â€˜Why Poor Health Indices Persistâ€™

Posted on: Tue 12-01-2016

Lawal Abubakar is the Chairman of Health Reform Foundation of Nigeria (HERFON), Kaduna State Chapter. In this interview, he gave reasons for the prevailing poor health indices in Nigeria. He also spoke on the imperative of the Universal Health Coverage among other issues.

HERFON has been a strong advocate of good health cover for all and recently the world celebrated the Universal Health Coverage day. What does health coverage entails? Universal Health Coverage means that all people can use the preventive, curative, rehabilitative and palliative health services they need, by ensuring that the use of these services does not expose the user to financial hardship. In essence, universal health coverage means not only those who can pay but those who need healthcare services should get them; that the quality of health services is good enough to improve the health of those receiving the services; and ensuring that the cost of using healthcare services does not put people at risk of financial hardship. The theme of this year’s Universal Health Coverage day was ‘Health for All’ and aptly captures the aspirations enshrined in the Sustainable Development Goals of ‘leaving no one behind’. The Goal 3 of the Sustainable Development Goals (SDGs), which is to ‘Ensure healthy lives and promote well-being for all at all ages’ incorporates the specific target for Universal Health Coverage: “Achieve Universal Health Coverage, including financial risk protection, access to quality essential health care services and access to safe, effective, quality and affordable essential medicines and vaccines for all”.

At the United Nations General Assembly held in New York in September 2015, President Muhammadu Buhari specifically pledged Nigeria’s commitment to strengthen mechanisms for the implementation of the Sustainable Development Goals SDGs in Nigeria, which includes Universal Health Coverage.

Nigeria is ranked one of the fastest growing economies in world. Does this growth reflect in the health system? We are all aware that Nigeria is ranked as one of the fastest growing economies in the world with growth rate of 6.21 percent in 2014 from 5.65 in 2008. Recently in 2014, the country’s Gross Domestic Product (GDP) was rebased, making it the largest economy in Africa, with a GDP of US $510 billion. Sadly, the country’s health system has long been blighted and reflected by negative health indices hardly coming to near international standards. 2015 data from the World Health Organization (WHO) showed that the life expectancy at birth of 54 years is below the Sub-Saharan Africa’s average of 56 years. The recent WHO maternal mortality report (1990 to 2015) showed that Nigeria’s maternal mortality ratio stood at 814 per 100,000 live births, with only a reduction of 39.7% within 15 years, which is lower than the 75% MDG 2015 target. Infant mortality rate is 39 in every 1,000 live births and under-five mortality rate is 89 in every 1,000 live births.

Are you saying that there are prevailing poor health indices in Nigeria? Yes. But the poor health indices in Nigeria are unequal between the geo-political zones of the country, with states in the Northern zones worse hit. The National Bureau of Statistics (NBS) MDGs performance tracking 2015 report has shown that, although the national average of Under-5 mortality rate was 89 deaths per 1,000 live births, Kaduna State recorded 167, which is worse than Katsina State that recorded 155 deaths per 1,000 live births. The NBS 2013 Statistical Report of Women and Men in Nigeria also showed geographical disparity in life expectancy at birth, with Kaduna State recording 48 years which is lower than Kano State that recorded 52 years. Reasons for these abysmal statistics are multifaceted. One key factor is the country’s poor budgetary allocation to health, which has in the past years hovered around 5-6 percent of total annual budget, and falls short of the 15% expected of a developing country in order to achieve the World Health Organization’s recommendation for optimum health coverage by 2015. Also, majority of Nigerians fund their health care out-of-pocket. This means directly paying for medical consultation, drugs and other health related procedures. This huge personal commitment has severe implications on personal finance and may force people to reduce spending on food and other basic and important health care needs.

What is your health projection for 2016? This year it is imperative we recognize and proactively tackle the barriers to Universal Health Coverage identified by experts which include weak Primary Health Care (PHC) system, high out of pocket payments, inadequate and motivated health workforce, among others. If these potential barriers and challenges are not addressed through strong political commitment by government and policy makers, the path towards achieving Universal Health Coverage may experience avoidable snags and delays; thus denying Nigerians the right to quality health care and protection from unnecessary financial risks. So, the members of HERFON in the 36 state branches and FCT Abuja, in solidarity with civil society organizations and advocates of Universal Health Coverage in Nigeria and across the globe wish to call for concerted efforts and deliberate actions by the Federal and state governments and partners within and outside the health sector to accelerate progress towards achieving Universal Health Coverage in Nigeria.

As the chairman of the Kaduna State Chapter of HERFON, how will you assess Governor Nasir el-Rufai’s government in terms of his commitment to the health sector? In this era of change in our consciousness and shift towards accountable government with the active participation and engagement of the citizens in governance, we are confident that the present government in Kaduna state, under the leadership of Malam Nasir Ahmed El-Rufai has not only developed the right policies and plans for achieving Universal Health Coverage for the citizens of Kaduna State, but will assiduously work towards strengthening and repositioning the weak health system to deliver quality, accessible, equitable and affordable health services to all the people of the state, and ultimately improving the poor health indices. However, we are specifically urging him to adopt and domesticate the 2014 National Health Act and set-up machinery for the implementation of the key provisions of the Act in order to re-organize the state health system to become more patient-centered. It is imperative to also establish a State-Supported Health Insurance Scheme (SSHIS) and its agency, in order to reduce high level of out-of-pocket expenses and promote higher level of financial risk protection.

By: Dickson S. Adama,

Daily Trust News

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