October 31st this year will mark the fourth year the National Health Act was passed into law. After a long, rigorous, but concerted advocacy championed by the Civil Society Organisations, CSOs, and Non-Governmental Organisations, NGOs, the act was signed on October 31st, 2014.
The passage was greeted with optimism in the hope of a total Health Sector overhaul. Looking back in retrospect, the road to the realization of the act appears farther despite workable implementation plans.
The aim of the Act is to establish a framework for the Regulation, Development and Management of a National Health System, to set standards for rendering health services in the Federation and other matters concerned therewith.
The Act was also enacted for the purpose of providing healthcare insurance to certain class of people who are actually deprived
However deliberate these benefits are, Nigerians have not been benefitting due to its non-implementation
The DFID-PERL Media Roundtable
In a Media Roundtable on its implementation, organised recently by Partnership to Engage, Reform and Learn (DFID-PERL) revealed low compliance to the law.
In his presentation, the PERL-LEAP Consultant Dr. Dale Ogbunbayo said that the Basic Health Care Education Fund (BHCPF) is hindered by the lack of a proper disbursement of structure. The law stated that a minimum of 1% of consolidated Federal Government Revenue and contributions from donor grants be earmarked for the BHCPF.
If the fund were rolled out appropriately, it would be utilized for the provision of drugs, vaccines, emergency health interventions, amongst other health packages.
He pointed out also that health institutions and practitioners disregard the section on the access to emergency healthcare in which they are obliged to treat patients without demanding prepayment.
Furthermore, the training, management and adequate staffing of public health facilities are hindered by poor funding even though a unit has been established by the Federal Ministry of Health to shoulder the task.
The other Side of the Story
In an interview with CSNews Network, a Medical Practitioner based in Lagos, Dr. Odiah Ehi, blamed the non-adherence of hospitals to government inability to inform Health practitioners and citizens about the NHA.
‘The citizens have to know what their rights are, that means they have to be taught and it should be enforced. So when they do know their right, the hospitals will have to be ready.”
Apart from making sure that they know their right, government should equip the hospitals whether public or private. They should have a visible mandate written on the wall. It should say for example blood transfusion is free.
Let them leave the government house and come to each of the hospitals to prove that mandate. When someone needs blood for example, the doctor will not be saying bring money, because it has been written there on the hospital wall that this thing is free.
There should be numbers, you can call this numbers, once there is prompt action, people will start believing the government and their policies’.
One of the lapses the report identified is the fact that no Nigerian health establishment is currently operating with a certificate of standards as directed by the law. Dr. Ehis blamed the government on this.
‘It boils down to the issue of policies. The government just makes policies and do not enforce. Now you are talking about certificate of standard, I have no idea about that. I have never even seen a commissioner or a representative to query me about why don’t you have this or that. They don’t visit.’ Dr. Odiah laments
A research corroborated the doctor’s argument. The study was carried out by Ace Medicare Clinics Limited a foremost private health-care provider in 2015 with over 150 medical practitioners filling the questionnaire. The study found out that 86.2% of the respondents claimed they were aware of the NHA, but only 20.8% had seen a copy and 17.7% have read it.
Read The Survey Report: Nigeria’s National Health Act: An assessment of health professionals’ knowledge and perception
Dr Ehis proposed punishment of law flouting doctors to ensure compliance with the law.
‘If people are not punished for wrongdoing, there will be general laxity. Sometimes, you cannot just ask the doctors, why are not informed? When you get into trouble and the law catches up with you. The rest of the doctors will have to start studying government policies. Information is supposed to be from up to down.
The commissioners to the heads of offices should be briefed. They should brief the NMA, should disseminate information to the doctors. When this does not happen and they guy (Doctor) is working in a hospital. Does he even have time in the hospital? Nobody tell him, the boss does not tell him because the boss does not even know’.
‘Training doesn’t basically mean that you have to invite everybody. Some can come to the place, have like a thirty minutes meeting to say well this is the policy study it. If you need any help, we will give you information, that’s some form of orientation too’. He concluded
The Power of Civil Societies and The Media
To ensure optimum adherence to the NHA, PERL has called for intensifies advocacy efforts by the media and civil society organizations. PERL charges the media to leverage on the 2019 election and use pictorial evidence, screaming headlines and shocking revelations to drive the campaign.
Media practitioners were also asked to utilize social media engagement, editorials and documentaries.
With the call on the fourth estate of the realm to lend their voice to the NHA compliance advocacy, one can only hope that concerned government parastatals and citizens alike will work hand in glove to beam light on the beneficial provisions of the NHA.
About PERL
The Partnership to Engage, Reform and Learn (PERL) is a five-year Public-Sector Accountability and Governance programme, funded by the UK’s Department for International Development (DFID). PERL’s support focuses on governments, citizens, and evidence-based advocacy and is being delivered through three ‘pillars’ which plan and act together to support sustainable service delivery reforms: Pillar 1- Accountable, Responsive & Capable Government (ARC); Pillar 2- Engaged Citizens; and Pillar 3- Learning, Evidencing and Advocacy Partnership (LEAP). The programme works at the federal level, in the partner states of Kano, Kaduna and Jigawa, and through regional learning and reform hubs in the South West, South East and North-East areas of Nigeria.
ECP’s focus is to facilitate citizens’ engagement of governance process and plans that contribute in delivery of public goods and services, in areas of policy making, implementation and monitoring.
Story by Mayowa Adeniran & Adebisi Adeniji
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