The Federal Government’s new plan to enroll about 2million Nigerians in the nation’s healthcare insurance scheme through the Basic Healthcare Provision Fund is a welcome development. The Coordinating Minister of Health and Social Welfare, Prof. Ali Pate, made this known during the medical palliative tour of Federal Capital Territory (FCT) Mandate Secretary of Health at Gwarimpa General Hospital, Abuja.
Pate also noted that the health and wellbeing of Nigerians were central to President Bola Tinubu’s agenda of achieving affordable and accessible healthcare services for all Nigerians. The FCT medical palliatives will support and improve the healthcare delivery system for its indigenes, especially pregnant women and mothers.
The government has also planned to strengthen the healthcare system through expanding primary healthcare to 8,800 Primary Health Care Centres (PHCs) across the 36 states. It will also establish a national emergency medical transportation committee. “We are committed to improving healthcare delivery in Nigeria and we will continue to work tirelessly to achieve this goal.” Pate stated. He called on state governments, health workers, development partners and private sector to work with the government to deliver healthcare to Nigerians.
While the plan to improve the healthcare delivery system through the health insurance scheme is commendable, we don’t think that enrolling only 2million Nigerians will do much to enhance the healthcare of over 200 million Nigerians. We also doubt that Nigeria has adequate healthcare facilities, equipment and the needed manpower to deliver a functional and quality healthcare for all Nigerians.
Currently, the nation’s healthcare sector is grappling with dearth of medical experts, including doctors, nurses, midwives and other health workers needed to deliver optimum healthcare to all Nigerians. The brain drain in the health sector is so acute that every new medical doctor produced in the country is hardly retained in the system. The migration of Nigeria’s health workers to Europe and America has become more pervasive in recent times. About 3,173 Nigerian nurses and midwives moved to the United Kingdom (UK) in one year. According to the UK Nursing and Midwifery Council (NMC) register, not less than 13,653 Nigerian nurses and midwives are practising in the UK.
A recent media report indicated that 650 medical doctors attend to over 3.6 million people in Kwara State. According to the Kwara State Chairman of the Nigeria Medical Association (NMA), Dr. Ola Ahmed, “a lot of our colleagues have been lost to brain drain in the name of Japa. This has really affected the healthcare delivery services to the populace.”
If the Federal Government is really serious about healthcare funding through the health insurance scheme, it must be prepared to expand the number of enrollees to a higher figure other than the paltry 2million people. Since health is on the concurrent legislative list, the state and local governments should be willing to contribute towards the health insurance of their workers and other citizens, including the elderly, pregnant women, nursing mothers and children.
The health insurance scheme can cover illnesses such as malaria, typhoid fever, hepatitis, pregnancy-related ailments, cancer, eye diseases and others that the poor cannot afford the medical bills. The health insurance scheme has become necessary now that out-of-pocket medical expenses have risen astronomically due to rising cost of drugs and other healthcare consumables.
Despite the envisaged benefits of the health insurance scheme, the government should guard against its abuses by the Health Maintenance Organisations (HMOs) and the healthcare providers. The inherent abuses in the system account for why healthcare insurance is not so popular in Nigeria. Furthermore, the health insurance cannot work where there is excruciating poverty and joblessness.
The only way the health insurance can work here is if the government can foot the bills of millions of Nigerians who need healthcare services but cannot access them. The government cannot guarantee Nigerians affordable and accessible health care delivery system when its annual budget for health is hovering between 5 and 7 per cent. This is against the 15 per cent allocation to healthcare which African leaders agreed to do in Abuja some years ago.
With the recurring poor funding of the healthcare sector, Nigeria cannot meet the Sustainable Development Goal (SDG) number 3 which aims to ensure healthy lives and promote wellbeing for all at all ages. According to the United Nations children’s Fund (UNICEF), “this goal addresses all major health priorities: reproductive, maternal, newborn, child and adolescent health; communicable and non-communicable diseases; universal health coverage; and access for all to safe, effective, quality and affordable medicines and vaccines.”
It further says that “SDG 3 aims to prevent needless suffering from preventable diseases and premature death by focusing on key targets that boost the health of a country’s overall population.” Unfortunately, Nigeria has really not done much to achieve the UN 17 interconnected SDGs. Let federal, state and local governments work in concert to ensure quality and affordable healthcare services for all Nigerians.