Nigeria: Improving Funding for Effective Health Coverage

Regional collaborations can reduce costs and make life-saving care more widely available, in the quest to achieve the UN Sustainable Development Goal #3 - "ensure healthy lives and promote well-being for all at all ages".
3 September 2019

As health financing remains a major concern in Nigeria, stakeholders in the health sector have stressed the need for government to consider implementation of the 15 percent budget recommendation by the World Health Organisation ( WHO).

The stakeholders said implementation of this will help the country achieve Universal Health Coverage (UHC), which according to WHO, means health coverage for all, without discrimination and leaving no one behind.

The WHO also stressed that everyone everywhere has a right to benefit from health services that they need without falling into poverty when using them.

The Sustainable Development Goal 3:8 targets achievement of 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.

However, four years after committing to this, about 90 per cent of Nigeria's population still pay Out-of-Pocket (OPP) to access healthcare services.

Reacting to this, the President, Nigeria Medical Association ( NMA), Dr. Fracis Faduyile, said health financing has a lot to do with patients accessing healthcare in their different hospital.

According to him, what is mostly practiced in Nigeria is out of pocket financing for health, lamenting that the practice cannot improve the health of the patients.

"Unfortunately, National Health Insurance Scheme that we have established to work on this has been ineffective because up till now since 2014, we have not had up to five per cent enrollment level. That is very poor and very pathetic situation," said Dr Faduyile.

He therefore recommended that more people should be enrolled into the health insurance scheme and that different state governments should establish their own health insurance scheme. This he said was necessary as most of the people in the scheme are the civil servants.

"The informal sector needs community basic health insurance scheme and we need private people to join in the scheme. It is when we have this that we can have enough funding for health and it can be used to purchase equipment for health and doctors so that health practitioners who are seeing patients will not be under pressure. It is on this note that we expect proper health financing for health and it is also on this that we can achieve universal healthcare," he explained.

The President, however, commended the government for the one per cent consolidated revenue fund budgeted for health but said although N55billion have been released, up till now, no single state has accessed that fund because all that is needed to access that fund have not been complied with.

Also, the Chairman, FCT NMA, Dr. Philips Ekpe, said obviously, one of the biggest challenges is that in budget for health, the recommendation of WHO is 15 per cent but the highest Nigeria has done is about 8.6 per cent and that was in 2016.

According to him, health in the country is mostly funded by the government. They are not looking for other ways. NHIS in the country has not really worked being controlled seriously by the government.

"We have the one per cent consolidated revenue fund, that is the only thing that has been done and the signing of the National health Act," he said.

He suggested that government should make Universal Health Coverage (UHC) compulsory so that people in both formal and informal sector will be enrolled into it.

He also called for private sector involvement in health financing while accusing state governments of diverting health funds.

Also lamenting poor health funding in the country, the Founder, Smile with me Foundation, Dr. Chioma Nwakanma, said the 2019 health budget is really pitiable as only N351.63 billion was budgeted for health.

According to her, "15 per cent of the national budget was meant for health in the 2019 budget but only 3.9 per cent was budgeted for health. With this, we are not ready or prepared for the next epidemic."

However, the federal government has expressed its commitment to working with state governments and investing in the health sector towards quality healthcare services with a view to achieving UHC.

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