The National Health bill seeking to enact a comprehensive health policy for Nigeria was finally passed by the Nigerian Senate yesterday after playing with if for nearly 3 years.
We have blogged severally about how this bill has been stalled and its effect on the delivery of health and health care in Nigeria.
Problems of our health care “system”….
Primary Health Care …the entry point into health services and most crucial for population health is in the hands off the weakest level of governance in Nigeria – The Local Governments. …So it did not really matter how many clinics the National Primary Health Care Development Agency built…once they were handed over to the Local Governments….well they remained empty buildings.
There is no legistlation describing the national health “system”, and defining the roles and responsibilities of the three tiers of government, and other stakeholders in the system.
Each Federal Medical Centre/Teaching Hospital is its own fiefdom…with huge budgets…and little management structures.
The private sector…is out of all formal loops….
So what does the new bill do?
- Regulation, development and management of the national health system with primary health care as the entry point.
- A National Tertiary Hospitals Commission with the responsibility of advising the President through the office of the Minister of Health on issues concerning teaching hospitals in the country.
- A Primary Healthcare Development Fund that will apparently provide basic health care to as many as possible through the National Health Insurance Scheme. The fund is to be administered by the National Primary Health Care Development Agency (NPHCDA).
Now we have spent 3 years talking the talk….we now have to implement… and therein lies the challenge.
We do not have a Minister of Health….so not sure who will lead…
The Chairman of the Committee on Health is on the run….so not sure who will monitor…
And with the history, the National Primary Health Care Development Agency (NPHCDA) in implementing anything (they are responsible for immunising our children (not)) …not sure who will implement…
But we remain hopeful….thats one thing we have a lot of in Nigeria.
Aluta…
Never doubt that a small group of thoughtful committed people can change the world; indeed it is the only thing that ever has…Margaret Mead