UNIVERSAL HEALTH COVERAGE AND COVID-19 CONTROL MEASURES IN NIGERIA
By Gloria Essien, Abuja
Universal Health Coverage (UHC), involves the provision of accessible and affordable healthcare services to the poorest and the most vulnerable population in a country.
According to the World Health Organisation (WHO), UHC is the organisation of healthcare systems in a way that provides a specific healthcare benefit package to all members of a defined population, through provision of financial risk protection in the course of accessing necessary healthcare services.
UHC is the major target of the world’s Sustainable Development Goals (SDG). The United Nations General Assembly in 2015 set the year 2030 for the global attainment of UHC.
The Nigerian government hit the ground running with a robust plan on how to achieve UHC by improving services at primary healthcare centres across the country through the National Primary Health Care Development Agency (NPHCDA). This led to the revitalisation of ten thousand primary healthcare centres across Nigeria for easy access to healthcare services.
The NPHCDA in a bid to ensure that Nigeria meets the 2030 target developed a document to improve the primary healthcare services in Nigeria for the next four years and another plan for the next 10 years.
The document provided updates on the progress across the agency’s key cardinal areas of focus in the last four years which includes up-scaling routine immunisation and the fight to end polio. The document also gives insight on plans for strengthening PHCs towards achieving UHC in a post-polio and post-Covid-19 era.
The Chief Executive Officer of the NPHCDA, Dr Faisal Shuaib who released the document in Abuja recently said the achievements, successes and lessons learned from the challenges encountered over the last four years have provided a foundation for driving the strategic 10-year roadmap for strengthening the Primary Healthcare System.
Going by the agency’s blueprint, a Primary Health Centre should have at least one or more doctors, a pharmacist, a staff nurse and other paramedical support staff and community health workers. It should also be well-equipped for deliveries, immunisation, preventive and basic curative care, coupled with an ambulance for referrals.
All these initiatives had facilitated Nigeria’s drive towards attaining UHC but for the advent of the dreaded Corona virus disease which caused a major setback to the system.
According to the 2020 Goalkeeper’s Report by the Bill and Melinda Gates Foundation, which is an annual scorecard on the world’s progress towards achieving global goals, says many low and middle-income countries (especially in Africa), who are lagging in the quest for UHC due to gender and geographical inequities, will now face a daunting task due to the impact of Covid-19.
Over nine months into Covid-19 outbreak in Nigeria, there are concerns about how well the country managed the pandemic and how it might affect the country’s ability to manage other equally deadly diseases in the future.
The Covid-19 pandemic caught the healthcare systems of many countries napping. Most countries across the world, including developed ones were ill prepared for the pandemic. The devastation Covid-19 brought on mankind was the repercussion for the years of neglect of the health sector by governments across the globe.
The pandemic has however reawakened the consciousness of governments around the world of the need for vibrant, viable, purposeful and resilient healthcare system designed to deliver quality healthcare services to all the residents of their countries at the best cost all year round.
At the inception of UHC Nigeria’s main strategic mechanism to achieve the programme was through her National Health Insurance Scheme (NHIS), which is a contributory social insurance health scheme.
Regrettably, since the formal launch of NHIS on June 6, 2005, less than five percent of Nigeria’s population has been covered by the scheme. Most enrolees are in the formal sector with very poor coverage of the informal sector. Successive governments at the federal state and local levels have not demonstrated appreciable commitment to the success of NHIS.
Governments at all levels, particularly states and local governments must take practical steps to encourage enrolment of their employees and the informal sector into the NHIS. The Federal Government should also embark on deliberate efforts to get the NHIS to scale up the number of enrolees in the informal sector.
It is gratifying to note however that President Muhammadu Buhari laid a solid foundation of which if properly implemented will fast-track the attainment of UHC.
On assumption of office, President Buhari signed the National Health Bill into Law. The National Health Act (NHA) is a viable framework, the implementation of which is to fast-track progress towards UHC. The Act sets the background to earmark adequate public resources to health towards strengthening primary healthcare through the Basic Healthcare Provision Fund BHCPF.
In order to be able to achieve the UHC in Nigeria, government must commit more funds to the programme. The Basic Healthcare Provision Fund, BHCPF is the healthcare financing programme under the National Health Act with the mandate to provide quality healthcare service to all Nigerians, especially the poor and vulnerable.
If adequately funded, the BHCPF will serve as a significant catalyst for achieving the UHC in Nigeria, especially in a post Covid-19 pandemic era.