HEALTH SECTOR REFORM AGENDA FOR THE BOLA AHMED TINUBU ADMINISTRATION

The Centre for Social Justice has proposed a comprehensive health sector reforms agenda for the Bola Ahmed Tinubu administration, outlining critical challenges and recommendations to improve the Nigeria health system. The proposed health sector reforms address various aspects of the sector, aiming to enhance accessibility, funding, accountability, infrastructure, and human resources for health.

Rising inflation is identified as a significant challenge impacting the health sector. CSJ highlights the need to ensure that resources available to the sector keep pace with the inflationary spiral. Additionally, the recent removal of fuel subsidy presents both downsides and upsides. While projected savings are significant, the reform has led to increased costs across various sectors, including healthcare. The health sector must advocate for its needs and ensure that it receives appropriate resources from the government’s proposed palliative measures fund.

The unification of the exchange rate is recognized as a positive step, offering potential benefits such as increased revenue for the government and a boost to exports. However, there are downsides, including increased costs of drugs, medicines, and human resources for health due to the depreciation of the naira. The health sector must find ways to mitigate the negative effects and provide alternatives for affordable healthcare access, particularly for the poorest individuals and families and those reliant on out-of-pocket expenditure.

Insufficient funding is a critical issue in the health sector, with poor public funding, population growth surpassing economic growth, and a fiscal crisis contributing to high out-of-pocket health expenditure. CSJ proposes attracting non-budgetary funds through private sector incentives and tapping into other public resources, such as legislator constituency project funds, to increase sector funding.

The full implementation of the National Health Insurance Authority Act (NHIAA) is emphasized as a crucial step towards reducing out-of-pocket health expenditure and achieving Universal Health Coverage (UHC). The NHIAA mandates health insurance for every resident of Nigeria and seeks to pool funds for UHC realization. The Act also establishes a social health insurance (SHI) scheme, including the Vulnerable Group Fund (VGF). CSJ recommends ensuring the NHIAA is made functional and collaboration between the National Health Insurance Authority and state health insurance agencies to activate the mandatory health insurance scheme.

The implementation of the Basic Health Care Provision Fund (BHCPF) under the National Health Act is reviewed, with the need for transparency and public audits of funds disbursed and managed. It calls for a review of the implementation guidelines to ensure that not less than 90% of the fund is dedicated to service delivery. CSJ emphasizes accountability and engagement mechanisms, calling for the preparation and presentation of an annual report on the state of health in Nigeria to the President and National Assembly. This would go a long way in health sector reforms.

Improvements to health infrastructure, including funding for upgrades and equipment, are proposed to address Nigeria’s loss of approximately $1 billion annually in health tourism. CSJ makes an investment case for the establishment of a Health Development Bank of Nigeria to provide medium- and long-term funding for health infrastructure and equipment at single-digit interest rates. This could be one of the ground breaking health sector reforms.

The availability of human resources for health is identified as a significant challenge, with Nigeria facing a low doctor-to-patient ratio and high levels of health worker emigration. CSJ recommends increasing government investments in medical human resource development and exploring agreements with destination countries to invest in health workforce development in Nigeria.

The comprehensive health sector reforms agenda proposed by the Centre for Social Justice covers critical challenges and offers recommendations to address the issues plaguing the Nigerian healthcare system. Implementing these reforms would contribute to improved healthcare access, funding, transparency, infrastructure, and human resources for health under the Bola Ahmed Tinubu administration.