The right to health is inextricably linked to the right to life. Nigeria is bound by certain laws and charters to protect the right to health of its citizens. The Sustainable Development Goal 3 is to ensure healthy lives and promote well-being for all irrespective of age. Meanwhile, Article 25 of the Universal Declaration of Human Rights states, “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”
Chapter two of the 1999 Constitution in sec 17 (3) provides for the rights to health of Nigerians, stating, “The health, safety and welfare of all persons in employment are safeguarded and not endangered or abused; there are adequate medical and health facilities for all persons.” Also, the recently signed National Health Insurance Authority Act, 2022 has an overriding objective to promote, integrate and regulate all health insurance schemes; improve and harness private sector participation in the provision of health care services; and do such other things that will assist the authority in achieving universal coverage in Nigeria. The protection of the right to health in Nigeria cannot be over-emphasised given that Nigeria has very poor health indicators.
First is the low allocation of budgetary resources to health which is usually in a single-digit ratio of not more than five per cent below the Abuja 15 per cent declaration. Second, more than 70 per cent of the population pays out of their pocket for health; this is far above the sub-Saharan target of 23 per cent for out-of-pocket expenditure in Africa. Progress in reducing maternal and child mortality is still very low in Nigeria compared to other countries in Africa. Other challenges in the health sector include poor medical facilities in the health care facilities, poor human resources at the health care facilities which are occasioned by poor remuneration of medical doctors and the growing number of medical brain drain. The level of patronage at the primary health care centres is also currently low due to the poor quality of care, and deteriorating facilities.
To solve these problems, the front-running political parties contesting for the 2023 general elections have outlined their plans for the health sector. The All Progressives Congress with its presidential candidate, Bola Tinubu, has promised to improve the nation’s healthcare infrastructure by collaborating with state and local governments to create a new network of local clinics and dispensaries providing primary healthcare and drugs for citizens. He also promised to increase the proportion of the annual budget dedicated to health care from 6.5 per cent presently to over 10 per cent, and to implement the National Health Insurance Coverage for most Nigerians.
The Peoples Democratic Party with former Vice President Atiku Abubakar as its candidate has promised to undertake administrative reforms, facilitate UHC by working with states to advance and motivate a realistic PHC service delivery plan that ensures that at least 65 per cent of Nigerians have access to a defined basic PHC and services package by 2024, rising to at least 80 per cent coverage by 2030.
The Labour Party with Peter Obi as its presidential candidate promises to provide health care to 133 million poor Nigerians, including pregnant women, children, the aged and the disabled. He also promised to strive to honour Nigeria’s commitment pursuant to the 2001 African union Abuja Declaration on HIV/AIDs, Tuberculosis and other related infectious diseases, which set a target of allocating 15 per cent of annual budgets to the improvement of the health sector in African countries.
The three candidates made a common promise to increase the number of persons enrolled under the health insurance scheme but they were not clear on how they would raise the funds to achieve the set targets. The target to increase health insurance coverage is in line with the strategic objective of attaining universal coverage. The UHC has a goal to improve healthcare by accelerating reforms to adequately finance the health system and realign resources in line with the responsibility for health across the tiers of the healthcare delivery system. To achieve this, whoever emerges winner of the 2023 presidential election should implement the NHIA Act that makes health insurance mandatory for all residents in Nigeria. The imposition of an insurance levy on all residents of Nigeria will generate the required funds necessary to fund the health sector. The next president should also commit to allocating 15 per cent of the entire annual budget to health, in line with the Abuja Declaration of African leaders.
Victor Emejuiwe writes via [email protected]
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