A coalition of not-for-profit organisations has called for increased investment in healthcare services and greater inclusion of youth in decision making around the basic health system to help them overcome entrenched marginalisation.
This was the thrust of a dialogue hosted by Nigerian Youth Champions for Universal Health Coverage (NYC4UHC), FindMyMethod and other partners in Abuja in commemoration of the Universal Health Coverage Day, a global celebration which holds on December 12 of every year.
The Universal Health Coverage is part of the United Nations Sustainable Development Goals 2030 which requires that all individuals and communities receive the health services they need without suffering financial hardship.
This includes the full spectrum of essential, quality health services, from health promotion to prevention, treatment, rehabilitation, and palliative care, according to the World Health Organisation.
Nigeria finances its public health service through a national insurance scheme but stakeholders believe the health sector is overly underfunded.
For participants in the dialogue who were mostly youth, the poor funding of the health sector had consistently left the country at the brink of collapse which was made evident when the coronavirus pandemic struck earlier in the year.
Nigeria’s annual allocations to health have been persistently below 5 per cent of the whole budget, a review of the country’s budget in the last five years has shown.
This is against the Abuja Declaration of committing at least 15 per cent of the yearly national budget to healthcare by African leaders in April 2001, following the widespread shortfall in the budget for health.
In 2019, the World Health Organisation rated Nigeria as one of the worst in healthcare delivery records globally, with a ranking of 187th out of 191 countries.
The Chairperson, Nigerian Youth Champions for Universal Health Coverage, Oyeyemi Pitan, said investing in the country’s health system must be government’s top priority following its apparent failure at ensuring quality health services during the ravaging pandemic.
“Nearly one year after the first COVID-19 case was reported in Nigeria, the message is clear: we must invest in health systems that protect everyone, now,” Oyeyemi said.
Despite the creation of the Basic Health Care Provision Fund (BHCPF) to strengthen Primary Health Centre (PHC) infrastructure, Oyeyemi said the country’s health situation was dire during the COVID-19 emergency.
The BHCPF was established to increase the fiscal space for health, strengthen the national health system, particularly at PHC level, and ensure access to care for Nigerians, especially the poor and vulnerable (women and adolescents) as well as contribute to overall national productivity, according to the Minister of Health, Dr Osagie Ehanire, in a statement in August.
“Because of weak PHC systems, child mortality rates are high (about 132 children die per 1,000 live births), children still die from preventable diseases like pneumonia and malaria killing about 24,000 people and contributing to an estimated 11 per cent of maternal mortality,” Oyeyemi said.
For Ms Pelumi Alesinloye-King, the Country Consultant of Find My Method, a digital platform that provides contraception information services for young people, the challenges bedevilling Nigeria’s healthcare system, especially in the area of sexual and reproductive health, go beyond the problem of financing.
Poor policy formulations and bad legislation on safe abortion practice may be responsible for the increased maternal mortality rate in Nigeria, Alesinloye-King observed.
“Our chart on maternal mortality rate is ranked. It will interest you to know that most of these deaths arise from unsafe abortion since it is not legalised in Nigeria.
“But currently in Nigeria, the laws around abortion say abortion is only legal if it is to save the life of the woman. As long as it is being criminalised, it means people still go for unsafe abortions out of retribution, that’s why we have more maternal deaths,” she said.
She also noted that there was a highly unmet need for modern contraception, adding that Nigeria was falling behind the 27 per cent commitment it agreed to.
Assessing Nigeria’s management of the reproductive healthcare system during the current pandemic, she said the pandemic had shown how poorly managed the system was.
“There was no water in some health centres and hospitals for women and adolescent girls. They were asked to get their own water to clean up themselves in some health centres. In some states like Ondo, hospitals were on strike and little attention was paid to the women and adolescent girls,” Alesinloye-King said.
She urged the government to work on policies and laws that would deliver quality reproductive healthcare services for women and adolescents.
Also, the programme officer, Education as a Vaccine, Ikenna Ugwumba, advocated the inclusion of the youth in decision making bodies on health issues set up by the government.
Ugwumba said that faulty policies were designed because the Nigerian society often did not consider the perspectives of young people.
“The Nigerian youth need to be at the decision-making table so that they can better bring their conditions to the forefront and design a way out of dealing with them.
“They have to be part of the process and being seen as technical partners,” he said, and expressed concern that no youth was on the Presidential Task Force on COVID-19.
Meanwhile, a representative Of the Ministry of Health, Amina Muhammad, agreed that investment in youth and the healthcare system would galvanise the smooth running of the country.
Other demands
The coalition demanded inclusion of adolescents and young people as beneficiaries of the BHCPF and full implementation of health policies across all states.
They asked that 2 per cent of the Consolidated Revenue Fund for Universal Health Coverage be allocated in the 2021 budget with effective strategies for its actualisation.
They called for a sensitisation programme for the public on the implementation of the Basic Healthcare Provision Fund.
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