What Nigeria must do to achieve Universal Health Coverage

Nigeria must improve on its health sector financing if the country is to meet the Universal Health Coverage (UHC) target by 2030. This was the consensus when some stakeholders gathered in Abuja on Wednesday to deliberate on ways to strengthen community systems towards achieving UHC.

Tagged “Universal Health Coverage by 2030: Driving the Agenda with community at the centre,” the event was organised by the Nigeria Network of Religious Leaders Living with or Personally Affected by HIV/AIDS (NINERELA+), a non-governmental organisation.

To achieve UHC, Innocent Ujah, president of the Nigerian Medical Association (NMA), said the country must strengthen its Primary Health Care system (PHC) and improve health sector financing.

Represented by Usman Galadima, Chairman Advocacy, monitoring and evaluation, NMA, he said PHCs in the country are dilapidated and can no longer provide quality services to the people.

“We have to strengthen existing health infrastructures, including primary health care system as most of the centres are dilapidated,” Mr Ujah said.

“2030 is still nine years away so we have to increase health sector financing and involve innovative means to strengthen infrastructure.”

UHC, which entails providing effective access — including financial risk protection — to essential healthcare for, at least, the poorest and the most vulnerable population, is key to achieving the world’s Sustainable Development Goals (SDGs).

It is the central target of the SDG 3, one of the 17 goals set by the United Nations General Assembly in 2015.

According to the World Health Organisation (WHO), a viable and people-oriented PHC system and robust financing structure is key in achieving UHC.

Only about 20 per cent of the 30,000 public PHCs in Nigeria is fully functional, according to a survey carried out by a non-governmental body, CISLAC in 2018.

Community participation

The National Coordinator of NINERELA+, Amber Erinmwinhe, said UHC has gained tremendous global momentum in the last few years and Nigeria must build on the momentum through strengthened community participation.

Ms Erinmwinhe explained that for UHC to be achieved, citizens must be part of a system that is designed to improve their access to quality health services without suffering financial hardship.

“Like the WHO rightly stated, UHC will not be achieved until health systems and their diverse stakeholders engage with each other in effective ways,” she said.

She noted that social participation has been a key component of advances toward UHC and a key element of an effective and equitable extension of health coverage.

“Today, we are setting the grounds for effective engagement between communities and other healthcare stakeholders and we are hopeful to engender more active participation of communities in the UHC agenda,” she said.

Ms Erinmwinhe appreciated partners who have worked to assist communities, particularly the vulnerable people who are at risk of being left behind.

In her remarks, a representative of Christian AID UK, Adam-Ogoh Anne, said the sustainable way to address poverty is by providing UHC to the people.

“In our strategic plan for the next seven years, we are committed to standing together with poor and marginalised people to ensure that we address poverty, speak truth to power and amplify the voices of the people who cannot do so through our 3P agenda,” Ms Anne said.

“We believe everybody is just one sickness away from poverty and therefore the sustainable way to address poverty is by providing UHC since health and poverty are intricately intertwined.”

She said for UHC to become the foundation of health care in the country, communities must come to the table and be part of the conversation that designs the framework for a healthcare system suitable for their population.

“We believe that UHC addresses issues of equity, access, and uptake of quality and affordable services.

“We believe that we need to contextualise the framework for the establishment of UHC If the programme will bring about deep lasting and sustainable change.

“We also believe that communities must contextualise the ideal situation to reflect the reality of their existence and get in the driver’s seat to take responsibility for their health-seeking behaviour,” she said.