Opinion: COVID-19 is a game-changer for health financing in Nigeria


A well being employee sprays his headset throughout a neighborhood testing train, as authorities race to comprise the unfold of the COVID-19 in Abuja, Nigeria. Photograph by: Afolabi Sotunde / Reuters

In April 2001, heads of governments for member states of the African Union gathered in Abuja, Nigeria, and pledged to commit not less than 15% of their annual budgetary allocation to the well being sector. This was additional bolstered in 2003 with the Maputo declaration.

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Practically 20 years down the road, whereas international locations like Rwanda, Botswana, and Zambia have been in a position to meet this goal, Nigeria has had its allocation to well being care constantly under the continental common of 9.8% for the reason that 2001 settlement; it has been lower than 5% of budgetary allocation up to now 5 years.

It was with a budgetary allocation of $1.09 billion, representing 4.14% of the entire budgetary allocation for 2020, that the nation recorded its first case of COVID-19 on February 27. The contagiousness of the illness, the havoc it has been wrecking in European international locations with robust well being methods, and the perceived weak spot of our well being system — attributable to poor well being financing amongst different issues — led to simultaneous speedy responses on many fronts by the federal authorities, state governments, personal sector gamers, worldwide donors, and personal people.

A few of these responses included: establishing isolation facilities, provision of medical provides and private protecting tools, renovation of hospitals, establishing testing laboratories across the nation, and provision of reduction objects to cushion the consequences of the pandemic.

Nonetheless, the query that begs to be answered is: Will this mark a brand new period for well being financing in Africa’s most populous nation?

As acknowledged by the World Well being Group, well being financing is without doubt one of the six constructing blocks of each well being system. It offers with points starting from fiscal house accessible for well being, who pays for well being companies, and when and the way it’s paid, to subsidies and protection for the poor and weak.

The present pandemic has demonstrated the central significance of well being in our nationwide life — with out it, now we have nothing. It has additionally proven how we will do issues otherwise just about financing well being care in Nigeria.

Over time, well being financing has been a significant barrier to constructing a robust well being care system in lots of low- and middle-income international locations — Nigeria being no exception. Efforts directed at tackling COVID-19 are already offering a manner ahead for addressing among the challenges of well being financing in Nigeria.

Going ahead — doing issues otherwise in post-coronavirus Nigeria

1. Enhance fiscal house for well being. The fiscal house for well being framework outlined by WHO gives an amazing alternative to reinforce well being financing in our setting. With its 5 pillars of conducive macroeconomic situations, reprioritization of well being inside authorities budgets, provision of well being sector-specific sources — sugar, alcohol and tobacco taxes, cellphone prices for well being — elevated effectivity in well being care expenditure, and use of well being sector-specific grants and overseas aids, there is a chance to extend funding accessible for well being within the nation.

In the intervening time, the entire well being expenditure is derived from the allocations for well being and allocations for the Fundamental Well being Care Provision Fund, which is put at 1% of the consolidated income fund. Because the inception of BHCPF, nonetheless, its allocation has at all times been under the earmarked 1% of CRF; the allocation in 2020 is about 50% lower than the worth of the 1% of CRF. Taking a stand to deal with this discrepancy in subsequent budgetary allocations will likely be a solution to begin rising the fiscal house for well being.

Extra so with the ubiquity of sugar-sweetened drinks within the nation and the very fact they’re in excessive demand in each rural and concrete facilities, the time is ripe for the nation to tax this product which has long-term detrimental results to well being and commit the tax totally to financing well being care within the nation.

2. Maintain coalitions for well being. One of many biggest efforts for tackling the coronavirus within the nation is the Coalition In opposition to COVID-19, which consists primarily of personal sector gamers. The group has raised over $64 million to deal with the pandemic and help authorities efforts.

But this coalition ought to transcend this pandemic period. The personal sector ought to institutionalize this coalition to strengthen the well being system, and particularly major well being care. This coalition must also be expanded to contain different well-meaning Nigerians, together with spiritual and conventional leaders who’re prepared to contribute to the nation’s well being sector. Doing it will make funds accessible for the bottom degree of care which is grossly underfunded, thereby bettering entry to care by essentially the most weak group in society.

3. Increase the nation’s medical health insurance protection. The therapy of COVID-19 sufferers gave residents a style of what common well being protection is, by way of value of care: A scenario the place there is no such thing as a fee of person charges on the level of care.

In the intervening time medical health insurance protection within the nation may be very low, particularly for the casual sector. After this pandemic, efforts at capturing the casual sector by means of the varied state medical health insurance schemes must be intensified and alternate approaches like funding by means of taxation must also be explored with a purpose to cut back the burden of fee on the level of care.

The present pandemic has demonstrated the central significance of well being in our nationwide life — with out it, now we have nothing. It has additionally proven how we will do issues otherwise just about financing well being care in Nigeria.

Taking maintain of this chance to deal with among the challenges of well being financing will mark the start of the optimistic transformation of Nigeria’s well being care indices and usher in an period of elevated productiveness within the nation.

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