Mainstream health in sectors to achieve universal coverage, AMSN urges FG 

The Academy of Medicine Specialties of Nigeria (AMSN’s) Rapid Response Initiative Group, with Prof Obi Onwujekwe as Chairman, has produced tailored advice for the new Minister of Health, Prof. Mohammed Ali Pate.

The advice comes ahead of the Academy’s convocation of six newly elected Fellows and one Emeritus Fellow, on October 27 to 28, 2023, with the theme, “Mainstreaming of Health in All Sectors for Achieving Universal Health Coverage.”

President, AMSN, Prof. Oladapo Ashiru, said it would focus on producing additional advisory to the Federal Government in achieving its health objectives for the country.

Until now, Nigeria has a weak health system, which is not primed to achieve any of the health-related Sustainable Health Development Goals (SDGs) targets, especially Universal Health Coverage (UHC).

Infant mortality rate in Nigeria is among the highest in the world, currently at 54.74 per 1000 live births, as opposed to 9.85 of Seychelles and 10.49 of Iran. It also has high burdens of both communicable and non-communicable diseases.

Nigeria also has high levels of child and maternal mortality rates. The life expectancy is less than 55 years. The Nigerian health system is sub-optimally resilient to everyday issues and to shocks such as disease outbreaks/pandemics. There are low investments in health, corruption and accountability issues, dearth of pro-poor health financing, and lack of political will to prioritise and decisively optimise the health sector. The sector is also bedeviled with medical tourism and brain drain of health workers, amongst other problems.

Ashiru, however, there are some existing policies, strategies, programmes and activities that if fine-tuned and well implemented, can help to strengthen the Nigerian health system and enable it to deliver good health outcomes.

He said there are also existing structures and health financing strategies such as the Basic Healthcare Provision Fund (BHCPF) that can be enabled for the
strengthening of the health system. Hence, the expectations of the new Minister of health are massive and Nigerians are looking forward to a massively improved health system that is resilient, able to achieve national and global health targets such as UHC and ensure some massive improvements in health outcomes.

Ashiru said the whole of government approach to health, advanced by the World Health Organisation, shows that healthcare must be considered a political priority and an integral part of any political agenda. Hence, the coming of a new government and appointment of new ministers to run the health system provides a great opportunity for the country.

The Academy recommends that since all the health systems building blocks are weak, a whole system appraisal and strengthening will be required; and health should be mainstreamed in all sectors for increased resource mobilisation and for addressing the social determinants of health.

The AMSN said the recommendations of the Presidential Committee on Health Sector Reform, March 2023 should be distilled, prioritised and implemented and the report of the Lancet Nigeria Commission provides some recommendations on high impact areas of intervention that should be implemented by the Federal Ministry of Health.

It said the 2014 National Health Act, 2016 National Health Policy, National Strategic Health Development Plan (NSHDP 2), Primary Healthcare Under One Roof (PHCUOR), National Health Insurance Authority Act, National Drug Policy, to mention but a few should be reviewed and fully implemented.

The Academy urges FG to institutionalise research culture in health policymaking by strategically funding health research and development as well as instituting mechanisms and structures for the use of evidence from research for decision making.

It said the country should more innovatively and aggressively plan and implement strategies for achieving UHC and there should be improved and broad-based consultative development of health budgets, which should be targeted at achieving set targets.

The AMSN said the FG should institute strategies for reversing medical tourism through aggressive three-tier health investments/human resource optimisation; expand primary healthcare reach, quality, and water/sanitation; address corruption in the health sector; expand the BHCPF to cover all PHC facilities in the wards; implement minimum standards for PHC PHCUOR to the letter; and use strategic purchasing for purchasing health benefit packages in social health insurance and yearly budgets.