Private sector healthcare providers have welcomed the Federal Government’s Economic Recovery and Growth Plan 2017-2020(ERGP) with the view that its implementation would boost and address the problems facing the health sector in the country.
The ERGP inaugurated by President Muhammadu Buhari in February 2017 articulates the government’s broad agenda for restoring growth, investing in people and fostering a globally competitive economy. The document lays out plans to invest in health and to improve the accessibility, affordability and quality of healthcare services by increasing access to primary health care services, expanding health coverage and improving the quality of the services provided as well as the roll out of the National Health Insurance Scheme (NHIS) across the entire country.
Although, the problems facing the health sector still, remains insufficient financing, inadequate and inequitable access, weak supply chain management, limited human resource capacities and insufficient coordination, cohesion and accountability, the document outline that Nigeria’s health system does not provide the level of service required to meet the needs of its population. At 52 years, the average life expectancy in Nigeria is lower than that of its peer African countries, unlike Ghana (61 years) and South Africa (57 years).
The prevalence of infectious diseases remains high as Nigeria ranks poorly on incidence of tuberculosis (128 out of 138 countries) and prevalence of HIV (123 out of 138 countries). On under-five child mortality, there are 89 deaths per 1,000 live births, a level far above the target of 64 deaths per 1,000 live births set in the UN Sustainable Development Goals (SDGs). Though some progress has been made over the last 20 years, the maternal mortality rate in 2014 was 576 deaths per 100,000 live births compared to 1,000 deaths per 100,000 live births in 1990. However, Nigeria has a long way to go to meet the UN SDG of 70 deaths per 100,000 live births by 2030. Part of the strategies outlined in the document include, revitalizing 10,000 primary health care centres and establish at least one functional primary health centre (PHC) in each ward to improve access to health care and Partnering with the private sector to develop at least one Mega-health centre in each State to provide high-quality preventive and curative healthcare among others.
These were issues discussed at a one-day stakeholders consultations on the role of the private sector in the Health Agenda of Nigeria’s Economic Recovery and Growth Plan, (ERGP) 2017 to 2020, organized by the Healthcare Federation of Nigeria’s (HFN) in collaboration with the International Finance Corporation (IFC) and Kainosedge Consulting Limited recently as the private healthcare stakeholders explored the implications of the strategies in the ERGP and the newly approved reforms on the Nigeria private health sector and the need for disruptive innovations, leveraging on technology and bespoke delivery vehicles for implementation of the Plan as well as the need for healthcare specific financing.
The President of the HFN Clare Omatseye, said the growth plan is a good move by the government in strengthening the health sector by bring in the private sector healthcare professionals, adding that it would be effective if they were implemented. She said: “One of the major pillars of the strategy is that partnership with the private sector, it won’t be just building hospitals but more about impacting the lives of Nigerians and the private sector comes with a lot of efficiency and the government recognition of our role through the partnership as well as leveraging on us for information is the beginning”, adding that “some of the things in the plan are high level and tactile only if they are implemented, which is where the efficacy of the private sector comes to play.” She stressed that the primary healthcare remained a big challenge in Nigeria, adding that the public-private partnership is the perfect mix where the private sector can take over the various Primary Health Centres as well as providing human resort and to run it, saying the country would have saved the secondary and tertiary hospitals from treating diseases such as malaria but focus on more bigger things.
She noted that government needed to create an enabling environment for private sector to thrive through the growth plan, as its implementation is the real challenge in executing the plan.“We need to carve a kind of monitoring and evaluation market and if we see it is not working, we go back and re-implement, we must work along side the government, recognize where the bottle necks are, reduce government’s interference with the bureaucracy that comes along with the offer and then be in the driving seat of some of the strategies.
She added that the mage-hospital as proposed in the document is a good plan the government should leave in the hands of the private sector and the financial partners to revive, as most of the public health care centres are dilapidated and obsolete, adding that “. “Government shouldn’t be building hospitals. Partnership with private sector can make a difference. We want to make a difference. Nigerians need and deserve high quality healthcare and that access is what we are here to do.” Continuing, she explained that the EGRP was designed to drive a structural economic transformation with emphasis on improving public and private sector efficiency in key sectors including health.”
The Country Manager, International Finance Corporation, World Bank Group, Nigeria, Eme Essien, said it was important for the private sector to dialogue for an improvement in the growth plan, adding that the plan focuses on short-term recovery and also the private sector’s major objectives. Adding that the forum seek to was to engage the Nigerian healthcare private sector in the implementation of the health Agenda of the ERGP as well as illicit the position of the private sector on the ERGP, debate and fully understand the impact of the plan on the private healthcare sector, determine the possibility of influencing the direction of implementation of the plan, The workshop will conclude with the drafting of a position statement on the ERGP which will ultimately act as a driver for the implementation of the Plan, as far as the Health Sector is concerned.
“We want a place where Nigerians are getting high level of growth, not just recovery. The growth agenda needs to change. The country budget focuses on one sector that we have no control over, so we face the implication of that. We saw that healthcare is one of the sectors that is under funded in the past, but when it comes to the economy as a whole, it is the most resilient and it is not promising, so we have to double our efforts to see how we can improve and support the sector. Private sectors are entrepreneurs and innovators in the healthcare that can make the difference. We need to get in the development agenda of the country, so healthcare is an exciting sector and trying to look for ways to fund the sector is very difficult for us,” she said.
Eme stressed that the plans are very positive, but will need a lot of continuing advocacy, which is important to keep the ERGP as a living document, adding that the government should acknowledge that the ERGP should be led by the private sector.
Meanwhile, the President, Pharmaceutical Society of Nigeria (PSN), Ahmed I. Yakasai, commended the ERGP as part as the government’s reform agenda, as he expressed optimism on its efficiency towards resuscitating the health sector, adding that the document would be effective if implemented.
“The government outlined clearly what they are going to do, especially, establishing diagnostic centres in each state of the federation – they want to give universal health coverage, bringing in tertiary institution students, primary and secondary school students, involve people in social services and then build one mega health centre through the private-public partnership in each state, and then increasing money to eradicate polio, measles, yellow fever and they signed agreement with May & Baker for the production of vaccines, – they want to reduce the influence of maternal and mortality rate – and the minister has been talking about one primary health centre in each ward, and then the e-health – telemedicine where everybody will have access to affordability, quality healthcare services and there will be monitoring and evaluation.
He added that if the government combines both budget and planning to supervise the document, and then give directives to MDAs as well as positioning desk officers to the president to push for the implementation the growth plan would work.