The right to health is inextricably linked to the right to life. Nigeria is bound by certain laws and charters to protect the right to health of its citizens. The Sustainable Development Goal 3 is to ensure healthy lives and promote well-being for all at all ages. Meanwhile article 25 of the Universal Declaration of Human Rights declares that “Everyone has the right to a standard of living adequate for the health and well-being of himself and of his family, including food, clothing, housing and medical care and necessary social services, and the right to security in the event of unemployment, sickness, disability, widowhood, old age or other lack of livelihood in circumstances beyond his control.”
Chapter two of the 1999 Nigeria’s constitution in sec 17 (3), provides for the rights to health of Nigerians, (c), “the health, safety and welfare of all persons in employment are safeguarded and not endangered or abused (d) there are adequate medical and health facilities for all persons”. Also, the recently signed National Health Insurance Authority Act, 2022 has an overriding objective to (a) promote, integrate and regulate all health insurance schemes; (b) improve and harness private sector participation in the provision of health care services and (c) do such other things that will assist the authority in achieving Universal Coverage in Nigeria.
The protection of the right to health in Nigeria cannot be over-emphasized given that Nigeria has very poor health indicators. First is the low allocation of budgetary resources to health which is usually in a single digit ratio of not more than 5 percent below the Abuja 15 percent declaration. Secondly more than 70 percent of the population pays out of their pocket for health; this is far above the Sub-Saharan target of 23 percent for out of pocket expenditure in Africa. Progress in reducing Maternal and Child mortality is still very low in Nigeria compared to other countries in Africa. Other challenges in the health sector include; poor medical facilities in the health care facilities, poor human resources at the health care facilities which is occasioned by poor remuneration of medical doctors and the growing number of medical brain drain. The levels of patronage at the Primary Health Care Centers, is also currently low due to poor quality of care and deteriorating facilities.
To solve this problems, the front running political parties contesting for the 2023 general election have outline their plans for the health sector. The All Progressive Congress, with former Governor of Lagos State, Bola Ahmed Tinubu as its candidates promises to improve the nation’s health care infrastructure by collaborating with States and Local Governments to create a new network of local clinics and dispensaries providing primary health care and drugs for citizens. He also promised to increase the proportion of the annual budget dedicated to health care from 6.5% presently to over 10% and to implement the National Health Insurance Coverage for most Nigerians.
The Peoples Democratic Party (PDP) with former Vice President Atiku Abubakar, as its candidate promises to undertake administrative reforms, facilitate Universal Health Coverage by Working with states to advance and motivate a realistic primary health care service delivery plan that ensures that at least, 65% of Nigerians have access to a defined basic Primary Health Care (PHC) and services package by 2024, rising to at least 80% coverage by 2030. It identified further that the (Current baseline PHC coverage levels range from 35% to 49% in different states). According to the document, by 2024, Atiku Abubakar promises to scale up national health insurance coverage and financial protection schemes to reduce by 40% the number of Nigerians who are impoverished due to out-of-pocket health care expenses.
The Labor Party with former Governor of Anambra State Peter Obi as its candidates promises to provide 133 million poorest Nigerians including pregnant women, children, the aged and the disabled. He also promised to strive to honor Nigeria’s commitment pursuant to the 2001 African union Abuja Declaration on HIV/AIDs, Tuberculosis and other related infectious diseases, which set target of allocating 15 percent of annual budgets to the improvement of health sector in African countries.
The three candidates, made a common promise to increase the number of persons enrolled under the health insurance scheme but they were not clear on how they would raise the funds to achieve the set targets. The target to increase health insurance coverage is in line with the strategic objective to attaining Universal Health Coverage. The UHC’s has a goal to improving healthcare by accelerating reforms to adequately finance the health system and realign resources in line with the responsibility for health across the tiers of the healthcare delivery system. To achieve this, whoever becomes winner of the election, should implement the National Health Insurance Authority Act NHIAA (2022) that makes health insurance mandatory for all residents in Nigeria. An imposition of insurance levy on all residents of Nigeria would generate the required funds necessary to fund the health sector. The winner of the election should also commit to allocate 15 percent of the entire annual budget to health, in line with the Abuja Declaration of African Leaders.
Program Manager, Good Governance
Writes from Centre for Social Justice,