Understanding Health Funding Mechanisms In National Health Act

THERE was a sigh of relief in many quarters   in December last year when President Goodluck Jonathan signed   the decade-old National Health Bill into law, thus making   the bill an Act. 

 The Act seeks “to provide a framework for the regulation, development and management of a national health system and set standards for rendering health services in the federation, and other matters connected therewith.” 

   One great feature that makes   the Act laudable is its provision for healthcare financing, through Basic Health Care Provision Fund. The fund is to be sourced   from the one per cent of the Federal Government Annual Grant, grants by international donors, and any other source.  While 50 per cent of the fund is expected be used for the provision of basic minimum package of health services to citizens, in eligible primary and secondary health care facilities through the National Health Insurance Scheme (NHIS), 20 per cent of it is expected be used to provide essential drugs, vaccines and consumables for eligible primary health care facilities. 

  On the on other hand, 15 per cent will be used for the provision and maintenance of facilities, equipment and transport for eligible primary healthcare facilities, and 10 per cent for the development of human resources for primary health care. Finally, five per cent of the fund will be used for emergency medical treatment to be administered by a committee appointed by the National Council on Health.  

  According to Section 4:1 and4: 2 of the Act, the National Council on Health is made of the health minister, who shall be the chairman, the minister of state for health, commissioners for health in each state of the federation, Secretary for Health in the Federal Capital Territory (FCT) and the permanent secretary of the Federal Ministry of Health, who shall be secretary to the Council.

 The Act also makes provisions for certain categories of people, especially the vulnerable ones, are exempted    from paying for health bills. 

   Section 3:1 of the National Health Act says: “The Minister, in consultation with the National Council on Health may prescribe conditions subject to which categories of persons may be eligible for exemption from payment for health care services at public health establishments.” Section3: 2 adds that “in prescribing any condition under subsection (1), the minister shall have regard to:(a) the range of exempt health services currently available, (b) the categories of persons already receiving exemption from payment for health services, (c) the impact of any such condition on access to health services; (d) the needs of vulnerable groups such as women, children, older persons and persons with disabilities.”

 On the healthcare financing, the Section 11:1 says: “There is hereby created a Fund to be known as Basic Health Care Provision Fund,” adding in Section 11:2 that “the Basic Health Care Provision Fund shall be financed from (a) Federal Government Annual Grant of not less than one per cent of its Consolidated Revenue Fund, (b) grants by international donor partners and (c) funds from any other source.” 

  Section 11:3 states that “money from the fund shall be used to finance the following:(a) 50 per cent of the fund shall be used for the provision of basic minimum package of health services to citizens, in eligible primary/or secondary health care facilities through the National Health Insurance Scheme (NHIS);

(b) 20 per cent of the fund shall be used to provide essential drugs, vaccines and consumables for eligible primary health care facilities, (c) 15 per cent of the fund shall be used for the provision and maintenance of facilities, laboratory, equipment and transport for eligible primary healthcare facilities, and (d) 10 per cent of the fund shall be used for the development of human resources for primary health care, (e) 5 per cent of the fund shall be used for emergency medical treatment to be administered by a committee appointed by the National Council on Health.”

 In Section 11:4, the Act continues: “The National Primary Health Care Development Agency shall disburse the funds for items 3(b)(c)(d) above through State and Federal Capital Territory Primary Health Care Boards for distribution to Local Government and Area Council Health Authorities.” 

 Section 11:5 adds: “ For any state or local government to qualify for a block grant pursuant to sub-section (1) of this section, such state or local government shall contribute (a) in the case of a state, not less than 25 per cent of the total cost of projects, and (b) in the case of a local government, not less than 25 per cent of the total cost of projects as their commitment in the execution of such projects.” Section 11:6 goes further to say: “The National Primary Health Care Development Agency shall not disburse money to any (a) Local Government Health Authority if it is not satisfied that the money earlier disbursed was applied in accordance with the provisions of this Bill, (b) state or local government that fails to contribute its counterpart funding, and(c) states and local governments that fail to implement the national health policy, norms, standards and guidelines prescribed by the National Council on Health, and  (7) the National Primary Health Care Development Agency shall develop appropriate guidelines for the administration, disbursement and monitoring of the fund with the approval of the Minister in Council.”