SGF inaugurates healthcare provision fund committee for improved health services

The Secretary to the Government of the Federation(SGF), Boss Mustapha on Tuesday in Abuja inaugurated a joint working committee of the health care provision fund.

The committee is tasked with the responsibility of ensuring the provision of quality basic healthcare services to the majority of Nigerians.

Mustapha explained that preference would be on people living in the rural areas and the vulnerable population.

Others, he said, are women and children under the age of five years, as well as the elderly, irrespective of their locations in the country.

The SGF was represented by Mr Andrew Adejo, the Permanent Secretary, Political and Economic Affairs, Office of the SGF.

He said that the Basic Health Care Provision Fund was the funding provision of the Federal Government established under the National Health Act, 2014 (NHAct) for the achievement of Universal Health Coverage (UHC) in Nigeria.

The SGF also said that the establishment of the fund by law was the turning point of healthcare services in Nigeria.

He added that it would bring relief to millions of Nigerians who have never experienced proper basic healthcare.

He stressed that it would also reduce out-of-pocket expenses for health services and improve Nigeria’s dismal performance on several health indices and overall quality of life.

He said, “Years after the establishment of the Fund, millions of Nigerians in the 36 states of the federation and the FCT are yet to feel its impact, given several challenges and delays in its implementation.

“The Fund was established within the National Health Act of 2014 to increase the overall financing to the health sector and to help improve access to primary health care services for all Nigerians, especially the poor and vulnerable.

“Specifically, the fund was to support the provision of a basic minimum package of health services to citizens; provision of essential drugs, vaccines, and consumables for eligible primary health care facilities; provision and maintenance of facilities, equipment and transport for eligible primary health care facilities.

“Development of human resources for primary health care; and emergency medical situations, such as Ebola and COVID-19.

The SGF further explained that the fund was financed by the federal government’s annual grant of not less than one percent of its Consolidated Revenue Fund (CRF).

He added that grants by international donor partners and funds from other sources also financed the fund in part.

The disbursement of the Fund, he added, would be 50 per cent for the provision of basic minimum package of health services to citizens, through eligible primary or secondary health care facilities promoted under the National Health Insurance Scheme (NHIS).

“45 per cent would be disbursed through the National Primary Health Care Development Agency to be utilized for the following: 20 per cent to provide essential drugs, vaccines, and consumables for eligible primary health care facilities.

“While 15 per cent will be for the provision and maintenance of facilities, equipment and transport for eligible primary health care facilities.

“10 per cent for the development of human resources for primary health care, as 5 per cent of the fund shall be used for emergency medical treatment to be administered by a committee appointed by the National Council on Health,” he said.

The SGF noted that access to the funds would be contingent, amongst others, on the provision of 25 per cent counterpart funding by states and local governments.

He acknowledged that President Muhammadu Buhari, had approved the operationalization of the basic healthcare provision fund (BHCPF) 2018/2019 budget with an appropriation of N55.1 billion.

Mustapha said in 2020, N44. 5 billion was earmarked but revised to N25.5bn (a decrease of more than 42.5 per cent) due to shortfall in revenue occasioned by COVID-19 and oil price volatility.

The SGF noted that the 2021 appropriation bill recently presented to the National Assembly proposed the sum of N35.03 billion for the fund through statutory transfer.

He commended Buhari’s commitment to ensuring that quality basic health care service was delivered to the majority of Nigerians.

The SGF stressed that, “It is also in alignment with one of the main objectives of the Economic Recovery and Growth Plan – investing in the Nigerian people.

“Furthermore, the BHCPF is critical to achieving Priority six (improving health, education, and productivity of Nigerians) of the nine priority areas guiding the policy directions of the Buhari administration over the years.

He expressed sadness that in spite of the President’s demonstrated commitment over the years, implementation of the fund had remained a challenge.

“Millions of Nigerians across the 36 States and the FCT, who could have been potential beneficiaries of the Fund remain without access to basic health care, six years after the enactment of the Act.

“One of the significant manifestations of the failure of the BHCPF to gain traction was the suboptimal state of our basic healthcare system when COVID-19 pandemic hit the country.

“More importantly, the Fund has been structured to impact on the poorest of the population by addressing preventable diseases and improving primary health care services at the grassroots.

“Therefore, the slow implementation of the Fund is fast becoming a missed opportunity for this Administration to improve the quality of life for the 100 million Nigerians that should come out of poverty,” he said.

The SGF, however, expressed optimism that the committee would, as a first step towards establishing a proper stakeholder coordination mechanism, liaise with the Bureau of Public Service Reforms.

He said that their objectives would be to get the highest level of political buy-in for the implementation of the fund and to bring stakeholders up to speed on the status of the Fund.

Mustapha urged the committee to have a shared understanding of challenges and bottlenecks in the process of implementation and agree on recommendations as action plans to fast-track progress of implementation.

He charged them to establish the need for the stakeholder coordination framework and other mechanisms to sustain momentum and submit a final copy for approval by the steering committee of reforms.

Earlier, in his speech, the Director General, Bureau of Public Service Reforms, Mr Dasuki Arabi, said it had been observed that several factors had been attributed to the slow implementation of the Fund.

He named gaps in the enabling Act to include silence on initiation, administration and governance of the BHCPF, weak buy-in from the states, low state of states’ readiness, and inter-agency rivalry.

Abari also said that the National Primary Health Care Development Agency, one of three gateways for disbursement, was statutorily mandated with developing operational guidelines for the entire Fund.

He said that this potentially posed challenges with cooperation from the two other gateways, amongst others.

Arabi said that the Bureau of Public Service Reforms (BPSR), with the support of the Foreign, Commonwealth and Development Office (FCDO)-Partnership to Engage, Reform and Learn (PERL), had undertaken an analysis of the current situation of the Fund.

According to him, this was in order to uncover the underlying issues and seek a way forward for faster implementation.

He said that the analysis identified the major cause of the issues to be lack of synergy and agreement amongst stakeholders on how to resolve issues and move the implementation forward for the sake of the citizens.

The Director General also said the committee was constituted to provide an effective stakeholders coordination mechanism towards the actualization of the Fund.

Mr James Sule, Permanent Secretary, Cabinet Affairs, Office of the SGF, in his remarks, described health as wealth and good health promotes development for any nation.

He urged the committee to ensure that a good job was done to ensure that healthcare in Nigeria could improve and address short comings that lead to Nigerians leaving the country to seek medical attention abroad.

Responding on behalf of the inaugurated committee members, Mr Joseph Umaru, Federal Facilitation Manager, Partnership to Engage, Reform and Learn, said the team would ensure that the best was delivered.

Umaru said the committee would work with the present administration’s desire to ensure that people, most especially those at the grassroots and the vulnerable, were carried along in developmental programmes.

It was reported that members of the committee were drawn from the public and private health sectors, NGOs with health practitioners, the House of Representatives and Senate committees on healthcare services.

Others were from the ministry of budget and national planning and ministry of finance.