"What would you like the government to improve after the elections in 2019?"
Abdulkareem gave a wry smile, pondering the question, his eyes fixed on the road as he made his way through the after-work traffic on Airport Road.
A seasoned Abuja taxi driver, after a moment, he replied.
"Abeg leave that one, we both know they will do what they want," he said.
"But what do you want?"
His look turned serious. "I want them to make my business easier. All these people that extort money from us should be removed from the roads," he replied.
"Okay, I understand that this is your business and your source of income. But after that, what else would you want them to fix?"
"Nothing else, they should just make my business easier," he mused and concentrated on his driving.
To Chijioke, a scientist at a diagnostic firm in Lagos, "Priorities differ according to states and their unique needs. For my state, I would say good and durable roads. If I say standard education, quality health care or jobs, how can one gain access to them?"
Obaseosuwake, an educator with a nonprofit organization that is working towards ensuring that the unreached and out-of-school children are reached with quality basic education, said "I want the government to put in place policies that will ensure every child, especially in rural areas, has access to excellent basic education. This should also include retraining of government teachers. Secondly, I want the government to focus on improving the quality of health care in health centers in the rural areas so women and children can access quality health services in these areas."
These three conversations reflect the kind of responses you get when you ask Nigerians their expectations for the government that comes into office after the 2019 elections. Understandably, in a country like Nigeria, people have many competing priorities in dire need of government's attention, but conversations like these reveal what truly feels important to people.
Economic progress, a fitting educational system, road infrastructure, and a reduction in the country's unemployment rate, are all important. But focusing on them and ignoring healthcare is counterproductive as they are closely linked. A healthy population is more economically productive; and children who are immunised, well fed and receive good basic healthcare perform better at school. If a community has access to good roads but experiences a disease outbreak that kills 80% of the residents, who will use the roads? In a recent Nigeria Health Watch breakfast dialogue with stakeholders and fellow commissioners, Dr. Jide Idris, the Lagos State Commissioner for Health, asked: "What is the point in building roads and bridges when the people to use them are dying?" Every Nigerian should have this question at the back of their minds as the momentum builds for the 2019 elections.
At the Future of Health Conference in 2015, Dr. Olaokun Soyinka fresh after his four-year tenure as Commissioner for Health in Ogun State, said that Nigerians always blame God for poor health outcomes instead of the people whose mandate it is to provide efficient health services to them. The National Health Service (NHS) in the United Kingdom (UK) is a good example of the impact of a government which understands the role of a healthy workforce in sustainable economic development Established 70 years ago, just after World War II during which the UK's infrastructure was badly damaged., it was the result of a dogged vision. Most governments would have focused simply on rebuilding their infrastructure, but on July 5, 1948, the NHS was launched by Aneurin Bevan the Health Secretary who saw the need for citizens to access free healthcare despite the poor economic situation of the country. For the first time, in the UK, doctors, nurses, pharmacists, opticians, and dentists were brought together under one umbrella to provide free healthcare services at different delivery points. Bevan's vision was far-reaching, and Dr. Idris noted in his talk that vision is crucial for an effective health sector, in addition to passion and good governance.
Nigeria became independent 12 years after the NHS was launched and today, we celebrate our 58th year as an independent nation. Successive administrations have had nearly six decades to work towards improving the life of all Nigerians. As Nigeria enters another round of election campaigns to usher in an administration to run the country for the next 4 years, citizens must examine the state of the nation with regard to healthcare. As a popular Hausa adage goes, "Lafiya Uwar Jiki," which means that health is the mother of the body.
There are certain pertinent questions that citizens should ask now, as the politicians prepare to campaign for votes they hope will launch them to power in 2019. As a Nigerian citizen, are you satisfied with the state of healthcare in our country? Is the primary health centre in your community functioning effectively? If not, what is your Senator, your House of Representatives Member, your Governor, doing about it? Can you access specialist care without having to raise funds to fly to another country? If you or your loved one were to fall ill, would you be able to pay for their care for the next six months? Do you have health insurance? Is healthcare affordable for you? Will it be affordable for your children?
An NOI Polls poll held before the 2015 elections revealed that political aspirants, political parties and what they see on the media are the factors that affect the voting behaviour of Nigerian voters, and not the agenda of the aspirants, their ideologies or the strategies they outline to improve the lives of Nigerians. If you take the time to read through the manifestos of the 67 parties listed on the INEC website running for elections in 2019, it would give you a clearer picture of the plans, or lack thereof, that most parties have to improve the Nigerian health sector.
So, as a Nigerian citizen, when next a political aspirant comes asking for your vote, tell them there are communities in your state that lack access to health care and ask about their evidence-based plans to provide for them. Tell them that families are thrown into poverty over high out of pocket payments for health and ask them what their plans are to remedy this. Tell them about that family member who died because they could not afford to travel to India for treatment and ask them how they plan to bring that help to you. Tell them about your hospitals where there is no power, no water and inadequate equipment. Tell them about your relative who died the last time health workers went on strike and ask them how they plan to tackle strike action. Tell them how rude the staff at your local clinic, health centre or hospital are, and how long you have to wait to be seen. Ask them how they are going to change these things. Remind them that your vote is your voice and that you plan to vote for your health in 2019.
It is time to move health to the forefront of Nigeria's political agenda. It is time to turn our focus as Nigerians to holding our leaders accountable to improve our health sector, ahead of the 2019 elections. It is time to #Vote4HealthNaija. As we did in 2015, here at Nigeria Health Watch, we will be supporting you through the #Vote4HealthNaija campaign and analysis.
#Vote4HealthNaija is a campaign whose goal is to get more Nigerians aware of the importance of health as a political issue ahead of the 2019 elections. We do not advocate for any political party. Regardless of who you vote for, ask your political aspirants what they plan to do for the health sector in your community, in your state, in Nigeria. Join the campaign by sharing how you intend to #Vote4HealthNaija on social media. Remember to tag us @nighealthwatch (Twitter), @nigeriahealthwatch (Facebook, Instagram). Let's put health at the forefront of the 2019 elections!