Dwindling Resources May Affect Health Act Implementation – Experts

By Abiose Adelaja Adams, Lagos

Public health experts have expressed concerns that the falling oil price in the international market may affect the implementation of the recently passed Health Bill, now known as National Health Act 2014.

The Act establishes the Basic Health Care Provision Fund, which is to be pooled from at least one per cent of the Consolidated Revenue Fund of the federal annual budget.

The president of the Nursing Association of Nigeria, Adeniji Abdulrafiu, told this website in an interview that this is a major source of worry given  Nigeria’s over dependence on oil revenue.

“As an association everybody is disturbed that the bill may not have the financial backing required with the state of the economy.”

The 2015 budget of N4.3trillion is lower than last year’s N4.6trillion, ostensibly in expectation of a shortfall in federally generated revenue arising from the falling oil prices. By implication, a whooping N43 billion (that is one per cent of the annual budget) will go into development of primary health centres, provision free maternal  and child health services and offering of some form of health insurance in secondary institutions and even up to tertiary levels in referral  cases.

“This is where our concern is. You know Nigeria is a monolithic economy. The question remains whether government will back it up with implementation,” Abdulrafiu stated.

Similarly, Emmanuel Otolorin, a professor of Obstetrics and Gynecology, and a public health expert, observed that “the bill was signed into law after the National Assembly had presented the budget, so we don’t know whether it will be adjusted, but I am assuming that the minister of finance will adjust it.”

For the implementation process, these experts are not sure it will be soon, given the current political terrain. “The attorney general has to make inputs before taking it to the relevant ministry and these may take up to mid-year, as this is election time,” noted Abdulrafiu.

However, the funding is not expected to come from only the federal government as Act envisages funds coming in from international donors and others.

Item 11 further states, “there is hereby created a Fund to be known as Basic Health Care Provision Fund; This fund shall be financed from (a) Federal government Annual Grant of not less than one per cent of its consolidated Revenue Fund, (b) grants by international donor partners, and (c) funds from any other source.”

It further stipulates that 50 per cent of the fund to finance national Health Insurance Scheme.

“The fund shall be used for the provision of basic minimum package of health services to citizens, in eligible primary or secondary health care facilities through the NHIS.

Furthermore, 20 per cent of the funds shall be used to provide essential drugs, vaccines and consumables for eligible primary health care facilities, 15 per cent shall be used for the provision of facilities, laboratories, equipment and 10 per cent shall be used for the development of human resources for PHCs.

Emphasizing why the implementation should take immediate effect, Otolorin pointed out that women and children are dying needlessly daily.

“With these bill women and children should be able to walk into the hospital free and get treated; this will improve quality of care and health seeking behaviour in Nigeria.”

Drawing from his experience, Otolorin observed that healthcare is not free in Nigeria unlike other oil producing countries. “I have worked in Saudi Arabia before and I can tell you that everything is free. Health is free, education is free. If a woman needs to do a caesarean section it is free. These are the benefits of being an oil producing country, but in Nigeria, we import petrol because we cannot refine it.”

This brings to fore once again, a recent statement made by the chief medical director of Lagos University Teaching Hospital, Chris Bode, in reaction to a woman who died the hospital in December due to high user fees

“Treatment in an Intensive Care Unit costs as much as N400,000 – N5 million in other hospitals in Lagos and LUTH ICU care is the cheapest.

To continue this level of care efficiently, cost of care must be recovered, otherwise there will be a decline in quality,” he stated. The 35-year

Folake Oduyoye victim in search for a better quality of care, enrolled at a private hospital, where she eventually gave birth through a ceasarean section. Due to complications, she was referred to LUTH here her husband spent close to N2million to get treated, yet was detained because he couldn’t balance the outstanding of N1million.



    A health cover would have easily taken care of that,” says Oyewale Tomori, president Nigeria Academy of Science.

    “That is what is meant to have a good welfare system; when there is such people will attend hospitals, they don’t have to pay for cards, drugs, gloves, vaccines, bed space, and they can attend clinics as many times as possible. The barrier to health is removed. Women and children are treated free. ”

    He criticized politicians seeking elective office, particularly the candidates in the February 14 presidential polls for not raising issues that matter to development and wellbeing of the citizens, but rather talking only about job creation.

    “It is only healthy and educated people that need jobs. Governments don’t create jobs, industries create jobs, government only creates and enabling environment. The real issue is to build the education systems, create free and affordable healthcare for people,” he said.

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