Universal health coverage (UHC) means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship. It covers the full continuum of essential health services, from health promotion to prevention, treatment, rehabilitation, and palliative care across the life course.
Protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because unexpected illness requires them to use up their life savings, sell assets, or borrow – destroying their futures and often those of their children.
Achieving UHC is one of the targets the nations of the world set when they adopted the 2030 Sustainable Development Goals (SDGs) in 2015. Fundamentally, the UHC is a policy component programme of the entire healthcare delivery system in Nasarawa State.Therefore, the problems confronting the state’s healthcare system over the years are likely to affect the policy’s implementation and sustainability. These problems among others include poor governmental allocation of funds to the health sector, inadequate supply of physicians accentuated by brain-drain syndrome in the health sector, poor distribution of health facilities or urban-biased establishment of health facilities, shortage of drugs, management lapses, corruption, attitude of the health workers, obsolete and dilapidated health infrastructure. Generally, the interplay of the above mentioned problems plaguing the state’s health sector have some constraining effects on the implementation and sustainability of the policy.
However, Nasarawa State has shown commitment to achieving UHC, though progress has been slow. The 2017 Lafia Summit Declaration affirms that UHC is key to ensuring equitable access to high-quality, affordable health care for all citizens in the State. Although the summit was built on a highly participatory stakeholder engagement process, its concomitant momentum has waned. A recent review of health-system financing for UHC in Nasarawa state shows high out-of-pocket expenses for health care, a very low budget for health at state level of government, and lack of health insurance implementation.
In recent years, the Centre for Social Justice (CSJ) has been working to improve access to health insurance and promote universal health coverage in Nasarawa State. This is a laudable effort, as healthcare is a fundamental right that should be available to all citizens, regardless of their income or social status.
The CSJ is a non-profit organization that aims to promote social justice and human rights in Nigeria. They work on a variety of issues, including public finance management, governance, gender equity, rule of law and social justice. One of their main focuses is on health policy and access to healthcare.
In Nasarawa State, the CSJ has been working under the #Righ2Health project to increase the number of people who have access to health insurance. The project is being carried out as part of the USAID-SCALE (Strengthening Civic Advocacy and Local Engagement) programme, which aims to influence policies and reforms across the most critical service sectors. Health insurance is a key component of universal health coverage, which means that everyone has access to essential health services without suffering financial hardship. This is a critical issue in Nigeria, where many people do not have access to basic healthcare services.
The CSJ has been working with the Nasarawa State Health Insurance Agency (NASHIA) to implement a health insurance scheme that is accessible to all citizens. This scheme is designed to provide financial protection to individuals and families in the event of illness or injury. It covers the cost of essential health services, including hospitalization, surgery, and diagnostic tests.
The health insurance scheme has been a success so far, with thousands of formal sector employees enrolled in the programme. This is a significant achievement, as it means that more people have access to healthcare than before. It also means that people who do get sick or injured are less likely to face financial ruin as a result of medical expenses.
CSJ works with the Centre for Citizens Rights, headed by Dr. Abdulazeez Adamu Bako in Lafia, Nasarawa State in implementing this project. The Centre for Citizens Rights is dedicated to promoting human rights and social justice in Nigeria. They work on a variety of issues, including the rights of women and children, access to education, and healthcare. Dr. Bako and his team at the Centre for Citizens Rights have been instrumental in advocating for better healthcare access in Nigeria. They believe that access to healthcare is a fundamental human right and that everyone should be able to access basic healthcare services.
There is an urgent need to fully operationalize the Nasarawa State Health Insurance Agency to cater for the burgeoning health needs of the population. Currently, less than 2% of Nasarawa state citizenry have health insurance coverage; most enrollees are in the federal institutions with no coverage in the state formal and informal sectors and inherent implementation challenges.
Political leaders in the state should therefore muster enough political will to ensure that quality and affordable healthcare services in Nasarawa state are provided. They should stop paying lip service to healthcare issues.
The government should prioritise the provision of affordable healthcare to all citizens. For the government to do this effectively there is the need to reinvigorate the Primary Health Care (PHC) system. The state government should bring back the basic healthcare services and make them available to all citizens.
Okeke writes from the Centre for Social Justice (CSJ) Nigeria
