Public Health Archives - Centre for Social Justice

Daily Dispatch Newspaper July 10, 2025- CSJ Lampoons FG Over Importation of Belarus Tractors

Center for Social Justice — Fri, 11 Jul 2025 09:59:41 +0000

Daily Dispatch Newspaper July 10, 2025

CSJ Lampoons FG Over Importation of Belarus Tractors

The Centre for Social Justice (CSJ) has lampooned the Federal Government for neglecting homegrown agricultural innovations against foreign manufactured.

The criticism followed the recent importation of 2,000 tractors from Belarus.

Lead Director, CSJ, Eze Onyekpere while speaking in Abuja on Tuesday at the National Workshop on Improving Visibility and Linkages between Agricultural Research Extension Services and Farming for Sustainable Food Value Chain in Nigeria, queried the rationale behind abandoning indigenous research outputs in favour of foreign imports, adjudging the move a disservice to agriculture development in the country.

He said: “Government can afford to do better. But the important thing is, what is the value of producing results and letting it lie on the shelf? For instance, the National Center for Agricultural Mechanization has produced mini-tractors, weeders, harvesters, and threshers.

“Recently, the President just launched 2,000 tractors. And I wanted to hear where they got it from. Of all places in the world, they were imported from Belarus.

“I was expecting if it’s not Nigeria maybe he should have said he got it from the United States, Britain, China, Japan, Germany, and suddenly it’s from Belarus. So what are we doing with the result of their research?”. he said.

He also decried the poor impact of publicly funded research institutes which affects agricultural productivity emphasizing that research outcomes should not sit on shelves or remain in academic journals, but be translated into real-world solutions that meet the needs of farmers particularly the smallholder women who are the backbone of Nigeria’s food system.”

Onyekpere said: “We found out that we have so many research institutes that are publicly funded, from those in different crops to fisheries to animal husbandry. But we’ve not had improved productivity, improved yield per hectare, and been able to tackle the prevalent pests and diseases across the nation and across so many crop value chains.

“What exactly are they doing, what are the innovations, what are the findings? And of course as we progress in this workshop you discover that there is a gap, there is a challenge, because the research institutes are doing tremendous good work. But that work is not getting into where it should go into to improve agriculture and to make sure they adopt good farming practices across the nation.”

He noted that the workshop aims to bridge the gap between what the research institutes and small holder farmers are doing vis-a-vis government interventions to proffer solutions to lack of agricultural productivity in Nigeria.

The Country Director Heinrich Boell Foundation, Sophie von Knebel charged Nigeria government to leverage on the challenges facing its agricultural system by leveraging on the opportunities and taking immediate, practical actions that can transform how knowledge is generated, shared, and applied.

Knebel advocatted for solutions that are not only impactful but also implementable in the short term, and sustainable in the long run in the country.”

The post Daily Dispatch Newspaper July 10, 2025- CSJ Lampoons FG Over Importation of Belarus Tractors appeared first on Centre for Social Justice .

Agric research materials must leave shelves for food production, Onyekpere tells FG, others

Center for Social Justice — Fri, 11 Jul 2025 09:52:44 +0000

Vanguard July 8,2025

Agric research materials must leave shelves for food production, Onyekpere tells FG, others

ABUJA – THE Lead Director, Centre for Social Justice, CSJ, Eze Onyekpere, Tuesday, called on the Federal and State Governments on the need to urgently look inwards to use agricultural researches abandoned in the shelves to galvanize food production.

Onyekpere made the call at a two-day ‘National Workshop on Improving Visibility and Linkages between Agricultural Research Extension Services and Farming for Sustainable Food Value Chain in Nigeria’, which he questioned the rationale behind abandoning indigenous research outputs in favour of foreign imports, calling the move a disservice to Nigeria’s agricultural advancement.

Onyekpere also lamented the impact of poorly funded research institutes, which affects agricultural productivity.

He emphasized that research outcomes should not sit on shelves or remain in academic journals, but be translated into real-world solutions that meet the needs of farmers particularly the smallholder women farmers who are the backbone of Nigeria’s food system.

The Workshop was supported by Heinrich Boll Stiftung (HBS) Nigeria, and CSJ collaborating with the Agricultural Research Council of Nigeria, ARCN, and the Small Scale Women Farmers Organisation of Nigeria, SWOFON, organised the Workshop.

He said: “Government can afford to do better but the important thing is, what is the value of producing results and letting it lie on the shelf? For instance, the National Center for Agricultural Mechanization has produced mini-tractors, weeders, harvesters, and threshers.

“We found out that we have so many research institutes that are publicly funded, from those in different crops to fisheries to animal husbandry but we have not had improved productivity, improved yield per hectare, and been able to tackle the prevalent pests and diseases across the nation and across so many crop value chains.

He also said the workshop aims to bridge the gap between what the research institutes and smallholder farmers are doing vis-a-vis government interventions to proffer solutions to lack of agricultural productivity in Nigeria.

Earlier, the Country Director Heinrich Boell Foundation, Sophie von Knebel, in an address of welcome charged the Nigeria government to leverage on the challenges facing its agricultural system by leveraging on the opportunities and taking immediate, practical actions that can transform how knowledge is generated, shared, and applied.

Knebel called for solutions that are not only impactful but also implementable in the short term, and sustainable in the long run in the country.

“We gather here with a shared purpose: to ensure that research outcomes do not sit on shelves or remain in academic journals, but are translated into real-world solutions that meet the needs of farmers—particularly the smallholder women who are the backbone of our food systems.

“The challenges confronting Nigerian agriculture are well documented: limited access to finance, weak extension structures, poor adoption of research outputs, and a persistent disconnect between innovation and implementation.

“Yet within these challenges lie tremendous opportunities—opportunities to take immediate, practical actions that can transform how knowledge is generated, shared, and applied.

“As we work to close the gap between research and practice, let us commit to solutions that are not only impactful but also implementable in the short term, and sustainable in the long run – what we call the “low-hanging fruit”, she said.

Meanwhile, the Executive Secretary, Agricultural Research Council of Nigeria, ARCN, Dr Abubakar Dabban, in paper titled ‘Agricultural Research, Training and Research, Training and Extension Services: How to make them Work for Small Scale Farmers in Nigeria’, said the Council came up with strategies including; Adoption of villages and schools: Addressing huge yield gaps between on-station and on-farm agricultural yields.

“ARCN established 578 AROCs so far. Agricultural Innovation Platforms: This is a channel for effective generation and diffusion of agricultural innovations in selected agricultural commodity value chains.

“The Agricultural Technology Transfer Centres (ARTTC): The ARTTC is a concept that is based on transfer of technology (TOT) to end-users and domesticated on a research institute sub-station.

“Community-based seed multiplication initiative: To alleviate the challenges of poor access to improved agricultural seeds, WAAPP implemented a community-based seed multiplication initiative with relevant stakeholders”, he said.

However, the ES called for increased funding of agricultural research in order “to meet the present and emerging challenges in the agricultural sector.

“Need for vibrant reward systems for researchers for innovations and linkage activities: Need for building the Innovative Capacity of researchers.”

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Making the 2023 health budget proposal work

Center for Social Justice — Mon, 28 Nov 2022 10:25:25 +0000

There are so many challenges with the federal health budget proposal for the year 2023. If approved by the National Assembly in its current form and substance, Nigeria’s health indicators may worsen and the expenditure will not produce value for money. The traditional approach of health enthusiasts is to demand increased funding but it needs to be emphasised that we need to get more value from the extant and available resources.

It is imperative to start this discourse with the revenue potential and capacity to contribute to the public expenditure of health ministries, departments and agencies. The major poser is the basis of the retained revenue projections of agencies in the health sector budget. Is it based on the empirical evidence of previously retained revenue or the proposals of the agencies, or the calculation of the ministry or Budget Office of the Federation/Ministry of Finance? For instance, the University College Hospital, Ibadan has a projection in excess of N4bn in the proposed 2023 health budget while the Lagos University Teaching Hospital has a projection of a paltry N48m and the Ahmadu Bello University Teaching Hospital only N8.1m. The gap is very wide and unaccounted for. Many health agencies that should contribute to the revenue have zero contributions. There should be a transparent, accountable empirical standard, on the basis of which these teaching hospitals and other agencies operate. As such, the variance between their respective retained revenue should be within respectable margins. Beyond teaching hospitals, this empirical approach should be applicable to the retained revenue of other agencies under the ministry.

Out of the ministry’s total capital vote of N404.075bn, the sum of N319.667bn is reserved and programmed for the ministry’s headquarters. This is 79.11 per cent of the entire capital vote. However, the headquarters’ share of the entire health vote is 29.76 per cent. This is the over-centralisation of resources at the headquarters. It should be disaggregated and only those resources needed for operations at the headquarters should be retained and others sent to the responsible agencies.

There are allocations of huge sums of money without details at the ministry’s headquarters totalling N310.252bn. This opacity is usually the foundation of the absence of value for money and creates opportunities for the mismanagement of funds. These include ERGP25195089 on Multilateral/Bilateral Tied Loans-Nigeria COVID-19 Preparedness and Response Project-World Bank in the sum of N43.557bn; Multilateral/Bilateral Tied Loans-Accelerating Nutrition Results in Nigeria-World Bank in the sum of N24.5bn; ERGP25195091 Multilateral/Bilateral Tied Loans-Immunization Plus & Malaria Progress by Accelerating Coverage and Transforming Services-World Bank in the Sum of N67.966bn; and ERGP25195092 on Multilateral/Bilateral Tied Loans-Nigeria COVID-19 Preparedness and Response Project-Additional Financing-World Bank in the sum of N174.228bn. There is also the provision for special interventions in Sustainable Development Goals one and two under Service Wide Votes in the sum of N55bn and N10bn respectively. These interventions would definitely include SDGs on health. However, there are no details and disaggregation beyond the lump sum provisions.

This is not acceptable in this day and age. The details of all bulk votes without details totalling N310,252,155,300 and the service-wide votes for health should be provided to the National Assembly and made public to the Nigerian people.

The Nigeria Family Planning 2030 Commitment states, “By the end of 2030, Nigeria envisions a country where everyone including adolescents, young people, populations affected by crisis and other vulnerable populations are able to make informed choices, have equitable and affordable access to quality family planning and participate as equals in society’s development.” Nigeria promised to improve financing for family planning by leveraging both existing and additional innovative domestic mechanisms but there is virtually no provision for FP in the health proposal. However, Nigeria had committed and cost the sum of family planning for 2023 to N24.881bn. According to the Nigeria Family Planning 2030 Commitment, the health budget should make provision for the sum of N24.881bn to meet the policy standard.

The National Strategic Plan of Action for Nutrition (2021 – 2025) Intervention projects a moderate and ambitious scenario. The moderate in 2023 is to cost N39.5bn while the ambitious will cost N57.5bn. The bulk of the resources provided for nutrition is Multilateral/Bilateral Tied Loans- ANRN-World Bank in the sum of N24.5bn. However, funding nutrition and its related projects with borrowed money are not sustainable in the short, medium to long term. And the funding neither meets the moderate nor ambitious scenario targets. The budget should meet the target.

Maternal newborn and child health constitutes a core content of the right to health as well as the minimum core obligation of the state. It is very strategic for the realisation of the rights of women, girls and the rights of the child. Essentially, it is a part of the right to health that is very inseparable from the right to life, from the context of dealing with life-bearing and life-saving issues. Considering Nigeria’s poor MNCH indicators, it is evident that the proposed vote of N19.371bn (calculated from all MNCH related expenditure in the ministry) will not be sufficient to deal with existing and emerging challenges. This needs to be increased.

There are expenditure heads considered frivolous, inappropriate and wasteful totalling N1.666bn. Considering the huge deficit funding requirement of the 2023 federal budget, expenditures should be targeted at yielding the best value for money. There is a “one-stop special publication on the achievement of the Federal Ministry of Health and all its agencies” in the sum of N110m. A one-stop special publication should not cost this much. There is already a vote for the publication of the annual state of health in accordance with the National Health Act- ERGP25156739. There is the “articulation of policies and strategic plans for retention of medical and health workers to stem brain drain in Nigeria” in the sum of N159.669bn. This is a waste because everyone knows why they are leaving and the government is not ready to address the issues. There is a redundant demand for vehicles including Prado jeeps. All these sums should be saved and re-programmed to the already identified areas in need of more funding.

In conclusion, the budget needs to be reworked and critical issues prioritised. Nigeria cannot be doing the same things over the years and reaping failure and still refusing to change.

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Analysing the 2023 health budget proposal

Center for Social Justice — Mon, 07 Nov 2022 07:28:51 +0000

This discourse reviews the federal health budget proposal for the financial year 2023. This review is done against the background of the Abuja Declaration of African Heads of State, Nigeria’s poor health indicators, and the challenge implicit in the inextricable link between the right to health and the right to life. It ends with some key recommendations.

The total sum allocated to the Ministry of Health out of the overall expenditure of N20.507tn is N1.097tn inclusive of the N47.649bn provided for the Basic Health Care Provision Fund. This is 5.35 per cent of the proposed budget expenditure. This is just about one-third of the 15 per cent Abuja Declaration commitment. However, there are other provisions related to health in the budget vis, provisions for the National Health Insurance Scheme fund of MDAs (N105.797bn), NHIS for military retirees (N4.481bn), NHIS for Corps members (N5bn) and GAVI/Immunisation counterpart funding (N69.570bn).When the foregoing is added to the allocation of the Ministry of Health, it comes up to N1.282tn which is 6.25 per cent of the proposed expenditure. This is still less than 50 per cent of the Abuja Declaration commitment.

Considering the fluctuating value of the naira, it is imperative to convert the allocations over the years to a more stable currency. Using the official rate of the Central Bank of Nigeria, the health votes have been undulating since 2015. In the years 2015, 2016, 2017, 2018 and 2019, it was $1.367bn, $1.269bn, $997.3m, $1.168bn and $1.221bn respectively. In 2020, 2021, 2022 and the 2023 proposal, it was $1.093bn, $1.332bn, $1.723bn and $2.647bn respectively. Evidently, the proposal for 2023 is the highest figure. The right to health is a forward-ever, backward-never right which demands continuous improvements in the pursuit of the highest attainable state of physical and mental health. From the benefits of scientific progress and emerging knowledge, the goal-post keeps shifting in the positive direction and implies a demand for improvements in financing.

If the votes that were not captured in the proposal of the Ministry of Health are removed, recurrent expenditure got 57.3 per cent of the votes while capital expenditure got 36.8 per cent of the health allocation. As usual, the recurrent vote is 98.1 per cent personnel, while only a paltry 1.9 per cent goes to overheads. This recurrent mix cannot facilitate functional health institutions that focus on effective service delivery when the overhead costs are simply not provided for.

There are concerns around the 1 per cent Consolidated Revenue Fund for Basic Health Care Provision Fund in the 2023 FGN budget proposal. The N47,649,312,042 provided for the BHCPF was included in the vote of the Ministry of Health instead of the statutory transfer as stipulated in the National Health Act. This poses a challenge because section 28 of the Fiscal Responsibility Act stipulates as follows regarding the duties of the finance minister on budgetary matters:

“Where, by the end of three months, after the enactment of the appropriation Act, the minister determines that the targeted revenues may be insufficient to the fund the heads of the expenditure in the Appropriation Act, the minister shall, within the next 30 days of such determination, take appropriate measures to restrict further commitments and financial operations according to the criteria set in the Fiscal Risk Appendix- such provisions shall not apply to statutory or constitutional expenditure.”

The above implies that if there is a paucity of resources for budget implementation, the vote provided for BHCPF would be subject to budget cuts alongside other budget lines that are not statutory transfers. This is very likely to happen considering the huge deficit financing of the 2023 budget. Therefore, the Federal Government should ensure that the BHCPF is captured appropriately under statutory transfers so that it can get the priority it deserves in the event there is a paucity of funds. It is even expected that funding for the BHCPF should be ring-fenced to the extent that it should not lapse at the end of the year (including undisbursed parts of the vote) but be carried over to the next. If Nigeria’s health indicators are frightening, why return money to the treasury or keep back budgeted funds in any year?

Surprisingly, the take-off grant in the Special Intervention Fund for the Vulnerable Group Fund provided in section 25 of the National Health Insurance Authority Act was missing from the health budget proposals. It is also not provided in the Service Wide Votes. The implication is that the Federal Government is not ready to kick-start the fund considering that the BHCPF, which is one the sources of its funding, is merely recycling existing resources already created by the National Health Act. It is not new, or more money for health. The imperative of this special intervention fund is the leveraging power it can bring to bear on the VGF. The activation of the Fund and indeed the compulsory health insurance regime of the National Health Insurance Authority are expected to pool trillions of naira every year in new funds to the health sector. The minimum the government can do at this time of lean resources is to activate this new source of funding, which can reduce the pressure on unavailable public finances.

The Minister of Finance has given hints on the 2022 Finance Bill. The expectation is that the bill should be used to right the wrongs meted out to the health sector over the years. Any tax, such as the sugar tax or aggravated excise duties on tobacco or any other tax justified and premised on the health of the population, should be dedicated to the health sector. It is unconscionable to use the health of the population to raise a tax and then put the money at the disposal of the bottomless pit of the general treasury where the proceeds of such tax can be frittered away on frivolous, inappropriate, wasteful, and sometimes illegal, and illegitimate expenditure. The executive and legislature should simply do the right thing.

In conclusion, the 2023 federal budget must ensure more money for health while tightening the loopholes to ensure greater value for health from all budgeted and programmed funds. It must also target equitable allocations and expenditure of public health resources so that even the vulnerable and the poorest of the poor are not left behind.

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CSJ’s Right to Health Cluster Meets in Abuja, 7 Other States To Validate of Policy Brief on Full Implementation of NHIA Act

Center for Social Justice — Fri, 04 Nov 2022 10:03:23 +0000

The Right to Health Cluster of the USAID/SCALE project anchored by the Centre for Social Justice has organized the validation meeting for the policy brief on the full implementation of the National Health Insurance Authority (NHIA) Act in Abuja. Similar meetings were held in Sokoto, Adamawa, Nasarawa, Imo, Ekiti, Bauchi and Rivers where the project is being implemented.

The policy briefs established the link between health insurance and universal health coverage, as well as the reasons for making health insurance compulsory. The policy brief reviewed key provisions of the NHIA Act and state legislations on contributory health and health insurance. It ended with recommendations on increasing health insurance coverage and improving the implementation of health insurance programmes.

In a keynote address by Egharevba Joy DGM Legal, NHIA, highlighted novel provisions of the NHIA Act, 2022 and the steps taken by the Authority to create public sensitization on the provisions of the Act.  She urged everyone to bring forward recommendations that will assist in achieving the objectives of the Authority, which is to promote, regulate and integrate health insurance schemes for the attainment of Universal Health Coverage (UHC).

Presenting the policy document, CSJ’s Lead Director highlighted simple public health measures to be taken by the population to reduce illnesses and promote good health. This will reduce the financial burden on the government and the out-of-pocket medical expenses on the population.

In Part 1 of the policy document, CSJ provides a description of the idea  and philosophy of health insurance. Part 2 articulates Universal Health Coverage (UHC) and its key components including coverage of the entire population, full spectrum of health services according to need and financial protection from direct payment of health services when consumed. The link between health insurance and UHC is explored in Part 3 while Part 4 dwells on reasons for making health insurance compulsory. The reasons include achievement of UHC, financial risk protection in accessing healthcare, equity in financing healthcare, facilitating the implementation of the minimum core state obligation on health and reducing the financial burden on government.

Part 5 reviews the key operative provisions of the NHIAA. The provisions reviewed include the establishment of the NHIAA, the establishment and powers of the governing council, the establishment of state health insurance and contributory schemes and participation in health insurance to be compulsory. Others are qualifications for operating a private health insurance scheme, licensing and accreditation, the Vulnerable Group Fund (VGF), implementing the Basic Health Care Provision Fund (BHCPF), contributions under health insurance schemes, registration of employers and employees, etc.

Part 6 deals with critical issues arising from the NHIAA and current practice including the fact that the governing council is yet to be established, the compulsive nature of health insurance is yet to kick in, operationalization of state health insurance schemes and the VGF, enlightenment and sensitization, database of vulnerable persons, transparency and accountability as well as the funding of the BHCPF. Part 7 is the conclusions while Part 8 is the recommendations. The summary of the recommendations is as follows: Constitute the Governing Council of the NHIA, operationalise the Compulsory Health Insurance Regime through administrative sanctions and an amendment of the Act to provide sanctions for non-compliance, engage in Massive enlightenment and sensitization and operationalize State Health Insurance and Contributory Schemes.

Other include a call to operationalize the Vulnerable Group Fund in accordance with S.25 of the NHIA through  the health insurance levy, SIN taxes and a special intervention fund, establish and Continually update a database of vulnerable persons, contributions by federal employees, improve accountability and transparency and properly Fund Basic Health Care Provision Fund to meet the statutory provision of not less than 1% of the CRF and this should be provided as a statutory transfer, instead of being a service-wide vote or just a mere vote under the Ministry of Health.

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National Health Insurance Authority Act and mandatory health insurance

Center for Social Justice — Mon, 22 Aug 2022 16:39:32 +0000

The National Health Insurance Authority Act was enacted in 2021 to repeal the National Health Insurance Scheme Act, to ensure the effective implementation of the National Health Insurance Policy that would facilitate the attainment of universal health coverage in Nigeria. This discourse reviews the idea of health insurance and its link to universal health coverage as well as the reasons informing the mandatory health insurance scheme. It seeks to point out that our laws are getting progressive whilst implementation seems not to be at par with the intention of the legislature.

S. 1 of the NHIA establishes the NHIA while S. 3 provides for its functions to include, but not limited to, promote, integrate and regulate all health insurance schemes that operate in Nigeria; ensure that health insurance is mandatory for every Nigerian and legal resident; and enforce the basic minimum package of health services for all Nigerians across all health insurance schemes operating within the country, including federal, states and FCT as well as private health insurance schemes. Others are to promote, support and collaborate with states through state health insurance schemes to ensure that Nigerians have access to quality health care that meets national health regulatory standards; and ensure the implementation and utilisation of Basic Health Care Provision Fund as required under the National Health Act and any guidelines as approved by the minister under that Act. S. 3 (b) of the NHIA Act, under the functions of the Authority, provides for the NHIA to ensure mandatory health insurance for every Nigerian and the country’s legal residents.

Health insurance is an insurance contract taken to cover the cost of medical care. The contract can be annually, monthly or over other fixed and certain periods of time. It typically caters for health care expenditures such as medical, surgical, prescription drugs, dental and other expenses incurred by the insured.

It is imperative to note that health insurance can be comprehensive or apply to a limited range of medical services. It may provide for full or partial payment of the costs of specific services. This is usually dependent on the quantum of the premium. Health insurance can reimburse the insured for expenses incurred from illness or injury treatments accessed or pay the health care provider directly. It ensures that individuals and families have access to health care services without any financial difficulty as opposed to out-of-pocket expenditure.

The major difference between health insurance and out-of-pocket health expenditure is that the latter insists that patients pay upfront to access health care services whilst health insurance provides the insured (or enrolees) access to health care services which payments would be settled from the pool of contributions (premiums) paid by all the insured in the health plan. The salient elements that are basic to all the health insurance varieties include: advance remittance of premiums into the pool, gathering funds together, and being eligible to enjoy the benefits for payment of premiums made, or for being employed in situations where employment entitles a person to enjoy the benefits of health insurance.

There is a distinction between health insurance and publicly funded healthcare system, which provides coverage for every citizen or resident under a free healthcare program. For instance, healthcare services available to indigent and poor persons by the Basic Health Care Provision Fund under S.11 of the National Health Act are not based on any premiums/insurance system but are funded through the statutory one per cent of the Consolidated Revenue Fund of the Federal Government.

The World Health Organisation defines universal health coverage as a situation where everyone has access to the health care services they require, at the time and place they require them without financial hardship. UHC connotes a scenario where all persons and communities have access to the health services they need, at the necessary time and where they are needed without financial hardship. The services being referred to include: essential health services ranging from health promotion to prevention, treatment, rehabilitation and palliative care.

To deliver these services, sufficient and capable health and care workers with optimal skills mix at facility, outreach and community levels are needed; they are to be evenly distributed and appropriately supported. UHC strategies enable everyone to access the services that address the most significant causes of disease and death in their society and also ensure that the quality of those services is good enough to improve the health of the people who receive them.

UHC safeguards all people from public health risks and protects all people from impoverishment due to illness, whether from out-of-pocket payments for health care or loss of income when a household member falls sick. Full-scale expansion of health insurance is pivotal to the attainment of the above goals. Improved health outcomes are hinged on the possibility of attaining UHC in that as more persons are covered, their basic health needs are met. Protecting people from the financial hardship of having to make out-of-pocket expenditures for health services reduces the risk of their sliding into poverty when unexpected ill-health necessitates using up life savings, selling assets, or even borrowing, etc.

Against the background of the foregoing, there are a plethora of reasons in support of compulsory and universal health insurance schemes in Nigeria. They are: to achieve universal health coverage, financial risk protection in accessing health care, introduce equity in financing health care and facilitate the implementation of the minimum core obligation of the state on the right to health. Others are to reduce the financial burden on the government, guarantee sustainability and credibility of health financing, facilitate the whole-of-society approach to health and set the building block for a vibrant and healthy population. Furthermore, health insurance is a means of poverty eradication, reduces inequality and uplifts the low strata of society.

However, despite the mandatory nature of the scheme, there will still be citizens who due to their special financial and physical circumstances, may not be able to afford the premium to make them eligible to be covered by a health insurance scheme. This is where the core obligation of the state on the right to the highest attainable state of physical and mental health kicks in to ensure that special equity funds established under the law will fill the gap. This ensures that such persons access at the very minimum, the minimum package of care provided in the National Health Act.

We now have a beautiful federal law on health insurance which is complemented by various state-level laws. These subnational laws also provided for compulsory and universal health insurance. Considering that insurance is item 33 on the Exclusive Legislative List of the 1999 Constitution, federal law will take precedence in the event of any conflict. What is now outstanding is the political will at the highest levels, expertise and capacity of the various executive and implementing agencies across the federation to ensure that the new regime of compulsory health insurance translates to improvements in universal health coverage.

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CSJ Organises 2023 Pre-Health Budget Validation Meeting In Ekiti State

Center for Social Justice — Sun, 21 Aug 2022 16:37:27 +0000

The Centre for Social Justice (CSJ) has organised the Ekiti State USAID-SCALE validation meeting for the 2023 pre-health budget memorandum at Kototel Hotel, Onigarri Road, GRA, Ado Ekiti, Ekiti State.

The pre-budget memo will serve as an advocacy tool for the right to health cluster and beyond to engage the Ekiti State Government on improving healthcare in the State.

From the review of existing budget commitments conducted by CSJ, Ekiti State’s public budget allocations do not meet the requirement of the funding needed to achieve Universal Health Coverage. The pre-health budget memo recommends among other things that there should be popular participation in the preparation of the health MTSS as well as the annual budget. This will ensure that the needs of the society are reflected and priotised especially in a time of paucity of funds.

The participants made key contributions to improve the document. One of such contributions was by Ogundero Oluwabunmi, Director of Programme Ekiti State Health Insurance. He suggested that the management of funds from the basic healthcare fund should be through a single account to ensure accountability and transparency.

Another contribution was made by Mr Timothy Idowu Gen. Sec. Coalition of Civil Society Organisations. He pointed out that the involvement of CSOs in the healthcare sector in Ekiti State is extremely poor and needs to improve if universal health coverage is to be attained in the State as well as the nation at large.

There were 28 participants at the workshop drawn from relevant ministries, departments and agencies of government including media and CSO partners.

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CSJ releases advocacy book to achieve UHC through PHC in Sokoto State

Center for Social Justice — Wed, 20 Jul 2022 19:02:56 +0000

The Centre for Social Justice (CSJ) has released a new book which is the outcome of a research themed “Achieving Universal Health Coverage (UHC) Through Budgeting For Primary Health Care (PHC).

The publication is designed as an advocacy manual focused on Budgeting for Primary Health Care (PHC) as an entry point for improving Universal Health Coverage in Sokoto State. PHC is part of tripod including secondary and tertiary health care and UHC and PHC are part of the right to the highest attainable standard of physical and mental health which accrues to all individuals without discrimination on the grounds of sex, religion, political opinion, place of birth or orientation among other things.

The Study is designed as an advocacy tool for improving funding for PHC in Sokoto State. It is to be used for various levels of advocacy engagement to relevant stakeholders working on PHC in the State and to develop training materials for capacity building of both State and non-state actors working on improving PHC services.

The Study focuses on Sokoto State and seven (7) of its total 23 Local Government Councils viz: Binji, Yabo, Sokoto North, Sokoto South, Gwadabawa, Tambuwal and Wurno. The established baseline is premised on the state records of poor PHC indicators including maternal and child health, family planning, water and sanitation, doctors and nurses as a ratio of the population.

The overall objective of this Study is to produce an advocacy tool with which to improve the budgetary process especially as it relates to funding for the attainment of UHC in Sokoto State.

Other objectives include: analyze the state and focal local government budgets so as to reveal possible gaps, deficiencies, challenges, value for money issues in the budgeting process; analyze the policies and legal standards governing PHC as well as budgetary and non-budgetary funding sources for PHC; and link analyses with relevant Public Finance Management (PFM) laws and policies operational in Nigeria and in Sokoto state. Furthermore, make recommendations on good practices of budgeting for PHC, especially to meet the minimum core obligations of the state and proffer general and specific recommendations following the findings.

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CSJ Publishes Sokoto State 2023 Pre-Budget Memorandum To Up Advocacy for PHC Funding

Center for Social Justice — Wed, 20 Jul 2022 18:50:18 +0000

The Centre for Social Justice (CSJ) has published a pre-budget memorandum for Sokoto State ahead of the 2023 fiscal year.

The document presents the key inputs of Civil Society Organisations (CSOs) into the Health Sector MTSS 2023 – 2025. This will equally serve as the input of CSOs to the 2023 State Government budget for the health sector. The primary focus is on Primary Health Care (PHC) as an entry point for Universal Health Coverage (UHC).

One of the rationales for the memorandum is that the Sokoto State Fiscal Responsibility Law (SSFRL) requires the State Government to prepare the Medium Term Expenditure Framework (MTEF)- three-year rolling plan containing the macroeconomic framework, fiscal strategy paper, expenditure and revenue framework, consolidated debt statement and statement describing the nature and fiscal significance of contingent liabilities. However, after preparing the MTEF, every Ministry, Department and Agency of the State Government (MDA) is expected to submit its Medium Term Sector Strategy (MTSS), which should focus on the medium term goals of their sectors and will feed into the broad goals of the MTEF.

The new book details the objectives of the MTSS exercise and the scheme for ranking priority projects and programs that will be part of the MTSS. It examines the rationale for the exercise, the linkages between MTSS and the annual budget and reviews the sectoral goals, objectives, targets and strategies for the Health MTSS.

Section Two is focused on health indicators and major challenges in Sokoto State related to the minimum core obligation of the State and Primary Health Care (PHC). Section Three reviews existing budget commitments and emerging issues using the Abuja Declaration (to commit 15% of overall budget resources to health care) and the provisions of the scenarios of the Sokoto State Strategic Health Development Plan II (SSSHDP II) as benchmarks. The benchmarking exercise shows that the State did not meet the Abuja Declaration obligations and there is a funding gap in the demands of the three scenarios of SSSHDP II.

The Section reviewed Local Government funding commitments in the seven focal LGAs (Binji, Yabo, Sokoto North, Sokoto South, Gwadabawa, Tambuwal and Wurno.) while analyzing the whole of government and health in all policies approaches to improving health care, especially PHC.

Section Four is on the Basic Health Care Provision Fund (BHCPF) and it shows that the State has started well in the two gateways of the State Primary Health Care Development Agency (SPHCDA) and the Sokoto State Contributory Health Care Management Agency (SOCHEMA). Steps have been taken to access the fund and provide services to the people.

Section Five discusses the sustainability of healthcare services. It affirms that sustainability is to a great extent dependent on the quantum and sources of healthcare financing. Section Six discusses the possibility of health insurance filling the funding and sustainability gap and draws attention to the SOCHEMA Law and the National Health Insurance Authority Act which provides for compulsory and universal health insurance in Sokoto State and across the Nigerian Federation. It makes a case for awareness creation and sensitization and eventual full enforcement of the Law.

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CSJ Holds Inception, Strategy Meeting For USAID-SCALE Right To Health Project

Center for Social Justice — Mon, 02 May 2022 04:55:07 +0000

The Centre for Social Justice (CSJ) Nigeria with the support of the Strengthening Civic Advocacy and Local Engagement programme of the United States Agency for International Development (USAID-SCALE) has held an inception and strategy meeting on the implementation of the project titled “Improving the Realisation of the Right to Health in Nigeria”.

The three-day programme saw participants from the committees on health of the Senate and House of Representatives of the National Assembly, the Federal Ministry of Health, the Nigerian Medical Association and the Medical and Health Workers Union of Nigeria.

Others include the National Health Insurance Scheme (NHIS), National Primary Health Care Development Agency (NPHCDA), the National Hospital Abuja, Health Management Organisations and a host of CSO and media partners.

The project will be implemented in the Federal Capital Territory (FCT) and 6 focal states of Sokoto, Adamawa, Nasarawa, Imo, Ekiti and Rivers. The project’s goal is to contribute to improvements in the realization of the right to health in Nigeria through enhancing respect for extant laws and policies, reforming laws and policies as well as mainstreaming transparency and accountability in public health sector expenditure.

The programme will be implemented through four critical objectives for action vis: (a) Improve legal and governance frameworks of the health sector through legislative and implementation advocacy; (b) Enhance stakeholder participation to improve transparency and accountability in health budgeting; and (c) Increase awareness and sensitisation of rights and duties on the right to health and (d) Build the capacity of cluster members and critical civil society stakeholders to effectively intervene for the improvement of the right to health.

Right to Health is the right of everyone to the enjoyment of the highest attainable standard of physical and mental health. Right to health extends to ensuring clean water, sanitation, food, nutrition and through a comprehensive system of healthcare.

The right to health is accorded recognition by several international treaties to most of which Nigeria is a party. The most important of these treaties are the International Covenant on Economic, Social and Cultural Rights (ICESCR), Convention on the Elimination of all Forms of Discrimination (CERD), the Convention on the Elimination of all Forms of Discrimination against Women (CEDAW) and the Convention on the Rights of the Child (CRC). Nigeria is also a party to two health-related civil and political rights treaties, namely the International Covenant on Civil and Political Rights (ICCPR) and the Convention against Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment. Regionally, the Right to Health is guaranteed under the African Charter on Human and Peoples Rights. Nationally, it is guaranteed under Chapter 2 of the Constitution of the Federal Republic of Nigeria 1999 (as amended), the National Health Insurance Scheme Act (1999) and the National Health Act, 2014.

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