Bukar: With Inclusiveness, Nigeria Can Achieve Universal Health Coverage

Engr. Abdullah Bukar is the Chairman, Board of Trustees, People Expertise and Excellence Foundation (PEEF). In this interview with Martins Ifijeh, he talked about the need for the Nigerian government to prioritise funding for healthcare. He also spoke on what PEEF is doing to change the narrative, as well as the organisation’s third annual PEEF conference holding today

What is PEEF all about?

The People Expertise and Excellence Foundation (PEEF) is a registered not-for-profit organisation comprising reputable professionals focused on proffering practical solutions to skills management challenges in Nigeria and Africa at large. Its vision is to be the leader and most respected organisation championing skills development in Africa, with a mission to increase skills proficiency and productive work within the African workforce.

What is the PEEF Annual Conference about?

The 2019 PEEF Annual Conference (PAC) is mainly about improving access to medical care for the citizens of this country through a better payment model and integration of traditional and complementary/alternative medicine. A great majority of people (approximately. 60-90 per cent) do not have access to good quality medical care unless they pay out of their pocket. Out of pocket payment in the face of poverty for most of the rural dwellers is like a death sentence passed should the money not be available. PEEF proposes alternative viable options to the current status quo. Secondly, we would like to highlight and re-emphasize the need to improve the skills of our medical personnel through training and other skills acquisition programs.

Why was Universal Health Coverage chosen as this year’s focus?

UHC is chosen because from the point of view of government’s responsibility on social security, she falls short on health. Less than five per cent of the population are adequately covered. There are options for improved access to medical care and this can be achieved through Continuous appraisal of the health system in terms of policy, operations and the users. There should be constant stakeholders meeting between government agencies, non-governmental bodies, and other key institutions relevant towards delivery of care in the country. The private sector should be allowed to be a major driver of care and be reimbursed appropriately for services rendered.

How can Nigeria achieve UHC?

Nigeria can achieve UHC if we are determined and ready to have inclusive stakeholder meetings that will strategize an actualization of UHC. According to the WHO Universal health coverage is the goal of ensuring that all members of the population and their communities have access to promotive, preventive, curative, rehabilitative and palliative health services that are of enough quality to be effective, without being exposed to financial hardship. · To expand health insurance systems towards achievement of universal health coverage, governments need to make progress along three axes: to “expand priority services, include more people and reduce out-of-pocket payments”. Services at the PHC level must be accorded priority and social health insurance schemes must be adapted in such a way that more people can be accommodated “painlessly” for wider coverage.

Nigeria’s NHIS is still struggling to move past four percent coverage rate, what do we do to address this, and how can this aid the country in achieving UHC?

The NHIS can move forward if most of the concerns of the users/operators of the scheme are addressed. Challenges faced by the scheme include: Inadequate legal framework. This needs to be amended to accommodate issues faced from the perspective such as being a regulator and operator at the same time. Definite funding mechanisms for the scheme as examples: Poor implementation of the Act, poor government funding of health care and the health insurance scheme, optional enrollment policy, inappropriate practices by the regulatory agency, the Health maintenance organizations and the providers, and ack of political will especially about funding

Government should improve funding for health, enact laws for enforcement, and then contributors to the scheme should be part and parcel of the decision-making process. Community based insurance should as a matter of urgency be deployed aggressively across all local government areas.