A former Minister of Health, Prof. Eyitayo Lambo, on Thursday stated that the challenges in the country’s health sector were as a result of bad leadership and poor governance that always led to failure of healthcare policies.
In a presentation he made at a seminar organized by the Ibadan School of Government and Public Policy (ISGPP) on health policies in Nigeria, Lambo regretted that many Nigerian presidents did not take healthcare as a priority while many health ministers also did not build on existing policies due to a reason best known to them or for political correctness.
He spoke on the topic: “Evolution and Challenges of Health Policy and Health Systems Development in Nigeria”.
He emphasized that leadership and governance are the most important building blocks in health systems and development instead of the erroneous belief that the success of the sector depends of good financing.
He said that according to the World Health Organization (WHO), the five pillars of a sound health care system are: service delivery, human resources, medicines, vaccines and technologies, financing and information
According to him, healthcare development would have gone far past its current status in Nigeria if successive administrations had taken healthcare more seriously and built on existing policies.
He pointed out that poor attitude of health workers, incessant strike actions, rivalry among health professionals, corruption and fraud in the system and heavy dependence on foreign drugs complicate the challenges.
Others include weak constitutional provisions for heath, lack of role definition for federal, state and local government on health, constant changes in leadership of health ministries and institutions, absence of inter-sectoral collaboration on heath and poor funding.
Lambo also decried the declining state of the National Health Insurance Scheme (NHIS) which was established during his tenure as Minister of Health during the Chief Olusegun Obasanjo presidency. He disclosed that a proposal to amend the NHIS Act for more effectiveness has been lying with the National Assembly for about five years now thereby frustrating stakeholders.
The former minister said that to resuscitate the country’s healthcare sector, Nigerians need to carefully elect only leaders who place healthcare on top of their priority list. He also called for the following:
- Clearly defined role for each tier of government
- Amendment of the constitution to reflect health as a human right
- Strengthening of the capacity for health policy and plan development, implementation, monitoring and evaluation at all levels
- Improvement of accountability in the sector.
- Inter-sectoral collaboration for health
- Increase in budgetary allocation to health
- Establishment and intervention of pressure groups to mount pressure on political leaders to deliver good healthcare to citizens when the leaders foot-drag.
The former minister also called for the implementation of the Basic Health Care Provision Fund as provided in the NHAct 2014 “to ensure free access of all Nigerians to a well-defined minimum package of health services.” He revealed that the bill was prepared in 2004 when he was minister but was only passed in 2014, and has not been implemented since then.
He advised the government to explore other creative ways to finance Health which may include air ticket tax, ‘sin’ taxes, and additional Value Added Tax (VAT) specifically for healthcare.
He also advised government to provide financial and other necessary support to the National Institute of Pharmaceutical Research and Development (NIPRD) to enable it develop drugs based on local herbs to meet local needs.
Lambo urged medical doctors to show good leadership by speaking for other categories of health workers in order to enjoy their support and bring harmony to the entire health system in Nigeria.
The Chairman, ISGPP Governing Board, Prof. Akin Mabogunje, added that lack of integration among the three tiers of government and other stakeholders is another challenge confronting healthcare delivery system in the country.
Speaking earlier, the Executive Vice Chairman, ISGPP, Dr Tunji Olaopa, acknowledged that civil servants sometimes play a negative role in policy implementation, but stressed that the problems are not insurmountable as he had offered a lot of solutions in his several books and public presentations.