“Translating Health Policy and Plans into Action:” HMH Prof. Isaac Adewole Remarks at Inaugural Cross River State Health Summit

Health Ministry NGR
Aug 9, 2017 · 8 min read

It is my great pleasure and honour to be at the inaugural state health summit organized by the Government of Cross River. The presence of His Excellency, the Executive Governor of Cross River State, Senator Professor Ben Ayade, is a reflection of the political will and commitment given by his administration to the State Health Agenda. Let me specially thank His Excellency for setting this summit up at this important period when Federal Government of Nigeria is refocusing the health policy and revitalisation of the health system.

I want to observe with admiration the theme for this State Health Summit “translating health policy and plans into action” which I consider not only relevant but very timely. We may recall that the emergency National Council on Health meeting held on 8thSeptember, 2016 adopted the new National Health Policy for the Country. The new policy is thus expected to ensure that Nigeria is well positioned to enter into the Post -2015 Sustainable Development Agenda (SDG) era with the right enabling and supporting policy environment.

The National Health Policy (2016) is expected to ensure alignment with existing and emerging global and local health developments. Our vision as contained in the policy is “Universal Health Coverage” (UHC) while our mission is “to provide stakeholders in health with the comprehensive framework for harnessing all resources for health towards achievement of UHC as encapsulated by the National Health Act.”

The new policy provides the basis for the second National Strategic Health Development Plan (NSHDP II), and also serves as the supporting framework for the successful implementation of the National Health Act (NHAct) 2014.

The National Health Act (NHAct) 2014 was enacted to ensure improved health outcomes; to provide a legal framework for the provision of health care services and to establish an organisational and management structure for the health system in Nigeria. To achieve this important objective of providing quality healthcare services to all Nigerians, the Act specifies that all Nigerians shall be entitled to a Basic Minimum Package of Health Services (BMPHS). The “Basic Minimum Package” is a set of preventive, protective, promotive, curative and rehabilitative health services or interventions.

To ensure Nigerians benefit optimally, the Basic Health Care Provision Fund (BHCPF or “The Fund”) was established under Section 11 of the National Health Act, as the principal funding vehicle for the BMPHS. PHC remains the foundation for the provision of healthcare services in Nigeria and this fundamental role is recognized by the NHAct. The current administration has also, in setting out our healthcare agenda, centred it around the provision of functional PHC in all political wards of the federation, with the ultimate objective of ensuring UHC for all Nigerians.

Translating Health Policy into Plans and actions

The effectiveness of a policy lies not only in wide stakeholders’ participation nor in its specificity in addressing challenges and constraints, in identifying strengths that should be nurtured, but also in translating the plans into concrete actions within available resources and capacities. This is precisely the focus of the Second National Strategic Health Development Plan.

With a frame work in place, states are to develop their state specific plans looking inwards to situations that need to be addressed with effective interventions within available resources and capacities. Developing the state strategic plan and translating the plan to annual actions will require enormous political will and commitment, having determined a course of interventions best to achieve better health for the citizens over a period of time with a set of targets in focus. Deriving annual actions from the strategic plan entails determination to stay on a collective pathway of action and responsibility for the improvement of health of the people to which all actors can hold themselves accountable. Going outside the plan having committed so much resources to developing it amount to a waste of resources, time and efforts.

Facilitating the Translation of plans into actions

In translating our plans to action, let us bear in mind that we need to go outside the health sector to interact and enjoy close fellowship with those sectors that impact on health. We need the Ministry of Planning and Finance as much as the Ministry of Water Resources as much as the Ministry of Agriculture and Education to mention just a few. We cannot afford to ignore the private sector participation as the public sector cannot do it all alone. We must cultivate healthy partnership with Development Partners for as long as they support us in the realization of our strategic plans and not necessarily a stand-alone agenda. Let us ensure that whatever plans we develop and the actions emanating from such plans are in alignment with other sectoral plans, which require the participation of other sectors in developing our health sector plans.

Human Resource for Health capacity has to be taken into consideration in the development of our plans and actions. No matter how good our plans are, it takes human resources to translate those plans to actions. Attention should be given to Human Resources to Health in terms of the existing gaps in number, skills and distribution and plans to address these in the short term (task shifting policy), medium term (production, recruitment and retention) and long term (condusive environment).

What we have done so far

Distinguished Ladies and gentlemen, let me share some of the achievement of President Muhammadu Buhari’s administration with you.

To enhance efficiency in the system, the present government under his Excellency President Muhammadu Buhari is working to make the PHC the entry point into the healthcare system. From the supply side, there are already ongoing efforts by the National Primary Health Care Development Agency (NPHCDA and the Federal Ministry of Health (FMOH) to ensure the availability of at least one functional PHC in each political ward in Nigeria. Based on this, it is hoped that within the next few years, the government will be able to renovate and make fully functional.

Mr. President’s vision is to provide access for all Nigerians to have good healthcare services. Although health is on the concurrent list, this government took special interest in the revitalization of existing PHCs in the country. Our vision is to make 10,000 of the available 30,000 PHCs functional in the life of this administration. We know this is a big idea that need huge investment. We have started the journey with Mr President personally kick-starting the drive at Kuchigoro community in Abuja. May I inform his excellency and other dignitaries here that State Governments are expected to champion this initiative through their State Primary Health Care Development Agency. Several Development partners have also bought into this idea. We need to make our existing PHCs functional and there is no need to construct new ones except in the North-East of the country.

From the demand side, the National Health Insurance Scheme (NHIS) is working with the states in a policy of decentralization of health insurance implementation to the States. This is believed to be the right response to the federal structure, with states having the constitutional power to legislate on health. When fully implemented, this will see the states using the social health insurance mechanism to finance their health systems, which is more efficient, equitable and transparent. The Scheme will mobilize resources centrally, which it will use to carry out risk adjustments, especially for the vulnerable persons in the country.

To bring all these efforts to fruition, some opportunities exist for the Federal Ministry of Health to implement these reforms. The FMOH has disbursed $1.5 million to each state in July 2016. This grant is from the Saving One Million (SOML) initiative to improve the health outcomes of Nigeria. We expect each state to use the money for its purpose and not to squander it on frivolities. Nigerians are monitoring the progress in each state.

The Basic Healthcare Provision Fund (BHCPF) represents yet another opportunity for the country. The Fund, which is a product of the National Health Act (2014), makes the provision of 1% of the Consolidated Revenue Fund (CRF) for the provision of a Basic Minimum Health Care Package (BMHCP), which satisfies the needs of Nigerians. Of this 1%, the National Health Insurance will receive 50% to provide demand side financing of this basic healthcare package. The NHIS plans to disburse its share to the States’ Health Insurance Schemes, who will purchase the basic minimum health care package for Nigerians. Forty five (45%) will be disbursed though the National Primary Healthcare Development Agency (NPHCDA). This will be for finance vaccines procurement, facility renovation and Human Resources for Health (HRH). To access this fund, States and Local Governments are required to make counterpart contributions. The Fund is to serve as an instrument to improve the overall health system by getting States and local governments to implement the national health policy, norms, standards and guidelines prescribed by the National Council on Health. The remaining 5% is to be used by the Federal Ministry of Health to address emergencies.

In realization of these objectives, the FMOH is currently piloting implementation of BHCPF in 3 states through the Global Financing Facility. We hope to share lessons learnt and prepare for roll-out across the 36-states of the country.

Ladies and Gentlemen, the Federal Ministry of Health is leading efforts aimed at mobilizing resources from other sources as we move to consolidate on effort in the pursuit of UHC. We are working with the Federal Ministry of Finance to see how we can get resources through the value added tax, telecoms industry, tobacco tax etc. In addition to all these, we are working on measures to reduce wastages within the system. These gains in efficiency will be a further source for Nigeria to improve its healthcare financing capabilities.

Another initiative of PMB is the Better health for All tagged Rapid Result Initiatives. We have offered free medical and surgical interventions for poor Nigerians who hitherto would not seek care for their ailments. We provide hope inspite of their despair and our joy is to see people with hopeless medical condition rise with be aiming smiles of appreciation.

This year, the FGN will be conducting cancer screening for men and women all over Nigeria. I implore all to support us as we try to bridge the gap of inequalities in the country.

Concluding Remarks

Your Excellency, I thank you for your support to this health summit and in particular to the health agenda in your state. Coming at a time the state is developing its strategic plan, this is indeed a very good strategy in having all stakeholders on board from inception. You have demonstrated political leadership, will and commitment worthy of emulation by other state executives. I wish you a very successful summit.

Health Ministry NGR

Written by

The official Medium channel of the Federal Ministry of Health, Nigeria. Honorable Minister: Prof. @IsaacFAdewole (Nov. 11, 2015). Managed by Press Unit

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