Transformation of Nigeria’s Healthcare

Lawal Dahiru Mamman

Nigeria has always been told she owes Africa and, by extension, the world talent necessary for continuous development. The yardstick is usually the nation’s human capital—a population of over 200 million. Truth be told, even as a country, we have not squarely harnessed this potential.

The reasons for untapped potential are not far-fetched. Among the top of the chart remains poor health indices of the populace. The Minister of Health and Social Welfare, Professor Muhammad Ali Pate, spoke to this effect in November 2023 during his speech at the Barewa Old Boys’ Association (BOBA) Annual Lecture and Award in Abuja.

In his presentation titled, “Nigeria’s Greatest Asset – Its Human Capital”, he said despite having a large, youthful population, Nigeria’s human capital development outcomes are unfortunately amongst the worst in the world. In terms of health, the country is, on average, among the bottom five performers in the world, with women dying from childbirth (maternal mortality), children less than one year dying (infant mortality), children under five dying (child mortality), and life expectancy.

He said: “We are also among the bottom ten performers in the world in terms of child stunting (malnutrition). Moreover, we have a double burden of disease, meaning in addition to infectious diseases like malaria, tuberculosis, and others, we have a fast-growing burden of non-communicable diseases such as diabetes, hypertension, cancers, and mental ill-health. At the same time, we are also ageing, with at least 5 per cent of the population considered aged.”

The more people in a country are healthy, educated, and productive, the more likely it is to experience long-term, equitable social and economic growth—health remaining independent variables to education and productivity.

Over time, the government has contributed its quota to improving the health of Nigerians, but Prof. Pate and his team are serving as a beacon of progress in the country’s health sector. Upon assuming office, improving population health for economic development occupied the top position on their to-do list. They are working on the talk.

According to the National Agency for Food and Drug and Administration Control (NAFDAC), they have so far successfully increased the number of local pharmaceutical manufacturers by 12%. Twenty (20) newly registered local drug manufacturers have invested over $2 billion in the erection and completion of WHO-compliant facilities that manufacture quality pharmaceuticals and essential medicines for Nigerians. This is a game changer, one must say.

Under his watch, Nigeria also unveiled four drugs manufactured by the Nigerian Natural Medicine Development Agency (NNMDA). The drugs were Namdune (200mg), meant for Anti-Aging; Namdasan (200mg), meant for anti-sickling; Aberecin (200mg), meant for anti-diabetes; and Nanobere (50kg). Evolution!

Fights against counterfeit drugs have also been taken to another level with the introduction of ‘Greenbook’, an application to verify registered drugs. With a robust database, patients, medical practitioners, and health providers will not live in fear of administering or consuming fake drugs. Impressive!

In August 2023, the United States Agency for International Development (USAID) revealed a survey that ranked Nigeria as the country with the second-highest malnutrition rate globally. Hence, the National Council on Nutrition (NCN) inauguration one month later is nothing but apt: a “healthy nation isn’t just a happier one; it’s also safer.” Commendable!

The rollout of the HPV vaccine against cervical cancer, which claims the lives of 8,000 women, cannot be over-extended. Lifesaver!

The inauguration of the National Health Research Ethics Committee (NHREC), the commissioning of the Noma Treatment Centre, and the revision of operational guidelines for the National Health Insurance Authority (NHIA) to achieve Universal Health Coverage (UHC) cannot go unmentioned.

All these, which should catalyze innovation, investment attraction, and collaboration in the health sector, will mean less if we do not acknowledge the initiative aimed at increasing Primary Healthcare Centres (PHCs) from 8,300 to 17,600 nationwide and training 120,000 Frontline Health Workers to reach the grassroots, who are the majority and most vulnerable.

Most recently, President Bola Ahmed Tinubu approved a comprehensive approach to revitalising PHCs through a Sector-Wide Approach (SWAp) and the Health Sector Renewal Program (NHSRIP) to ensure quality healthcare is a reality for all Nigerians.

At the heart of this transformation is the Basic Healthcare Provision Fund (BHCPF) reform. Recognising the need for a more robust governance structure and clearer guidelines to make healthcare more accessible to vulnerable groups.

To prevent disruptions in service provision while BHCPF 2.0 is being developed, the release of N25 billion to the National Primary Health Care Development Agency (NPHCDA) and the National Health Insurance Authority (NHIS) has been approved.

The redesign of the BHCPF aims to align public and development partner resources towards improving population health outcomes, focusing on maternal and child health as key priorities.

The revised guidelines will prioritise vulnerable groups, such as the poorest women and children, displaced populations, and others, aiming to reduce maternal mortality rates and out-of-pocket payments. They will also standardise quality of care measures across primary healthcare facilities, ensuring that resources are allocated in a tiered manner to address health inequities.

Prof Muhammad Pate convened the Ministerial Oversight Committee (MOC) to deliberate on advancing Nigeria’s primary healthcare delivery through SWAp. The assessment of the BHCPF revealed the need for reforms in its programmatic, operational, and fiduciary aspects.

All 36 states and the Federal Capital Territory (FCT) have committed to rectifying these flaws through a remediation plan and a signed compact with the federal government; citizens and civil society organisations will have to monitor the use of BHCPF resources, ensuring they are used for their intended purposes.

In the spirit of transparency, the ministry also provided a dedicated email address and phone line for reporting potential misuse of funds. The ministerial oversight team and relevant institutions like EFCC, ICPC, and DSS will also monitor and investigate credible reports to ensure the proper use of resources for primary care services.

Continuing on this trajectory by the minister and his team might just be the right instrument required to forge a transformed healthcare system in Nigeria for citizens to contribute significantly to development even across her geographical boundaries.

Lawal Dahiru Mamman writes from Wuye District Abuja. Email: dahirulawal90@gmail.com

April 04, 2024