- World Health day 2024Centre for Social Justice (CSJ), a Nigerian Knowledge Institution, welcomes the theme of the 2024 World Health Day celebration. By focusing on “my health, my right”, the day provides an opportunity for stocktaking on the interventions and results achieved by all stakeholders towards the realization of the highest attainable standard of physical and mental health in Nigeria.
We recall that Nigeria is a state party to a plethora of international and regional standards providing for the right to health including the International Covenant on Economic, Social and Cultural Rights (“ICESCR”- article 12), the Convention on the Elimination of all Forms of Discrimination against Women (“CEDAW”- article 12), Convention on the Rights of the Child (“CRC”- article 24), and the African Charter on Human and Peoples’ Rights (article 16), etc.
We also recall the intendments of the National Health Act (NHA) inter alia, to protect, promote and fulfil the rights of the people of Nigeria to have access to health care services and to define and provide a framework for standards and regulation of health services. We further recall that the National Health Policy envisions universal health coverage for all Nigerians, with an overall goal of strengthening Nigeria’s health system, particularly the primary health care sub-system, to deliver effective, efficient, equitable, accessible, affordable, acceptable and comprehensive health care services to all Nigerians.
CSJ is concerned by the inexplicable paucity of the Constitution of the Federal Republic of Nigeria 1999 on the right to health, as the right to health is missing from the Bill of Rights found in Chapter Four of the Constitution. There is hardly a mention of the word, “health”, in the Constitution. We are concerned about Nigeria’s poor health indicators including very high out-of-pocket health expenditure of 70%; high levels of maternal, child and infant mortality and morbidity and low life expectancy. We are further concerned about the very low enrolment on the compulsory health insurance regime of the National Health Insurance Authority Act (NHIAA); as well as the low budgetary releases, low utilization and the poor results in the operationalization of the Basic Health Care Provision Fund meant to facilitate access to health for the poor. Furthermore, the Vulnerable Group fund provided in the NHIAA is yet to be set up.
Against the background of the foregoing, CSJ makes the following recommendations:
- The National Assembly (NASS) should utilize the opportunity of the ongoing constitution review to include the minimum core state obligations on health as justiciable rights in Chapter Four of the Constitution. The right should include free primary health care, maternal, new born and child health, free medical consultation in public medical institutions; free medical care for all persons over 65 years of age, persons in detention and persons with mental health challenges, etc.
- The National Health Insurance Authority should take steps to enforce the compulsory health insurance regime of the NHIAA to raise more funds for health care.
- Funding should be provided for the take-off of the Vulnerable Group Fund provided in the NHIAA. This will enhance resources available for implementing the right to health.
- NASS, working with the Executive and State Governors should consider altering the funding of the BHCPF from not less than 1% of the Federal Government’s consolidated revenue fund to not less than 2% of the Federation Account. This will ensure that all tiers of government contribute to funding the right to health and remove the need for counterpart funding for the BHCPF.
- All backlogs of due statutory transfers/first line charges under the BHCPF should be expeditiously released by FGN for the improvement of health service delivery.
- For improved accountability and transparency, transfers to state agencies under the gateways of the BHCPF should be published in the print and digital media – newspapers, websites and blogs. The names of all beneficiaries enrolled in the free services of the BHCPF should be published on a portal on a state by state, local government and ward basis. Furthermore, the names and locations of all health centres where BHCPF services are available across the Federation should be published on a website.
- FGN and states should enhance value for money and service delivery in all health expenditure and involve critical civil society actors in all steps. These actors include national, state and local government level CSOs, the media, communities and citizens resident in the areas of the health centres, etc.
- FGN and the states should ensure the full implementation of the National Health Act.
Eze Onyekpere Esq.
Lead Director
