF)

According to the ministry of health, the implementation of NHActs will enable the government fund projects, programmes and policies geared towards Universal Health Coverage (UHC) in Nigeria by 2025.

Speaking on the importance of UCH for every country at the recent 2nd THISDAY Healthcare Policy Dialogue in Abuja, the Director-General of WHO, Dr. Tedros Ghebreyesus, said Health is a fundamental right that should be enjoyed by all people, not a privileged few.

According to him, “No one should fall sick and die because they are poor or do not have access to health services. There is no single path to UHC. All countries must find their way. “The question is not whether countries can afford to invest in health. The question is whether countries can afford not to invest in health.”

He urged Nigeria to find its own path to UHC, pointing out that countries do not have a choice when it comes to investing in health.

Also, the Health Systems Specialist with the BHCPF Committee, Dr. Jimlas Opeyemi Ogunsakin, pointed out that, “for the first time in the history of Nigeria, we have this massive social development program in the health sector outside of the normal budgetary allocation to health. This is going to be a very massive investment in health, especially covering the people at the local level, at the community level. If this is implemented, it’s going to improve service delivery, both on the supply and demand side of healthcare, within the PHC system. It is going to be fabulous.”

However, the Senate, with the cooperation of the House of Representatives, resolved to mandate Committees on Appropriations to ensure that the pledge to set aside 1 per cent of the Consolidated Revenue Fund for the Basic Health Care Provision Fund (BHCPF) is met.

The usual promise?

The President of the Senate, Dr. Bukola Saraki, disclosed that the National Assembly will ensure that one per cent of the Consolidated Revenue Fund (CRF) is set aside in the 2018 Budget, to boost the provision of basic primary healthcare services across the country.

Saraki revealed this in his address at the ongoing 58th Annual General & Scientific Conference of the Nigeria Medical Association (NMA).

According to him the funds would enable the federal government provide and fund quality basic healthcare services for the benefit of Nigerians when the 2018 Appropriation Bill becomes a law, adding that once this one per cent is put into law, the legislators will embark on the next stage, “which will be to ensure that we get value for money, for transparency in the use of the funds.”

He said, Since the 8th Senate, I made a promise with the commitment and support of my colleagues that we will deliver a gift to Nigerians on the issue of universal health coverage.

“I am very confident that the appropriation bill that will come out in the next few days will have a one per cent coverage in the house. To us in the national assembly this is key to addressing the health sector. We hope that by the time the bill is passed, you will have that one percent.

“It is a promise that we have made to Nigerians, and one that we are determined to keep. In July last year, I launched the Legislative Network for Universal Health Coverage and urged the federal government to honour the Abuja Declaration (2001), while calling for full implementation of the National Health Act 2014.

“Therefore, there is no better place than here today, to announce that the issue of funding will be attended to in our budgetary review of the 2018 Appropriations Bill.”

He urged NMA to work closely with the government to ensure proper utilisation of the funds.

In his speech, the Vice President Yemi Osinbanjo explained that “while public sector investment in healthcare must be substantially improved, it’s unlikely that it would ever be sufficient; in other words, paying for healthcare ‎from budgets will not be enough to move the needle in healthcare funding.

“It is no longer news that we inherited a troubled healthcare sector, and that the healthcare sector has been troubled for a long time. As one of the manifestation of the severely low spending on the infrastructure generally, and healthcare in particular, I think what we have seen through the years is a scandalously low level of funding for public health, especially healthcare in particular.

“The level of public sector investment in healthcare in our recent past has in no way reflected our earnings or high earnings, especially in the periods between 2010 and 2015; that was when we earned the highest in oil prices‎, and the devastating insurgency in the North-east has succeeded in bringing an already torturing healthcare system in that part of the country to its knees.”

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