By Emejuiwe Victor
THE National Health Act (2014) was passed into law so as to address the challenges of funding in the health sector. The effects of poor funding have led to high infant and mortality rate in Nigeria. The World Health Organisation statistics indicate that 126 deaths occur in every 1000 babies during childbirth. Also 75 deaths occur in every 1000 children during or immediately after birth. The reason for these deaths has been traced to lack or low level of funding. The lack of access to well equipped medical facilities, basic drugs, qualified medical personnel, basic vaccines and ante-natal/post natal care are caused by low level of funding.
The National Health Act 2014 Section (11) makes provision for a minimum of one percent of the total sum accruable into the consolidated revenue fund to be dedicated to Basic Health Provision Fund.
According to the Act, money from the fund shall be used to finance the following: (a) 50% 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 percent of the fund shall be used to provide essential drugs, vaccines and consumables for eligible primary health care facilities; (c) 15 percent of the fund shall be used for the provision and maintenance of facilities, equipment and transport for eligible primary health care facilities; and (d) 10 percent of the fund shall be used for the development of human resources for primary health care; (e) 5 percent of the fund shall be used for emergency medical treatment.
The responsibility the disbursement and management of these funds is left under the control of the National Primary Health Care Development Agency (NPHCDA). In a recent policy dialogue held with the NPHCDA, the agency disclosed that the provision for the basic health provision fund was not contained in the proposed 2016 budget. Taking a close look at the 2016 proposed budget, it is noticed that only N17.7bn was allocated to the agency.
However, if the basic health fund was to be implemented, the agency should be getting between N30bn to N35bn. This amount is meager compared to the funding gap of N300bn annually required to address the health challenges at the primary level of care.
In spite of the missing provision of the basic health fund in the 2016 budget, it was disclosed that, the president has given the go-ahead to the national steering committee for the management of the Basic Health Provision Fund, to set up modalities for the launching of the fund, which is billed to take place before the end of January 2016. The president is to launch the fund in person.
Knowing PMB as a president who backs his words with action, it is, therefore, paradoxical for him to be prepared to launch a fund for which provisions were not made. The following posers are drawn by stakeholders; perhaps Mr. President hopes to implement only half of the items contained in the listed basic provision package and forget the rest.
Also, it could be an oversight from the Ministry of Health for the provision not to be included in the proposed budget? If the later be the case, it is not late for the National Assembly, through its committee on health, to raise an observation to this effect and include it before the final approval. The final poser could be the willful act of impunity in adhering to the provisions of the NHA 2014.
Nigerians believe that the era of impunity is over and a vote for change would guarantee their welfare. Therefore, the APC-led federal government is not expected to fail to implement the NHA in this regard. Already, the growing rate of deaths amongst our mothers and children is alarming. We cannot afford to draw back the hands of the clock by not implementing the provisions of the Act. Amongst the projects to be embarked upon by the NPHCDA, if the funds are available is the equipping of 10,000 hospitals nationwide with adequate facilities. Each ward in the federation shall be fully equipped with basic health facilities.
Also included are the mapping and engagement of qualified health personnel in each of the wards and the provision of special vaccines etc. It is well noted that our mothers and children are currently turned back from government hospitals as a result of lack of special vaccines.
These vaccines are meant to handle incidences of viruses such as Rota-Virus, against diarrhea and vomiting, measles and chicken pox, meningitis, hepatitis etc. To acquire these vaccines, parents pay through their nose in private hospitals and 90% of Nigerians cannot afford this.
The President and the members of the National Assembly should take note of the challenges in accessing basic health care services and endeavor to abide by the provision of the NHA 2014 by making provision for the 1% in the NPHCDA 2016 budget. Other funding measures should also be explored and channeled into the Basic Health Care Provision Fund.
.Victor writes from Abuja