Importance of the National Health Act

I am happy, very excited, not about tomorrow’s Christmas shindig but about the new National Health Bill which President Goodluck Jonathan signed into law on December 9, 2014. Health, they say, is wealth and a healthy nation is a wealthy nation. For those familiar with the “Israelite journey” of the bill at the National Assembly, its signing into law is a worthy Christmas gift from Mr. President to Nigerians. This is the second time the National Assembly will pass the bill as President Jonathan withheld assent when it was first passed, necessitating another legislative review of the all-important bill. All is well that ends well and I add my voice to hundreds of others who have appreciated the President for this wonderful act.

What actually is the health Act all about? The Act, experts say, seeks to provide a framework for the regulation, development and management of a National Health system and set standards for rendering health service in the country. Some of the accruing benefits of the new Act include the provision of free basic health care services for children under the age of five, pregnant women, the elderly and persons with disabilities in the country. Additionally, the law guarantees the universal acceptance of accident victims in both public and private health institutions. Interestingly and deservedly too, the new law bans senior public officers’ use of public funds for treatment abroad, especially for ailments that can be treated locally.

The former President, Nigerian Medical Association, Osahon Enabulele, noted that if enforced, the essential provisions in the Act would help Nigeria achieve the Millennium Development Goals 4, 5, and 6 which aim at reducing maternal and infant mortality rates by the year 2015. At present, Nigeria has the highest infant and maternal mortality in Africa. A Demographic Health Survey in 2013 reportedly found that Nigeria contributes about 13 per cent of global maternal mortality, with estimated 36,000 deaths annually. Thus, the coming of this Act is expected to reverse that ugly trend as more pregnant women would have access to free delivery services while their children are assured of standard paediatric services in the nation’s health facilities.

The ex-NMA boss added that with this new Act, “There will be improved funding of health care services at the grass roots so that people don’t have to travel far to access medical services. There is a Basic Health Provisions Fund for primary health care centres in the Act and it is to be majorly funded with one per cent of the Consolidated Revenue Fund of the Federation. This, undoubtedly, will re-energise Nigeria’s primary health care system.” It is on record that the 772 primary health care centres in the country offer sub-optimal services due to poor funding.

The Chairman, Health Reform Foundation of Nigeria, Board of Trustees, Benjamin Anyene, was quoted as saying that the implementation of the bill will save the lives of three million women and children over a five-year period. At present, over 5,000 Nigerians allegedly travel to India, the United Kingdom and the United States for treatment while on the average, over $800million is reportedly lost annually by Nigeria to medical tourism. In the view of the Supervising Minister of Health, Dr. Khaliri Alhassan, the new National Health Act would cause government’s savings in health care delivery to rise from N17bn in 2015 to over N211bn in 2025 if the Act is fully implemented.

The minister opined further that “Individuals and families will have more disposable income through reduction in catastrophic health expenditure occasioned by very high cost of out-of-pocket spending when the mandatory social health insurance scheme that will be supported by the Act is implemented.” Moreover, “The Act provides for a minimum package of essential health services for all citizens to guarantee a more productive life and will impact positively on infant, child and maternal mortality rates which currently are highly unacceptable at 69 and 66 per cents respectively.” The minister concluded by saying that, “The multiplier effects of this will holistically manifest in increased life expectancy of Nigerians, as well as increased productivity. It is the singular instrument required to unlock economic goodness and health to Nigerians.”

Listening to all these glowing tributes to the law gladdens one’s heart. But until the rotten tooth is pulled out, the mouth must chew with caution, so says a popular African proverb. It is not yet uhuru as the coming into effect of the Act is the easiest part. Implementation and enforcement are harder to achieve. Is there really the political will to give full expression to the execution of this Act? We would not have to wait for long. The 2015 budget estimate was just placed before the National Assembly last Wednesday, December 17. Let’s see what the Federal Government wants to do in the New Year in the health sector.

From the Pharmaceutical Society of Nigeria comes a worthy advice as relayed by its National President, Olumide Akintayo. He urged the President to appoint stakeholders from all cadres of the health profession to ensure the successful implementation of the Act. His words, “The process of appointing the drivers of salient aspects of the Health Act should therefore logically follow the conduct of a competitive selection process from a pool of professionals who have competent skills and cognate experience. We maintain with strong emphasis that such skills are found in all cadres of the health profession not just one profession.” That statement is pregnant given the fact that unhealthy rivalry among the different medical professionals have been destabilising the Nigerian health sector for some time now. As I write this, health workers aside the doctors in the public health sector have been on strike for upwards of two months now with its disastrous consequence on public health and safety. This is coming on the heels of a similar strike earlier embarked by the Nigeria Medical Association.

The Presidential Committee of Experts on Inter-Professional Relationship in the Public Health Sector headed by a former head of service, Alhaji Yayale Ahmed, last Friday, December 19, submitted its report to President Jonathan. The committee reportedly found 50 conflict areas among the health professionals. I do hope the President will match words with action by ensuring that the White Paper committee reviews the report expeditiously in time to make room for early implementation. The danger is, if this cold war among health professionals persists, the implementation of the new National Health Act will be compromised and rendered ineffectual. Thus, all relevant stakeholders must play their part in the full implementation and enforcement of this “Messianic Act.” There is the need for adequate sensitisation of the populace on this Act so that we all can positively take advantage of it.

Merry Christmas!