Nigeria's National Health Bill: A Call for an Immediate Assent

In Year 2000, Nigeria ranked 187^th out of 191 countries in the ranking of health systems by the World Health Organization. Although the Nigerian people needed no ranking to know that the health system was in a marasmic-kwashiokor state, the WHO report served as an awakening call to the political class to take actions expeditiously to reverse the deplorable situation. Reports of various technical committees set up by the Federal Ministry of Health culminated in the submission of a HealthCare Reform policy in the form of National Health Bill to the National Assembly in 2004.

It appeared as if the bill made the federal legislators narcoleptic as it took seven years of advocacy and protests before it was finally passed in May 2011.

A protest that preceded the passage of the National Health Bill in 2011

The provisions of the bill include but not limited to;

• Free medical care for children under 5 years old, pregnant women, the elderly (above 65yrs) and physically challenged people. 
• A minimum of 2 per cent of consolidated fund of the federation for primary health care.
• A guaranteed basic minimum health package for all Nigerians
• Unconditional acceptance and treatment of patients with emergency health conditions by public and private health facilities.
• Absolute confidentiality of medical records
• Ensures good quality of healthcare services through the issuance of Certificates of Standard to all health facilities.

The full document can be downloaded here: http://www.herfon.org/docs/Harmonised-NATIONAL-HEALTH-BILL-2011%20doc.pdf

Within the seven years the bill stayed in the National Assembly, it was estimated that Nigeria lost 7 million children and 3.8 million mothers. A few months before the passage of the bill, President Goodluck Ebele Jonathan reportedly made commitment to the UN Secretary General that he would sign the bill as soon as it was passed. While Nigerians were in ecstasy about the passage of the bill despite the delay, one had expected an immediate presidential assent. Unfortunately, that is yet to come almost one year after.

President Jonathan with UN Secretary-General, Ban Ki Moon. 

While I must acknowledge that there may have been significant improvement in the Nigerian health care system in terms of infrastructure and human capacity development over the last 12 years, same cannot be said of the health of the Nigerian people. Nigeria has consistently maintained an unenviable position in the bottom quarter in all global development and health indices. Some of these include;

•         156^th out of 187 countries in UNDP ranking of global Human Development Index 2011
•          41^st out of 53 African countries in 2011 Governance Rankings by Mo Ibrahim Foundation
•          104^th out of 110 countries in Prosperity Index by Legatum Institute, a London based public policy organization (our health system ranked 106^th).

According to the National Bureau of Statistics (NBS), almost three-quarter of Nigerians (72%) lived below poverty line in 2011, an increase from the previous years even as the global poverty level has remained on the decline. Following the subsidy removal policy that led to a 50% increase in pump price of premium motor spirit (PMS) without a concomitant rise in income, more Nigerians are bound to fall below the national poverty line. The lingering insecurity problem in some parts of the country has also grounded the economy of the affected states and brought untold hardship to the people. Experts have predicted that Nigeria may have more poor people than China by 2015 if the current trend continues. Victims of the Boko Haram terrorism are either losing breadwinners/ life investments and/or getting permanent disabilities. This suggests that much more Nigerians would not be able to afford quality health care thereby worsening the morbidity and mortality from prevalent preventable and curable diseases.

Below are our tragic and deteriorating health indices:

• 1 million children die every year => 2740 per day or 114 per hour; the highest in the world
• 52,900 women die from pregnancy related causes every year => 145/day or 44 per hour; the 2nd highest in the world. In other words, 1 in every 13 Nigerian women die from pregnancy and child birth.
• 292,000 neonates (babies below 28 days old) die every year => 800 per day or 33 per hour - the 2nd highest in the world. 
• Average Life Expectancy of 50years, among the lowest in the world.

Although some professional bodies reportedly complained about some provisions of the bill; this is not unexpected in a democracy and as such cannot reasonably explain the delayed assent. No responsible government would be leading a country with the above health indices and delay action in reversing the situation. I humbly call on our dear President Jonathan to kindly sign the National Health Bill without further delay. I also implore all well meaning Nigerians and lovers of the Nigerian people to join this call for presidential assent to the bill. 

God bless you! God bless Nigeria!!

References

•      WHO Health Ranking 2000 - http://thepatientfactor.com/canadian-health-care-information/world-health-organizations-ranking-of-the-worlds-health-systems/
•          Legatum Institute Prosperity Indx - http://www.prosperity.com/country.aspx?id=NG
•          UNDP Human Development Index - http://hdr.undp.org/en/media/HDR_2011_EN_Tables.pdf
•      WHO World Health Statistics -  http://www.who.int/whosis/whostat/EN_WHS2011_Full.pdf