Founder-President of the Wellbeing Foundation Africa, Mrs Toyin Saraki has said that Nigeria is in the midst of a national health crisis.
Mrs
Saraki, who is the Chair of Nigeria's Primary Healthcare Revitalization
Support Group, however added that the solution to the crisis is within
the nation’s grasp.
She made the comments
in an opinion editorial for Reuters titled “Primary healthcare and
education are where impact can be felt in Africa.”
Read the full article below:
Over
twenty-five years since the landmark 1978 Alma Ata Declaration asserted
the critical importance of primary healthcare, many countries still lag
well behind the standards needed to give every citizen even basic
health protection.
Nigeria is a case in
point. The country is in the midst of a national health crisis;
one-third of children under the age of five are stunted due to poor
nutrition; and more than 41,000 children become newly infected by HIV
every year.
Yet the solution – unlike
with so many development challenges – is within our grasp. Technology,
has increased access to vulnerable communities and, crucially, new
pioneering funding mechanisms mean that key areas of primary healthcare,
from midwifery to general practice, could be rapidly improved.
The
Nigerian National Health Act Basic Healthcare Provision Fund was
developed in 2014 and was designed to improve Nigeria’s poor primary
healthcare. But three years on, the Act remains only partially
implemented. Primary healthcare, the cornerstone of a healthy
population, has been left by the wayside. It must be prioritized.
Take
reproductive, maternal, newborn, child and adolescent health and
nutrition, a key facet of primary care. Nigeria’s new healthcare
narrative includes the revival of the Midwives Service Scheme previously
established in 2011, the creation of a national health management
information system and a strengthened focus on maternal and newborn
health.
The aim is to provide an easily
accessible route to care, producing quick and visible impact that will
altogether affect the lives of every Nigerian, especially the most
vulnerable. This would be a revolutionary set of initiatives but they
are yet to be funded, and yet to be delivered.
CHRONIC UNDERFUNDING
Overall,
gains in PHC and efforts to implement long-overdue universal health
coverage in Nigeria have been thwarted by chronic underfunding. The
Abuja Declaration of 2001 saw members of the African Union pledge to
spend at least 15% of the national budget on healthcare. Yet, Nigeria
currently allocates a mere third of that pledged amount to public health
services.
As chair of the Nigeria's
Primary Healthcare Revitalization Support Group, I believe that primary
healthcare investment, both from the private and public sector, is key
to ensuring universal healthcare for all Nigerians.
From
a social investment perspective it is also a huge opportunity to see a
social return on money invested. The nature of primary healthcare – the
ability to monitor and manage delivery of, for example, the Wellbeing
Foundation Africa's Mamacare antenatal and postnatal health access
through birth preparedness classes, or by the USAID-funded MPowering
Healthworkers Program which engaged mobile-technologies in training
midwives in Ondo State of Nigeria– means that money invested in, can be
quantified by results gained.
For
innovative social impact investors, there is an opportunity here for
collaboration between both the central and state level governments in
Nigeria to fund real change.
In Mali,
Nigeria’s West African neighbour, the Novartis Foundation implemented an
initiative aimed at improving access to PHC, specifically for children
and women in one region. The project targeted 200,000 inhabitants from
rural areas and was funded by both regional and district partners.
The
results were remarkable: between 2008 and 2010 the community health
associations increased their average score by 10%, improving
particularly in the areas of internal governance and support to
healthcare personnel. During the same period the utilisation rates for
prenatal consultations increased more than 30%.
PARTNERSHP WORKS
In
Nigeria, the Primary Healthcare (PHC) Revitalization Support Group
Program is working with the Nigerian state and development partners to
take the kind of innovative financing mentioned above and use it to
drive and deliver the kind of interventions the Government has already
pledged to achieve. The government must also increase efforts to
harmonize and streamline additional sources of funding to PHC, and
reduce the barriers to access that restrict healthcare services to so
many.
In opening up PHC to the private
sector, social impact investors have the opportunity to co-fund tangible
and visible improvements to healthcare. At the multi-state level my
foundation, the Wellbeing Foundation Africa, has already seen the impact
that public-private partnerships can bring to maternal health
provision.
The breadth of public-private
partnerships should not stop at healthcare: partnerships of this nature
should also be applied to areas such as primary education. The Rajasthan
Education Initiatives, for example, engages global and local private
actors in supporting Rajasthan’s State Government in India, impacting
over 6,000 schools through various interventions, and training 22,000
teachers in ICT training.
Such an
initiative could be replicated in Nigeria and beyond; indeed, Nigeria
has taken nascent steps through its recently piloted nPower program to
drive nationwide graduate internships in the areas of agriculture,
education and health.
It is only by
strengthening capacity and concrete frameworks at primary levels of care
and education services that we can build the resilience to cope beyond
endurance in times of crisis, and improve the wellbeing of citizens in
the long-term. The good news is we have the means to achieve this. We
now have to take it.
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