"My name is Amos Nathan, I am making a creative statement, vote for health Naija"
When Mr. Nathan made this statement, just outside the Federal Medical Centre, Yenagoa in Bayelsa State, people around him burst into laughter, possibly because of the frankness of his comment. Having spoken his mind, he walked away oblivious of the people murmuring around him.
Outside the very busy Ipata Market in Ilorin, Kwara State, 75-year-old security man, Kayode Alade said in Yoruba language, "Thank you for this opportunity to tell you some of the things that matter to me the most especially when it comes to health. We have never been given that opportunity before."
In Hausa language, an elderly woman said, "To be honest healthcare is a very key issue especially with children and pregnant women, diabetes and hypertension." She was interviewed in Kano State.
The Nigeria Health Watch team travelled to eight states across all the geo-political zones in Nigeria, in October 2018 in a bid to understand the voting priorities of Nigerians. The following states were visited (Bayelsa, Ebonyi, Lagos, Kwara, Osun, Sokoto, Kano, Gombe and the Federal Capital Territory). There was no mention of people's political party affiliations during the interviews. Specifically, the team wanted to understand if Nigerians considered the health agenda of political aspirants when deciding who to vote for. However, the team sought to find out first what issues informed their voting priorities and how important these issues were to them when they were making voting decisions.
Respondents targeted a range of respondents, parents (outside schools), blue collar workers, traders (in markets), students (at educational institutions), healthcare workers and civil servants. The following questions were asked;
What areas do you consider important and want the new administration (federal & state) to improve on when they come into power in 2019?
Which one of these areas would you want the government to focus on the most?
Do you consider healthcare plans of aspirants when deciding who to vote for?
What are the top health issues that matter most to you?
What questions about health would you ask a political aspirant who seeks your vote
Responses varied across the different states visited and highlighted differences in voting priorities. Many respondents from the south east were concerned about good roads, electricity and jobs while their counterparts in south-south of Nigeria and the north were concerned about security. However, a recurring theme was healthcare, as a majority of respondents alluded to the fact that without a healthy society, most of the other issues they mentioned would be meaningless. The respondents cited different choices when asked about specific areas of healthcare they felt should be improved. Strengthening primary healthcare, protecting people against out of pocket spending, maternal and child health were all prominent concerns.
Numbers don't lie: Evidence for health planning
As stated by Mr. Alade, it is very important to give citizens the opportunity to share the issues that matter the most to them and highlights the need for political aspirants to actively engage with their constituents and the wider Nigerian public. In this way, political aspirants would be better able to prioritise the issues they tackle accordingly, should they be successful in their bid for a political office. In this way also, they can better address the challenges that really matter to Nigerians.
Nigeria Health Watch in collaboration with NOIPolls conducted a survey in October 2018, in order to find out the voting priorities of Nigerians in the run-up to the 2019 elections. The results revealed that 86% of respondents polled mentioned health as one of the issues that mattered the most to them. Next in priority was education and agriculture. A large proportion (81%) of those polled stated that they will consider the health agenda of political aspirants before voting in the 2019 elections. On the question of whether health has been given sufficient attention during political debates, 66% of respondents felt that health has not been given enough priority in political debates. Nigerians are not very confident in the healthcare system, this was highlighted by the fact that only 26% of those surveyed were very confident in the Nigerian healthcare system, versus 44% who were not confident in the Nigeria health system.
Disaggregating the data showed that 90% of respondents between the ages of 18-35 and 80% of respondents between the ages of 36-60 consider health as an extremely important issue when deciding who to vote for in 2019 elections. Free medical treatment for all and free medical care for children were highlighted as top issues on the list of the most attractive health promises they wanted to see delivered by political aspirants.
How do you take the next steps?
Someone asked, "so how do I vote for health Naija?"
The goal of the #Vote4HealthNaija campaign is to help Nigerians understand that everyone has a right to quality healthcare, we must demand that leaders priortise our health and they are held accountable for the promises they make in healthcare delivery. It aims to provide a guide for them to know and ask the right questions of those who seek their votes during elections. It empowers the public to be more critical and demand that aspirants not only make promises but also share strategies on how to realise these promises.
But above all, the responses from the poll provide evidence for health planning for political leaders. The expectations highlighted by the respondents is a representation of what Nigerians want and should be aligned with existing roadmaps and strategic policy documents to improve health for Nigerians. Free medical treatment for instance is in line with the push for Universal health coverage and is a priority issue for Nigerians, according to the poll . The drive for Universal health coverage is to ensure that all people have access to quality and affordable healthcare, without having to suffer financial hardship. It was clear from respondents that they wanted financial risk protection, especially those in the informal sector.
The race to meet global development targets in health is unrelenting, such meeting the target to achieve the Sustainable Development Goals by 2030. While we celebrate important milestones and successes, we must use every opportunity to keep building momentum and the elections is one of such opportunities.
So, we at Nigeria Health Watch join Mr Nathan, Mr Alade and all the respondents we interviewed across the country to urge all Nigerians to #Vote4HealthNaija in the 2019 general elections so that health is pushed up the agenda of political aspirants.