Lambo advocates implementation of Basic Health Care Provision Fund

Former Minister of Health, Prof. Eyitayo Lambo has called for the implementation of the Basic Health Care Provision Fund as provided in the National Health Act (NHA) 2014 “to ensure free access of all Nigerians to a well-defined minimum package of health services.”He disclosed that the bill was prepared in 2004 but was passed into law in 2014. He however lamented that the law has not been implemented since then.

Speaking at a seminar organized by the Ibadan School of Government and Public Policy (ISGPP) with the topic: “Evolution and Challenges of Health Policy and Health Systems Development in Nigeria,” Lambo regretted that Nigeria had implemented three different health policies in the recent past without achieving their targets.

He blamed healthcare delivery woes in Nigeria on policy somersaults as a result of bad leadership and poor governance.Lambo also identified leadership and governance as the most important building blocks in health systems and development instead of the erroneous belief that the success of the sector depends of good financing.

He listed five other building blocks in health according to the World Health Organization (WHO) as service delivery, human resources, medicines, vaccines and technologies, financing and information. The former Minister said many Nigerian presidents did not take healthcare as a priority while many Health Ministers also did not build on existing policies due to a reason best known to them or for political correctness.

According to him, healthcare development would have gone far past its current status in Nigeria if successive administrations had taken healthcare more seriously and built on existing policies.

He pointed out that poor attitude of health workers, incessant strike actions, rivalry among health professionals, corruption and fraud in the system and heavy dependence on foreign drugs complicate the challenges.

Others include weak constitutional provisions for heath, lack of role definition for federal, state and local government on health, constant changes in leadership of health ministries and institutions, absence of inter-sectorial collaboration on heath and poor funding. Lambo also decried regressing state of the National Health Insurance Scheme (NHIS), which was established during his tenure as Minister of Health during the Chief Olusegun Obasanjo’s tenure. He disclosed that a proposal to amend the NHIS Act for more effectiveness has been lying with the National Assembly for about five years now thereby frustrating stakeholders.

To turn things around in the country, he called for clear definition of roles of each tier of government, amendment of the constitution to reflect health as a human right, strengthening of the capacity for health policy and plan development, implementation, monitoring and evaluation at all levels and also improvement of accountability in the sector.

Lambo stressed the need for inter-sectorial collaboration for health, increase in budgetary allocation to health and the need for Nigerians to carefully elect leaders who will take healthcare as a priority in governance.Where they drag their feet on health, Lambo called for establishment and intervention of pressure groups to mount pressure on political leaders to deliver good healthcare to citizens.

He advised the government to explore other creative ways to finance health, which may include air ticket tax, ‘sin’ taxes, and additional Value Added Tax (VAT) specifically for healthcare.He also advised government to provide financial and other necessary support to the National Institute of Pharmaceutical Research and Development (NIPRD) to enable it develop drugs based on local herbs to meet local needs.

Lambo urged medical doctors to show good leadership by speaking for other categories of health workers in order to enjoy their support and bring harmony to the entire health system in Nigeria.

The Chairman, ISGPP Governing Board, Prof. Akin Mabogunje, added that lack of integration among the three tiers of government and other stakeholders is another challenge confronting healthcare delivery system in the country.

Earlier, the Executive Vice Chairman, ISGPP, Dr. Tunji Olaopa, said the school was established to serve as a platform to critically examine public policies with a view to coming up with proposals to enhance them for a better governance system in Nigeria.Though Olaopa acknowledged that civil servants sometimes play a negative role in policy implementation, he explained that the problems are not insurmountable, stressing that the solution is what he has offered in his several books and public presentations.