NUHCAN RELEASES ITS POSITION ON COVID-19 DISEASE MITIGATION, NATIONAL HEALTH ACT 2014 (NHAct 2014) AND UNIVERSAL HEALTH COVERAGE (UHC) IN NIGERIA.
ABOUT NUHCAN: Established and incorporated/registered in 2019, the Nigeria Universal Health Coverage Actions Network (NUHCAN) is a registered nongovernmental, nonprofit making, nonpolitical, nonreligious, autonomous Organization, whose purpose is the coordination of all recognized Civil Society Organizations, Private Voluntary Organizations, Institutions and Individuals involved in Universal Health Coverage activities and programs in Nigeria. NUHCAN is also a member of the Global Civil Society Engagement Mechanism (CSEM) for UHC2030, and its membership ensures multisectoral and multidisciplinary collaboration in the effort to achieve UHC in Nigeria. NUHCAN member-CSOs are found in all 36 States and FCT of Nigeria.
NUHCAN’S CONCERNS ABOUT THE COVID-19 PANDEMIC AND NIGERIA’S HEALTH SYSTEM AT THIS JUNCTURE Since the first diagnosis of COVID-19 disease in a patient that flew into the country from Italy on 27th, February 2020, NUHCAN has held two webinars, directly contributing to the aggregation of ideas and recommendations on the most likely effective measures that will lead to the success of the mitigation efforts of the Presidential Task Force (PTF) against COVID-19 Pandemic.
A key demand of NUHCAN on the PTF in its first webinar, was that the PTF should work through Health Networks of CSOs like NUHCAN to achieve the expansion of the Nigeria National Response to COVID-19 pandemic in communities and the primary health care level. And that for a strong equity-focused, gender-focused and people-led effort to achieve Universal Health Coverage (UHC2030) in both the COVID-19 era and post COVID-19 period, there should be no other alternative to working with NUHCAN and the civil society.
The overall goal of the second webinar was to highlight the importance of maintaining a functional Primary Health Care System alongside containing and controlling the COVID-19 disease, so that efforts to achieve Universal Health Coverage (UHC) by 2030 in Nigeria, will not be derailed or hampered.
The PTF has some success stories to tell Nigerians, but it has not effectively engaged the CSOs like NUHCAN, to fight against mis/dis-information about COVID-19 pandemic. The rampant misinformation is the main reason for the widespread complacency, denial and noncompliance by most of the population with proven mitigation advice to guard against the spread of the deadly disease/pandemic, and which puts the whole population of 200 million citizens at grave risk (i.e. should the second wave of COVID-19 currently devastating Europe and USA reach Nigeria’s shores, like it did in the first wave on February 27, 2020; it will be tragic).
THE CONSEQUENCES OF NOT WORKING WITH CSO NETWORKS LIKE NUHCAN ARE POPULATION-WIDE COMPLACENCY AND ABANDONMENT OF PROVEN MITIGATION MEASURES AND MESSAGES; OCCASIONED BY THE WIDESPREAD ENGAGEMENTS IN RISKY BEHAVIOUR BY THE POPULACE, PEDALLED THROUGH MIS/DISINFORMATION AND INFODEMIC.
NEWS REPORTS adorn the local and international media to show that misinformation is widespread and that it is not confined to the lay public and policy makers in Government, but in fact even trained health workers absorb the fake messages to the detriment of patient care.
NUHCAN’S DEMAND 1:
NUHCAN demands that the Presidential Task Force on COVID-19 should engage NUHCAN (whose members are in every State and FCT) and the civil society, to sensitize and mobilize Nigerians at the grassroots in the communities, on the correct COVID-19 mitigation approach and information in their local languages, including pidgin English, to counter the mis/dis-information about COVID-19 disease without further delays, as the current state of complacency and abandonment of the proven mitigation messages (e.g. frequent washing of hands with running water and soap/alcohol based hand sanitizers, wearing face masks, physical distancing, cough and sneezing etiquette) poses a huge risk to public health if the second phase of this deadly pandemic currently ravaging Europe and USA reaches Nigeria’s shores, now that international flights have resumed after the Lockdown. (Nigeria MUST not be caught unprepared!!!)
II. THE CALL FOR A REVIEW OF THE YET-TO-BE-DULY-IMPLEMENTED NATIONAL HEALTH ACT 2014 (NHAct 2014) IS PREMATURE, AND NOT EVIDENCE-BASED
NUHCAN is of the strong view that the recent/on-going ‘çall for memoranda’ from the public and organizations for a ‘Review/Amendment of The NHAct 2014’, is not only premature but unnecessary and wasteful on the scarce national resources for the health sector, because the 6-year old Act has hardly been implemented, and therefore has not been tested to know whether its provisions work or not.
Not even any of the Acts Statutory Committees is effectively functioning, since they were inaugurated in early 2017, including the foremost National Tertiary Health Institutions Standards Committee (NTHISC). The NHAct 2014 has not been formally and professionally evaluated, is not even ready for evaluation as there is no formal report of its implementation (on which to base the evaluation), talk less of a Review/Amendment given its checkered history.
The NTHISC, for instance should have set the Benchmark Standards that every health facility in the country should aspire to and meet (and awarding the Certificate of Standards after accreditation). The unfortunate short history of the untested Act is supported by the quotations below: –
‘—– The National Health Act 2014 which took about 10 years to prepare has yet to be implemented, according to a former Health Minister, Prof. Lambo (05/13/2017).
“——– On April 12, 2018, the Federal Government launched the logo and beneficiary identification card for the Basic Health Care Provision Fund (BHCPF) in Abuja, which signaled the beginning of a brand new programme for the Nigerian healthcare sector. That was the first time since the passage of the National Health Act in 2014, that the Federal Government has earmarked funds for the BHCPF (Basic Health Care Provision Fund).
- ‘’———- But between that earmarking of the fund and now, the World, including development partners, healthcare stakeholders, the World Health Organisation (WHO), and most importantly Nigerians had their fingers crossed, to see if government would toe the same path of unfulfilled promises it was known for in the past (May 9, 2019, THISDAY Newspaper, Launching of BHCPF- FMoH),’’
NUHCAN’S DEMAND 2:
NUHCAN demands that current move to review the NHAct 2014 be suspended until it has been sufficiently implemented and its provisions tested, and that any funds appropriated for the Review/Amendment of NHAct 2014 which has hardly been implemented so as to know the gaps and shortcomings therein, should immediately be applied to the strengthening its implementation through the improvement of the Nation’s Primary Health Care facilities by skilling the manpower, providing equipment, drugs, tests, utilities, etc. It is also imperative that the implementation of the NHAct 2014
must be subjected to professional evaluation based on an official report of its implementation from inception.
What are therefore overdue include the presentation/validation of the report of the implementation of the NHAct2014, review of the implementation by stakeholders including NUHCAN and civil society, and professional evaluation of the implementation in order to have informed positions and recommendations based on which further actions shall be agreed upon.
III. ACHIEVING UNIVERSAL HEALTH COVERAGE (UHC) IN NIGERIA The COVID-19 pandemic is devastating lives and livelihoods everywhere in the World, worse in the parts of the World with temperate climate, so far. However Nigeria being a tropical country does not mean that its citizens can be complacent, because it is not yet a proven fact that temperature ‘per se’ is why the rates of infection differs in different parts of the World. Nigerians were glad to hear many VIPs in the country declare that they ‘never knew that Nigeria’s health system was so bad’, at the peak of Nigeria’s first wave of the pandemic.
NUHCAN is concerned, therefore, that nine months into this deadly pandemic, very little is being done to upgrade primary health care facilities or beef up availability of equipment, medicines and commodities, 24/ power and water supply and increase human resource capacity and capability all over the country, especially knowing that without a strong and functional PHC, there cannot be attainment of Universal Health Care (UHC) with less than a decade to 2030.
Without a functional PHC, care for non COVID-19 cases, continues to be neglected, as the number of cases escalate ‘silently’, because COVID-19 cases take up available resources, because the mitigation approach is skewed in favour of spending resources almost exclusively in Teaching Hospitals and Federal Medical Centres, to the continuing neglect of the Primary Health facilities. To worsen the situation, CSOs like NUHCAN who have always been present in and are trusted by the local communities are not engaged to help take messages to the population.
It is clear that the spread of misinformation would may not have gained so much ground if NUHCAN are commissioned to ensure that the people receive accurate messages.
NUHCAN’S DEMAND 3:
NUHCAN demands that the PTF should immediately use the current fortuitous low point of the number of COVID-19 cases in the country, to extend its mitigation efforts to the primary health care tier of the health system, so that both COVID-19 disease and non COVID-19 conditions are given adequate attention, and demands that the PTF should without further delay engage and commission NUHCAN member-CSOs in the on-going information dissemination and sensitization aspect of the campaign, if Nigeria is not to fail to achieve the UHC by 2030, which will be another disaster, even as damaging as the pandemic, if not more.
Signed: Dr. Uzodinma Adirieje, NUHCAN
Executive Secretary, NUHCAN
Professor Joseph Ana, Chairman, Research and Documentations Technical Working Committee, NUHCAN