Mrs. Shaibu recently went to a primary health centre (PHC) in the Federal Capital Territory with her very sick infant child. Her baby was running a temperature and was refusing to eat. After consultations with a doctor, the baby was diagnosed with malaria and Mrs. Shaibu was given a prescription for urgently needed medications.
Instead of heading to the pharmacy to buy the drugs and start treatment, she remained seated in front of the doctor and begged to be given the drugs. She simply could not afford them. The cost of the drugs totalled 1,000 Naira, about US$2.20.
Mrs. Shaibu’s situation is common in Nigeria, which has the highest concentration of poor people in the world. Nigeria’s high rate of poverty, coupled with a long-neglected primary healthcare system and a rapidly growing population, has put immense pressure on the creaking healthcare system which is also dealing with the COVID-19 pandemic. As a result, Nigeria loses about 2,300 children under the age of 5 daily. Nigeria also has the highest rate of maternal mortality in the world.
How to #MakeNaijaStronger
Through Make Naija Stronger (MNS) campaign, ONE is campaigning with our partners to reverse these poor health outcomes by securing access to healthcare for all Nigerians and moving Nigeria towards Universal Health Coverage.The Basic Healthcare Provision Fund (BHCPF), a central feature of the 2014 National Health Act, is at the centre of MNS campaign. The BHCPF was designed to provide a basic minimum package of health services to Nigerians at PHC all over Nigeria. But it didn’t receive funding in the federal budget between 2014 and 2017. It was finally funded in 2018, after intense campaigning by ONE and a broad coalition of civil society organizations, medical professional groups, youth and women’s groups and the private sector.
The BHCPF is to be implemented by the Federal Ministry of Health (FMH), National Primary Health Care Development Agency (NPHCDA), National Health Insurance Scheme (NHIS) and National Emergency Medical Treatment Committee (NEMTC). The NEMTC is appointed by the National Council on Health. As of February, 2021, all 36 states and the Federal Capital Territory have expressed interest in the programme, with states at various levels of implementation readiness. The Federal Government has also begun releasing BHCPF funds to the accounts of the gateways. However, since the initial disbursement of funds appropriated in 2018, there have been no further releases of funds to the gateways from the federal treasury, hampering the ability of the gateways to fully deliver the programme.
NHIS receives 50% of the fund for the provision of a Basic Minimum Package of Health Services to all Nigerians through state insurance programmes. NPHCDA receives 45% of the fund to provide consumables e.g., drugs, vaccines, etc and to fund the operations of PHCs through state primary healthcare development boards. NEMTC oversees the provision of emergency medical treatment through an allocation of 5%.
In order to access BHCPF, each state must meet a set of broad administrative requirements, complete facility quality assessments, build capacity of staff, meet financial commitments and create structures to receive programme funds. Presently, all 36 states and the Federal Capital Territory have signed on to implement the programme within their borders.
Making the promise of health care a reality
Despite this progress, obstacles remain to the full implementation of BHCPF nationwide. States are at different stages of preparation, with some lagging far behind. State governments are required to contribute 25% of the necessary funding for the implementation of BHCPF in their states through a matching grant structure. So far most states have failed to allocate these funds in their budgets.
In addition, funds appropriated for BHCPF in the national budget for 2020 and 2021 have not been released to the relevant agencies. This threatens to reverse the early gains of the programme and stop its expansion into some of the most vulnerable communities in Nigeria at a time when the need for a functional, effective primary healthcare system has been laid bare by the COVID-19 pandemic. It is more essential than ever for citizens to demand that BHCPF is fully implemented in every state in Nigeria. .
Sign the petition, monitor implementation in your state and make it clear to the federal and state governments that BHCPF must work. It is crucial for the millions of people like Mrs. Shaibu and her child who only survived and recovered due to the intervention of the kind-hearted workers at the PHC. No child in Nigeria should face the prospect of death because their family cannot afford treatment for easily treatable diseases like malaria.
Nigeria must recommit itself to delivering access to healthcare to all its citizens, particularly the poorest and most vulnerable. In order for this to happen, all of us need to join the campaign to realize BHCPF’s full promise.