The minister of Health has also said that the provision of “universal health care is not complete without inclusiveness”. This inclusiveness in financial risk protection and equitable service delivery would ensure that every Nigerian, regardless of sector, tribe or creed should have access to publicly funded quality health care.
On August 21, President Muhammadu Buhari swore in a set of newly appointed ministers to serve in his cabinet. The appointment of Dr. Osagie Ehanire as the substantive minister of Health was followed with relief, as there had been not a little anxiety over who would be designated to steer the complexity of the Nigerian healthcare space.
Having served as Nigeria’s minister of state for Health between 2015 to 2019, where he worked closely with Professor Isaac Adewole, the former minister of Health, Dr. Ehanire is not an unfamiliar figure in Nigeria and is quite cognisant with the various nuances and challenges in the Nigerian health sector. An orthopaedic surgeon and Fellow of the West African College of Surgeons, the new minister of Health has over the last four years not shied away from engaging with a fair number of some of the myriad challenges prevalent in Nigeria.
In a courtesy visit paid him by the Society of Family Physicians in his capacity as minister of state for Health shortly before the dissolution of the 2015 – 2019 cabinet by President Buhari, Dr. Ehanire spoke on the importance of addressing social issues and providing social services as a route to economic growth and in particular highlighted the role of water, sanitation and hygiene, immunisation coverage, nutrition and health education in turning around Nigeria’s poor health indices. It was also reassuring to hear the then minister of state speak on the importance of addressing mental health conditions as “a global health problem greatly afflicting Nigerians”. In Nigeria, about 20–30 per cent of the population are said to suffer from mental disorders and placed against the backdrop of the country’s estimated population of over 200 million people, the mental health burden on the country is immense. Unfortunately, mental health disorders in Nigeria have received little attention with very low levels of awareness of the Nigerian public on mental health issues and high levels of stigma on individuals suffering from mental health disorders, their families and loved ones.
The staggeringly high amount of out-of-pocket payments (over 70 percent of the health care expenditure) that Nigerians routinely spend in order to gain access to health care services have over the years been an albatross that has stunted the nation’s growth.
The minister of Health has also said that the provision of “universal health care is not complete without inclusiveness”. This inclusiveness in financial risk protection and equitable service delivery would ensure that every Nigerian, regardless of sector, tribe or creed should have access to publicly funded quality health care. In a Nigeria HealthWatch-conducted survey, regular Nigerians were asked possible areas of focus for the minister. Health financing, strengthening of primary health care, medical brain drain, emergency services and functional blood banks were among the areas highlighted as key areas of focus for the ministry. The staggeringly high amount of out-of-pocket payments (over 70 percent of the health care expenditure) that Nigerians routinely spend in order to gain access to health care services have over the years been an albatross that has stunted the nation’s growth.
Robert Yates, an internationally recognised expert on universal health coverage (UHC) and progressive health financing, and head of the Centre on Global Health Security at Chatham House, following Dr Ehanire’s appointment, proffered that the minister should, “persuade Muhammadu Buhari to treble domestic tax financing for health.” The 2019 allocation to healthcare is 4.1 per cent of the national budget, falling far short of the 2001 Abuja Declaration commitment of 15 per cent of national budgets being earmarked to fund healthcare. With competing demands from critical areas such as national security, power and education, it is increasingly clearer innovative ways of raising domestic financing should be explored to sustainably increase the fiscal space available for health.
…the minister acknowledged the potential of a strong primary healthcare system in Nigeria to reduce the country’s disease burden by up to 50 per cent, with an expected outcome that would not only spell progress for the country but also greatly impact the global disease burden of which Nigeria contributes a significant proportion.
In his address at the legislative retreat for defining the Nigerian National Assembly’s health agenda, the minister acknowledged the potential of a strong primary healthcare system in Nigeria to reduce the country’s disease burden by up to 50 per cent, with an expected outcome that would not only spell progress for the country but also greatly impact the global disease burden of which Nigeria contributes a significant proportion.
As world leaders in health and global development gather in New York later this September at the United Nations High-Level Meeting on Universal Health Coverage, it would be interesting to note the commitments made by Nigeria towards universal health coverage. For the honourable minister, it is critical that the goal of affordable, universal healthcare is kept at the top of the agenda. By ensuring that the lives of every single Nigerian matter and no one is left behind, the country will have put in place another important building block to achieving the sustainable development goal of good health and wellbeing, which is the fulcrum for achievement of many of the other goals. These, of course, include no poverty, economic growth, zero hunger and reduced inequalities. After all, to quote Dr. Ifeanyi Nsofor, the 2018 Aspen New Voices Fellow, in his TEDX talk with the same title, “without health, we have nothing”. The good health and wellbeing of over 200 million Nigerians and the country’s economic prosperity will, to a large extent, depend on that focus.
Adaeze Oreh, a family physician and public health expert, is a 2019 Aspen New Voices Fellow.
