The Nigerian government and the Nigerian Medical Association have disagreed over the status of the National Health Act, a law that came into effect in 2016 to improve the access of Nigerians to health care delivery.
While the Minister of Health, Isaac Adewole, in an exclusive interview with PREMIUM TIMES, said the Act had been substantially implemented, the NMA President, Mike Ogirima, said that was far from the truth.
The National Health Act was signed into law in 2014, after 10 years of consideration.
The Act aims to establish a framework for the Regulation, Development and Management of a National Health System; to achieve the Universal Health Coverage and meet the Millennium Development Goals (MDGs).
The Act also provides for the elimination of quacks from the health sector and provides healthcare insurance to certain class of people who are actually deprived, among others.
According to the minister, all aspects of the Act have been implemented except its provision for a Basic Health Care Provision Fund.
In the interview with PREMIUM TIMES held on January 31, Mr. Adewole, a professor of Medicine, was asked if the fact that millions of Nigerians continue to suffer the burden of out-of-pocket expenses on healthcare, one of the problem that were to be addressed by the Act, was due to the failure by government to act on the National Health Act.
But the minister denied that that was the case.
“That’s wrong, it (the Act) was passed to law, signed in 2014, gazetted and released early in 2016. When you say we have not implemented the Act, then I think you need to read the Act. Then you will give us credit because we have implemented it almost fully.
“Every part of the Act has been implemented, apart from the Basic Health Care Provision Fund. And on our own, we are doing a pilot project and that pilot project will entail offering healthcare to eight million Nigerians in three states in the next few months.
“In our budget, we also put some money as part of the pilot project. We don’t want to cover the whole country at a go, but we can start gradually and learn from that.
“The Act enables and empowers the minister to determine what the basic health care packages should be and I have done that. All the committees we have formed, such as the National Council on Health, are meeting.
“Under this administration, the National Council on Health met four times, including two emergencies. We had an emergency meeting on Lassa fever. In terms of working with the commissioners, we are there. In terms of national health policy, we are there. Yesterday, I received notification of an approval for us to do a nationwide survey on HIV.
“So if there is one tiny beat of the Act that is yet to be implemented, you can’t say we’ve not implemented the Act or that it’s not working. People should be more categorical. There is one Yoruba proverb that says the calabash is heavier than the plate but what the person was referring to is a cold or wet calabash because the dry one is not heavy.”
However, Mr Ogirima, the President of NMA, disagrees with the minister.
Mr. Ogirima, also a professor, told PREMIUM TIMES in a phone interview that apart from the Basic Health Provision Fund which the minister made mention of, several other parts of the Act are yet to be implemented and operationalised.
“What have they even implemented in the Act? The components of the Act are so numerous. The Government and the Minister of Health only went ahead to set up many implementation committees, but a lot of things are yet to be implemented and operationalised.
“When you talk about the certificate of standard for every health institution in the country, nobody is going around to issue that certificate of standard. A clinic needs to have some basic requirement. Can the government tell us one clinic they have visited? Can the committees tell if they have formed any committee on certificate of standard? That committee they formed is supposed to go round and register all clinics, hospitals and even teaching hospitals and private hospitals.
“There are many mushroom clinics and hospitals scattered all over the country. There is a lot of quackery in the system. On top of that, the Medical and Dental Council of Nigeria, Pharmaceutical Council of Nigeria and all the regulatory bodies that are important in health care are not constituted
“Then, the one they said is yet be to implement is getting at least one percent of our consolidated revenue into Basic Health Provision Fund. This fund is for the vulnerable in the society. Subsequently, the government has not made that provision in all their budgets, including the 2018 budget.
“So you can see that the law has not being operationalised and that’s the summary of it. NMA under my leadership has led a coalition of stakeholders in the health sector and we are in court challenging the government over this issue.
“They are denying citizens their rights to access to basic health funds. No certificate of standard, the vulnerable are suffering, pregnant women are suffering.
“Children underfive5 are not immunized. The immunization coverage rate in the country fell from 70 percent to about 35 percent and they are not doing anything about that,” Mr. Ogirima said.
The Nigerian Medical Association, among other health workers, had over the years protested the non-implementation of the National Health Act.