• Commits $2m to Nigeria’s basic healthcare fund

The Bill and Melinda Gates Foundation have upbraided federal government’s funding of healthcare system in the country urging that more resources be channelled to the tertiary and secondary health levels.

While annual healthcare provision for an individual in the United States is $10,000, it is a mere $6 in Nigeria. Only four percent of Nigeria’s budget is designated for health.

Speaking through its Nigeria Country Officer, Dr Paulin Basinga, the foundation noted that though the 2014 National Health Act requires one per cent of the nation’s consolidated revenue to be channelled toward basic healthcare provision fund that would guarantee access to health by all, the policy has not been implemented.

He said there was need to build a stronger PHC system in the country to ensure preventive and curative measures of diseases at the community levels.

Dr Basinga then urged government to make strategic legislations towards funding Universal Health Coverage (UHC).

“Through this legislation, funding priority will be geared toward revitalisation of primary healthcare system thereby reducing the nation’s disease burden and death rate. If the nation has strong primary healthcare system, the health needs of 90 per cent of Nigerians will be addressed.”

Basinga in the meantime disclosed that the foundation has committed two million dollars to Nigerian’s Basic Health Care Provision Funds to fast-track implementation by the government toward the realisation of UHC.

He made the disclosure on Wednesday in Abuja during a visit by officials of the National Institute for Policy and Strategic Studies (NIPSS).The group made a study tour on the foundation and Development Research and Project Centre (dRPC) which is under the Partnership for Advocacy in Child and Family Health (PACFaH) @scale project.

The money according to Basinga was donated as a strategy that would allow money to flow from the Central Bank of Nigeria (CBN) account down to primary health care facilities.

He further noted that the organisation has signed a Memorandum of Understanding (MoU) with the government to enable it meet its commitment of buying vaccines among other consumables that would drive UHC.

Likewise, he identified funding as a major gap in the realisation of UHC.

 “We are excited in this journey toward UHC and we have been stirring the government to build a stronger PHC system through improved funding among others so that the UHC can be a reality,’’ he said.

Basinga identified the six building blocks of UHC as financing, facilities, human resources, commodities, religious and community leaders as well as data.

He emphasised that in order to drive UHC there was need for facilities to be situated in places where they can easily be accessed by all the pregnant women and children, among others, without hitches.

Moreover, he emphasised, the commodity must be readily available at all times; like the test kits and treatment for malaria and typhoid, among other diseases.

Stressing that the capacity of health workers at health facilities must be built to adequately meet the health needs of the populace, he also called for collaborative efforts by philanthropists, civil society organisations, individuals and policy makers to ensure realisation of UHC to guaranty accessible, affordable and quality healthcare services for all irrespective of status.

• Says Nigeria loses over N400 billion annually

By Lillian Okenwa

Many were left in shock when President Mohammadu Buhari said last week that his government’s inability to address various health challenges has resulted in increasing medical tourism in which Nigeria loses over N400 billion on annual bases. 

He made this disclosure last Thursday during the inauguration of Senior Executive Course 41, 2019 of the National Institute for Policy and Strategic Studies Kuru, Plateau State with the theme “Funding Universal Health Care Delivery in Nigeria.”

The President posited that his government has shown strong commitment in the revitalization of the health sector adding that in spite of this, the sector was still characterized by low response to public health emergencies, inability to combat an outbreak of deadly diseases and mass migration of medical personnel out of the country.

“Government has shown strong commitment in the revitalization of the health sector. These efforts notwithstanding, our health sector is still characterized by low response to the public health emergencies, inability to combat the outbreak of deadly diseases and mass migration of medical personnel out of the country. This has resulted in increasing medical tourism by Nigerians in which Nigeria loses N400 billion on an annual basis,” he said.

President Buhari who was represented by Governor Simon Lalong of Plateau State said his government had in January this year flagged off Primary Healthcare Revitalisation Programme with the aim of having 10,000 functional primary healthcare facilities with at least one functional healthcare facility in every political ward across the country.

Coming from a president who spent all his medical vacations in Europe in the last four years, several minds were agitated as to what exactly he was talking about.

Judge Egbas of Pulse Nigeria, chronicles his odyssey.J

“Here’s a timeline of Buhari’s health travels.

February 5, 2016

Buhari embarks on a six-day medical vacation to London.

June 6, 2016

Buhari takes to the skies for a 10-day medical vacation.

Presidency says Buhari has to travel to deal with a ‘persistent ear infection.’

January 19, 2017

Buhari is off to London again on a medical vacation.

February 5, 2017

Buhari writes the national assembly, asks lawmakers to extend his London medical leave.

March 10, 2017

Buhari returns to Nigeria but doesn’t resume work immediately. Presidency says ‘he’s working from home.’

May 7, 2017

Buhari embarks on trip to London for another medical vacation. He returns after 104 days.

August 19, 2017

Buhari returns to Nigeria and it takes him a while to resume work because rats have reportedly damaged furniture in his office.

Presidency announces he’ll be working from home.

May 8, 2018

Buhari is off to London for ‘medical review’—another name for a medical vacation.

It is his 5th medical trip since he was inaugurated president on May 29, 2015.”

In April 2016, Buhari reportedly told the nation that he does not favour medical tourism and that he would not encourage the political class to do so.

“While this administration will not deny anyone of his or her fundamental human rights, we will certainly not encourage expending Nigerian hard-earned resources on any government official seeking medical care abroad, when such can be handled in Nigeria”, Buhari said, according to a statement from the Health Ministry at the time.

More worrisome is that Prof. Isaac Adewole, Nigeria’s health minister after close to four years in office can hardly lay claim to any significant impact on the country’s health sector. In the last few years, various medical unions, including the Nigerian Medical Association, which he belongs to, raised questions about his effectiveness in office.

Within the last four years, all federal government health institutions in Nigeria including federal medical centres, specialists’ hospitals, orthopedic hospitals, psychiatric hospitals among others at various times had to shut down due to industrial action while the president visited United Kingdom for his health care.

On the website of the Federal Ministry of Health, there is a list of 44 tertiary health facilities comprising 20 teaching hospitals and 24 federal medical centres, a number of which should have been able to handle the President’s condition but these medical establishments have remained in critical states of despair.

It was even widely reported that budgetary allocations to all these facilities were dwarfed by the provisions made for the Aso Rock Clinic (State House clinic).

In October 2017, the president’s wife, Mrs. Aisha Buhari caused a stir when she said the Aso Rock Clinic could not boast of a syringe despite huge allocations made to it. She related that when she was sick, she was advised to travel abroad because of the poor state of the clinic, adding that she had to go to a private hospital owned by foreigners when told that the x-ray machine in the State House Clinic was not functioning.

The question is, what has happened to the implementation of the National Health Bill, 2014 for example? How much has been achieved with the penetration of the National Health Insurance Scheme and the expansion of the programme to include ordinary Nigerians? What are the plans of this government to improve Nigerians’ access to health information as an important ingredient for preventive care?

Another nagging issue is the welfare and conditions of service for medical personnel in the country.

It was wildly reported that last month, hundreds of Nigerian doctors gathered at a hotel in Abuja, and Lagos, for an exam conducted by the Saudi Arabian health ministry.

Reports also disclosed that weeks before the attempt by Saudi Arabia to entice Nigeria’s medical best, dozens had sat for the regular Professional Linguistic Assessments Board (PLAB) exams at the British Council. Scaling through this test will enable them to work in the UK.

Over the last few years, about 2,000 doctors have left Nigeria blaming the mass exodus on poor working conditions.  While the annual healthcare provision for an individual in the US is $10,000, in Nigeria it is a paltry $6. Merely four percent of Nigeria’s budget is designated for health.

Sadly, four years into the Buhari administration, poor primary, secondary and tertiary healthcare services/facilities have bedeviled the country.

These challenges were meant to have been effectually tackled if the government had delivered on its promise to bring healthcare delivery closer to the people. This was meant to be achieved with the rejuvenation of 10,000 primary health care centres across the country. The minister of health, a professor of medicine, had emphasised that resuscitating primary healthcare was one of the top priorities of the government. This is still being awaited.

In 2017 while inaugurating the Model Primary Health Care Centre for Universal Health Coverage in Nigeria at Kuchigoro Primary Health Centre, Abuja the president assured that Federal Government will continue to ensure more Nigerians have access to quality basic health care services. He expressed hope that the provision of quality health care service would reverse the poor health indices in the country, noting that his administration would fulfill all its promises made to the people.

Yet, many primary healthcare centres across the country are still dire straits. Today, a state of public health concern has been declared as nearly 2,300 children under five die daily and about 145 women also die daily in Nigeria from pregnancy and childbirth related matters. Most pregnant women still use the services of traditional birth attendants for delivery.

Strangely, the Minister of Budget and National Planning, Sen. Udoma Udoma said President Buhari’s administration places very high value on improving health care delivery and social welfare of Nigerians. Speaking at the opening of the ‘Value for Money in Health Sector Workshop’, Udoma said Buhari’s administration was prioritising health related expenditures in all the national budgets.

“As we are able to demonstrate and show improved healthcare outcomes for the money we are currently spending, government at all levels will be encouraged to further increase funding to the health sector,” the minister said.

…as the nation declares state of emergency on maternal and child deaths

By Lillian Okenwa

A state of public health concern has been declared on maternal, new born and child deaths as nearly 2,300 children under five die daily and about 145 women die day-to-day in Nigeria from pregnancy and childbirth related matters.

The Executive Director, National Primary Health Care Development Agency (NPHCDA), Dr Faisal Shuaib who made this disclosure in Abuja on Monday raised urgent concerns about these deaths occurring at primary health care (PHC) and community levels. 

Expressing concern while presenting the agency’s strategic approach to rapidly reduce maternal and child mortality at community levels, he likened the 145 daily maternal deaths to having a fully loaded Boeing 737-300 airplane, with 145 women crashing every single day in Nigeria, killing everyone on board.

“Every day in Nigeria, approximately 145 women die from preventable causes related to pregnancy and childbirth, this is equivalent to having 1 Boeing 737-300 series airplane, fully loaded with 145 women crashing every single day in Nigeria, killing everyone on board.

“Every day in Nigeria, approximately 2,300 children under five years die mainly from preventable causes. Similarly, this is equivalent to having 15 Boeing 737-300 series airplanes fully loaded with 145 children under five years old, crashing every single day in Nigeria and killing all the children on board.

“One out of every eight Nigerian children dies before having a chance to celebrate his or her 5th birthday.

“Having noted the high rate of maternal, new born and under-five child mortality and the insufficiency of our efforts to reverse the trend, I hereby declare a state of public health concern on maternal, new born and child deaths occurring at the primary health care (PHC) and community levels.”

Meanwhile, Section 33 of the 1999 Constitution (amended) adequately provided for the right to life. This provision clearly states that every person has a right to life and no one shall be deprived intentionally of his life, save in execution of the sentence of a court in respect of a criminal offence of which he has been found.

Many Nigerians are however left in a quandary since government has not taken sufficient care to provide basic health care to keep them alive in spite of clear constitutional provisions.

Shuaib said the establishment of a National Coordination Centre within the NPHCDA to provide oversight on Reproductive, Maternal, Neonatal, Child, Adolescent Health plus Nutrition (RMNCAH+N) activities at PHC level, would help tackle the challenge of preventable deaths.