LIVE UPDATE: #HealthDialogue: Policymakers, experts, others discuss achieving Universal Health Coverage in Nigeria

The two-day National Health Dialogue organised by the Premium Times Centre for Investigative Journalism, PTCIJ, the Project for Advocacy in Child and Family Health, PACFaH, and the Project Pink Blue will start today, in Abuja.

The health dialogue would be chaired by the Vice President, Yemi Osinbajo, and hosted by the Minister for Health, Isaac Adewole, at the Musa Shehu Yar’Adua Centre, Central Business District, Abuja at 9 a.m. daily.

The Emir of Kano and former Governor of the Central Bank of Nigeria, Muhammadu Sanusi II, will deliver the keynote address at the programme.

According to the organisers, the dialogue is a platform that will bring together stakeholders in the health and development sectors to discuss the challenges and prospects of Universal Health Coverage in Nigeria.

“Since the enactment of the National Health Act in 2014, there have been several efforts targeted at providing quality and affordable health care for Nigerians in line with the goals of Universal Health Coverage. However, these goals are yet to be achieved.

“The Dialogue will recommend actionable strategies for sustainable health care financing,” the organisers said.

PREMIUM TIMES brings you live updates of the event.

9.33am: Participants have started arriving for the #healthdialogue

Presentation by Dr. Faisai Shuaib, Director, Primary Health Care Development Agency.

Arrival of the Minister of Health, Prof. Isaac Adewole.


10:47 AM The discussion was set in motion by Dr. Faisal Shuaib, the executive director, Nigeria Primary Healthcare Development Agency.

He discussed ‘primary healthcare under one roof as a mechanism for delivering universal health coverage’

Mr. Shuaib said people in the village most times have to sell what they have to get treatment for their ailments.
He said this shouldnt be so and as such that is what UHC, intends to take care of.

He explains that primary health care is important for achieving Universal Health Coverage, UHC.

UHC is people having access to the healthcare they need without suffering financial hardship. No matter who you are, poor or rich, everyone should have same healthcare that improves the health outcome and not suffer financial crisis in taking care of their health, he said.

Mr. Shuaib said the recent trend in the county is not encouraging as it requires making progress in coverage in three directions and achievement of six critical objective – access, equity, quality, financial risk protection, efficiency and sustainability.


10:50 AM: He said the solution is improving efficiency by providing oversight on activities of all PHCs IN LGAs and with partners.

He announced the introduction of community health influencers promoters services at the community level.

“This program will engage 20 women per ward that will be trained over 3 months to provide simple intervention for health service delivery.”

Mr. Shuaib decried the poor coverage recorded in immunisation in the country.

“We only have 33% coverage in routine immunisation. It is bad that we can only vaccinate only 33% of our children. What happens to the rest. This is why we are engaging with states to find solutions for immunisation for every child in Nigeria.”


10:57 AM The publisher of the leading investigative online newspaper, Premium Times, Dapo Olorunyomi, in his welcome remark appreciated the presence of everyone.

He said the health dialogue was conceived as a platform for policy makers, health experts and advocates to discuss the challenges facing achieving UHC in Nigeria.

Mr. Olorunyomi said the dialogue was put together by PTCIJ, Premium Times, Project Pink- Blue, and PACFah.

He said the dialogue for Premium Times is a way of giving meaning to accountable journalism as it is written in the constitution.

The dialogue is expected to proffer a way forward to health challenges in the country.


NACA D.G, Sani Aliyu.


11:00 AM: Runcie Chidebe, one of the partners of the program, in his opening remark decried poor funding for cancer treatment in the country.

“Over 72,000 people die of cancer. This means as I’m speaking to you, someone is dying of cancer.

“We need to focus on funding cancer treatment because it is eating deep into the health system,” Chidebe said.

In his remark, the acting director of the National Health Insurance Scheme, NHIS, Attahiru Ibrahim, said the scheme is partnering with NPHCDA to ensure maximum health coverage in the country.

The acting NHIS chief said the scheme is mandated to ensure full accesible supple of health service to match the demand of health services.

“This is not yet done,” he said.

He said that the scheme is working towards creating NHIS at state level.

“We are decentralising NHIS to the state to replicate the service delivery on the federal level so as to meet direct demands of the people.

“We are working to towards deploying our programs at the state level so every state will establish its own health insurance scheme.”


11:23 AM: The DG of the National Agency for the Control of Aids, NACA, Sani Aliyu, said universal health coverage is the basic right of every citizen.

He said Nigeria should not rely on the help of donors for the fight against HIV AIDS.

According to Mr. Aliyu, it is time to start sustainable health treatment for AIDs because donors might eventually start pulling out.

“Universal health coverage will open the door for more access to cure and fight against preventable and sustainable ailments especially people living with HIV/AIDS.”

He said what the dialogue is asking for is the right to health and having proper funding to make it happen.

12:11 PM: In his address, Isaac Adewole, the health minister, said health is a basic human right that is not negotiable.

He said the APC manifesto was clear on its commitment to health.

According to Mr. Adewole, the goal is that 80% of the country will have access to health services near their houses.

Mr. Adewole also noted that everybody should be held accountable for poor service delivery both at federal, state and local level.

“The health commissioner in Nasarawa should be health accountable for service delivery in his state and so also other commissioners in other states as well as at the local government level.”

He urged the media to work closely with the health ministry in the task for universal health service delivery. “Health is a priority but we are not there fully.”

He also said there are recorded improvements in health funding in the country.

“Bauchi state appropriated 16 per cent of its budget on health which is an improvement.

“We are hoping that in the next 16 months, things will change. That is why this dialogue is necessary.

“Over 180 million people, Nigeria is a huge country with huge potentials. This has been driven by high fertility rate the country is blessed with. We need therefore to use this as a yard stick to change the phenomena and change the population pyramid of the country so as to have more workers than defenders.

“We have alot of communicable diseases in the country driven by infectious and parasitic diseases. We need to reduce this burden. There will be more cases of cancer in the future. We need to be prepared.

“There is increase in maternal mortality especially at child birth. We need to ensure that women deliver under extreme supervision to cut this down.”

Our major problems again is that we have more poor people, that’s why we are investing in poor people so as to change this narrative, he said.

He said the health ministry is working towards ensuring free surgery scheme for poor people across the country.

“We need to change functionality of our health care system.”

Mr. Adewole stressed the need to revitalise the primary health care. He said the PHC is meant to handle simple health cases which are often taking to the secondary and tertiary health care centres which are meant to handle serious issues such as cancer.

“We are trying to reverse this so that 80% of everybody in this country will get close access to a PHC, 10 per cent secondary and 10 per cent tertiary hospital and we need to replicate this in all the states.

“Most of the money we get from the states is invested in paying salaries. We need to invest more in providing health delivery in the state.

This dialogue will work outr plan on how to handle health service funding.

Mr. Adewole said the health service act has been implemented, “what remains is the funding.”

On revitalisation of PHCs, he said new structures will not be built but adequate upgrading, rehabilitation and equipping of already built or yet to complete PHCs across the country.

He however said new structures will be built in Borno because of the ravage done by Book Haram in the region.

He further addressed the poor system of cancer in the country.

He said the government is not also shutting the door on alternative and traditional medicine.

“We are ready to work with them once they provide proof of their methods and we regulate their products because that is how all opithodology medicine started.”

He further encouraged the private sector to join the race in the provision of quality health care delivery in the country.


12:32 PM: In his speech, the Vice president, Yemi Osinbajo, represented by the director, Voice of Nigeria, Osita Okechukwu, said healthcare for Nigerians is important to the Buhari administration.

He explained that the president is interested in health issues, but poverty is also a major issue to look at.

The vice president decried the enormous amount of money spent on medical tourism.

“Medical tourism costs billions of dollars and we want to stop that trend because it is draining our reserves.

Mr. Osinbajo also made reference to the lingering ethnic tension and agitations in some regions in the country which President Muhammadu Buhari addressed in his first national address on Monday after 103 days medical vacation in the UK.

“When the president said everybody has a right to live where ever he/she likes in the country, He was trying to register peace because a bad speech can cause hypertension to someone somewhere.”

He added that the Buhari government is committed to providing quality health service delivery for Nigerians, “that is why we are supporting this dialogue.”

He urged the states to also join in so as to ensure universal health coverage in the country.

Tea break commenced at 12: 20 p.m.

Watch live update below:

Group photo with the partners

Health Minister, Isaac Adewole leaving the event centre.

Group photo with the minister.


1:49 PM: Panel discussion 1: Lessons learnt and best practises in NGO advocacy for health financing in child and family health.

First panel discussion has 7 panelists which was headed by Dr. Omowunmi Olabalu – development research and project center.

Chinwe Onumonuh, one of the panelist, said everyday Nigeria loses 111,000 women every year to maternal health issues.

“That is why we are advocating for proper family planning.”

Ms. Onumonuh said through “One voice advocacy” a project to help reduce maternal child health mortality, family planning has been put in the fore.

“Family planning is seen as an appendage in terms of mother and child mortality.

“The one voice advocacy made it easy for policy makers to make critical decision on how to go about the programme and investment in family planning,” Ms. Onumonuh said.


1:54 PM: Another panelist, Beatrice Eluaka, said 2,300 children die daily from preventable diseases.

“Half of these deaths is caused by malnutrition.”

“Those who survive are just 33%. This means that in every 3 children, one is stunted and stunting affects the growth and development of the human brain.

“We have developed a policy to tackle malnutrition in collaboration with PACFAH and the federal government to make sure the policy is achieved.”


2:17 PM: Aminu Magashi, a panelist, praised the increase in domestic health funding in Kaduna, Kano and Bauchi.

He said 100 per cent fund for immunisation has been released in some states in the North. N125 million in Kaduna, N171 million in Bauchi and half of N91 million in Niger state.

We are using our advocacy to galvanise action in the states involved, he said.


2:43 PM: Emmanuel Abanida, a family planning consultant, said the lessons learnt in all advocacies by NGOs is that the health sector needs urgent reforms.

“Nigeria is in trouble when it comes to health challenges.”

Pharm Ayuba, a panelist, said one in every 8 children in Nigeria die before their 5th birthday.

“When you look at it you will see that 236,000 children will die every year from preventable deaths of pnuemonia and diarrhoea.

Ayuba, however, expressed delight over governments commitment in tackling pnuemonia and diahorria.

“We are happy to tell you that the government has reviewed the essential treatment guideline to include treatment of children for pnuemonia and diarrhoea.

“It took 6 Years before the review could be done after the WHO had released the guideline.

“We are joining the government to review this guideline across the country so as to reduce childhood killer disease to drive down child mortality to a single light.”

Emmanuel Abanida, a family planning consultant, said the lessons learnt in all advocacies by NGOs is that the health sector needs urgent reforms.

“Nigeria is in trouble when it comes to health challenges.”

Pharm Ayuba, a panelist, said one in every 8 children in Nigeria die before their 5th birthday.

“When you look at it you will see that 236,000 children will die every year from preventable deaths of pnuemonia and diarrhoea.

Ayuba, however, expressed delight over governments commitment in tackling pnuemonia and diahorria.

“We are happy to tell you that the government has reviewed the essential treatment guideline to include treatment of children for pnuemonia and diarrhoea.

“It took 6 Years before the review could be done after the WHO had released the guideline.
“We are joining the government to review this guideline across the country so as to reduce childhood killer disease to drive down child mortality to a single light.”

Adama Kachala, a representative of the Muslim women’s association said the association is present in the 36 states of the country with more than 600 affiliates.

She said the Muslim women association is supporting any advocacy group that want to tackle issues that concern women.

“We are meeting with tradional leaders to help make poor women and children get the much needed health care.

“We have trained 221 faith based organisations to advocate issues affecting women and children in terms of family planning, routine immunidation, nutrition and reduction of child killer diseases.

“We are using the traditional leaders because they are more closer to the people.

“We use these collaborations across all states to promote peaceful coexistence of various tribes, religions and ethnic groups.”
Omawunmi Olabalu, who chaired the first panel, stressed the need for collaboration between civil society and the government.

She said the “one voice advocacy” made it possible to push for more advocacy.

She, however, said the major challenge health advocacy is facing in the country is the non-openness of getting information especially from the government.

“The issue of transparency has been an issue, especially in releasing funds for projects.”

Ms. Olabalu urged the media to do effective reports on health challenges bedeviling the country.

Cross panel discussions:
A participant asked the panelist to throw more light on the roadmap for sustainability of the projects and health goals.

In response, yuba, a panelist, said they are building capacity in all the states were projects are done

“The people we put in place will sustain the projects.”

On the question of how to handle family planning in relations with the religious complexity in Nigeria, Adama Kachala said the Muslim women association,FOMWAN, and the Christian Association of Nigeria, CAN, sat together to discuss family planning from both holy books: the Bible and Qur’an to back family planning initiative in Nigeria.

Also on family planning, Emmanuel Abanida, a family planning consultant, said that the idea is not to discourage people from child bearing but to create space on how to manage the economic capacity in child delivery.

“Arguments have shown that fertility rate has colleration with innovations.”

Participants are on another break.

Panel 2:
Discussion: The role of legislators in guaranteeing Universal Health Coverage, UHC.

The Chairman, house committee on health, Oyo State House of Assembly, Silas Okunlola said UHC is possible and that the improvement recorded in the last two years backs that claim.

The panelist said he did not believe in family planning in the past, but through advocacy in Oyo State, “I have been convinced to key into the progress of family planning and I’ve also championed advocacies for family planning in the state.”

He said there is always a thug of war in getting other legislators to agree to a health policy but advocates have helped in educating legislators to understand more health related issues.

A panelist also from Oyo State said budgetary allocation bills passed to law in achieving UHC goals are hugely affected by poor funding.

The chairman, committee on health, Bauchi State House of Assembly, Ibrahim Katagum, said the preliminary sessions enable legislators respond on what is happening in their constituency, especially in the health sector.

He said he will communicate the deliberation of today’s dialogue to other members of the legislature so as to achieve UHC.

Mohammed Okepede from Nasarawa House of Assembly said the challenge the state is facing in legislating for health is non-openness of health ministries.

A panelist, Chika Uche, said the 8th assembly had decided to have a committee for PHC and communicable diseases before they were lumped together.

“Basically 80% of our diseases are treatable which is why we need to get 80% of the people to get close access to PHCs.

“In the 2017 budget, there was a deliberate effort to increase funds for agencies PHC.”

Uche stressed the need to contain diseases so as to bring down their spread.

A participant encouraged all states to look into issues on mental health as it is becoming rampant in the country. The participant also asked why mental health is not covered by NHIS.

A representative of NHIS however argued that the scheme encompasses mental health.

Another participant also asked the legislators to make sure there are no other bills or laws that might hinder or counter the UHC Act and other laws that might be passed to favour it.

A female participant stressed the need for both state and federal legislators to harmonise laws that have been countering health related bills thus causing states to shy away from implementing or contributing funds for health issues.

Uche Okoli, a panelist, in a closing remark urged stakeholders to keep politics aside when addressing health issues.

Panel 3: The funding question in Universal Health Coverage.

Daniel Iyayi, the Nasarawa State health commisioner, said large investment is needed to achieve UHC in the country.

Mr.Iyayi advocated for alternative sourcing for funds in terms of health care financing especially for vulnerable groups, women and children.

“If there is no fund, UHC will be a mirage.”

Gafar Alawode, another panelist, said some things should taking into cognicance when dealing with health financing for UHC.

“The first question is how much do we need and the other is who are we spending the money on? Another critical question is where is the money coming from?

Mr. Alawode said government is the key to financing health.

In his contribution, the DG of NACA, Sani Aliyu, said the NHIS was not designed in a progressive way. “It should begin by appropriating health care from the vulnerable perspective.

“Making sure the poor get quality and are mostly covered as much as possible”, Mr. Aliyu said.

The NACA boss said it is wrong to begin the insurance scheme with the government workers.

Mr. Aliyu compared the poor arrangement of Nigeria’s health scheme with that of Ghana and Gabon.

“Nigeria went down the NHIS route the easiest way and it is time we come back to the drawing board to make it work.

“We need to create a sustainable funding source. The biggest challenge for UHC in Nigeria is funding and unless this is sorted out, it will remain a problem.”

Mr.Aliyu tasked the government to evolve a strategy that will provide for the vulnerable group.

“Only 1.7p er cent of the countries population is covered by NHIS. States should come up with plans to key in on health insurance”, Mr. Aliyu added.

Mr.Aliyu stressed the need to add value for the funds received for implementation of health projects to ensure equity.

He said Nigeria should start looking for ways to fund its health needs and stop looking for foreign donors.

Mr. Aliyu in his closing remark said donor confidence can be increased by ensuring accountability and reducing waste and making sure procurement is across all chains involved.

Panel discussions ended at 4:30 pm.

Lunch break and closure of today’s dialogue session.

Day 2 of the health dialogue will continue tomorrow by 9:am at same venue, Musa Yaradua centre Abuja.

Premium Times will also bring you live updates and you can as well follow the conversation on twitter with #healthdialogue.

The keynote address of the Emir of Kano, Muhammadu Sanusi was delivered by his representative, Umar Bala.

The emir explained that he was unable to make the event due to previous engagements.

He expressed delight in the opportunity to speak on the role of Traditional and Religious Leaders in Community Health Care under the theme Universal Health Coverage, Prospects and Challenges.

Mr. Sanusi said no doubt the much celebrated effort of Governments in the attainment of Universal Health Coverage is congruent with the continued quest by communities for accessible, affordable and qualitative health care services.

“We are not unaware of the current inadequate healthcare coverage especially that of maternal, childhood mortality, Skilled Birth Attendants, unmet needs of the family planning, among others, have continued to show how far we are from achieving our goal and objectives, particularly in the Northern part of the country.

“It is important to note that the Nigeria National Policy on Health has as its goal, to provide adequate access to primary, secondary and tertiary health services for the entire Nigerian population based on the principle of social justice, equity and the ideals of freedom and opportunity affirmed in the 1999 constitution.”

According to the emir, Kano State shares problems of having the highest population in the country and the lowest number of health workers.

He said Kano State had a discussion with the ministry of health on the need for the Emirate Council to provide support and collaboration with government in community mobilisation on primary health issues.

“We therefore promulgated the Kano Emirate Council Committee on Health, KECCoH, to work on these challenges.

“The government and our development partners have always considered the traditional and religious leaders as primary agents for community mobilisation in the development programmes because they have been involved as gate keepers in various community oriented programmes ranging from immunization, control of communicable diseases, maternal and child health, eradication of diseases and so on.”

He added that with the traditional and religious leaders coordinating with the communities for improved services, government should be more agile on their responsibilities in meeting-up the ever rising demand for services at all times.

“We are not unaware of the various efforts made by the government and development partners in the health sector, and we are indeed grateful”, he said.

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