What the Se­nate may ask the min­is­te­rial nom­i­nees?

Daily Trust - - HEALTH -

The long wait is over as Pres­i­dent Muham­madu Buhari (PMB) has sub­mit­ted the first list of the min­is­te­rial nom­i­nees to the se­nate for screen­ing. The screen­ing process will start soon to en­able the es­tab­lish­ment of a fed­eral cab­i­net and for the 2016 bud­get process to com­mence soon­est.

Al­ready in the list one can see three names that can po­ten­tially be as­signed ‘Min­is­ter of Health’ and ‘Min­is­ter of State for Health’ if screened and ap­pointed by PMB. Whether those three hap­pen to meet our min­i­mum stan­dards or not, chances are two of them will emerge to lead our health sec­tor. We must be pre­pared to con­tinue our ad­vo­cacy and sen­si­ti­za­tion.

My in­ter­ven­tion to­day is about some po­ten­tial ques­tions that the se­nate could ask the likely nom­i­nees that will head the health sec­tor, so that the nom­i­nees are aware what need to be done, and how their pre­vi­ous ex­pe­ri­ence could help in cat­alyz­ing ac­tion for change in the health sec­tor.

It is im­por­tant for the se­nate to ask about their knowl­edge on global hap­pen­ings and how that could shape Nige­ria’s post 2015 health agenda. Are they aware of the events that hap­pened dur­ing the just con­cluded United Na­tions Gen­eral Assem­bly in New York, par­tic­u­larly on Fri­day 25th and Satur­day 26th Septem­ber 2015?

The launch of the Global Strat­egy for Women’s, Chil­dren’s, and Ado­les­cents 2.0 cov­er­ing 2016 -2020 which will build on new ev­i­dence, in­clud­ing the need to fo­cus on crit­i­cal pop­u­la­tion groups such as new­borns, ado­les­cents and those liv­ing in frag­ile and con­flict set­tings; build the re­silience of health sys­tems, im­prove the qual­ity of health ser­vices and eq­uity in their cov­er­age, and work with health-en­hanc­ing sec­tors on is­sues such as women’s em­pow­er­ment, ed­u­ca­tion, nutri­tion, wa­ter, san­i­ta­tion and hy­giene. It will align with the tar­gets and in­di­ca­tors de­vel­oped for the 17 Sus­tain­able De­vel­op­ment Goals frame­work.

How will the nom­i­nees sit­u­ate Nige­ria in all these global tar­gets, and what could they do dif­fer­ently to im­prove qual­ity of care in line with these global stan­dards?

Another ques­tion is on Nige­ria and health re­lated Mil­len­nium De­vel­op­ment Goals. The last 15 years have be­ing un­prece­dented all over the world with one clar­ion call ‘im­ple­ment Mil­len­nium De­vel­op­ment Goals (MDGs) and achieve all its tar­gets by 2015.’ 15 years is over and we are now in 2015 and say­ing a fi­nal good bye to MDGs and wel­com­ing Sus­tain­able De­vel­op­ment Goals (SDGs).

The Se­nate should be in­ter­ested to ask the nom­i­nees Nige­ria’s progress, achieve­ments and chal­lenges in achiev­ing re­duc­tion of ma­ter­nal and child deaths. What were the in­ter­ven­tions that sup­ported re­duc­tion of ma­ter­nal and child deaths and what in­no­va­tions and ex­pe­ri­ence are they bring­ing to the ta­ble to im­prove and sus­tain qual­ity of ser­vices?

The Se­nate should also ask ques­tions re­lated to health care fi­nances. For ex­am­ple Nige­ria is un­able to co- fund its 2015 vac­cine pro­cure­ment, World Bank had to bail out the coun­try with a soft loan. We are un­able to pro­cure Re­pro­duc­tive Health and Fam­ily Plan­ning Com­modi­ties in line with the FP2020 Lon­don Sum­mit Com­mit­ment, in­ter­na­tional de­vel­op­ment part­ners are help­ing us out with that.

Our health bud­get over the last years as com­pared to the na­tional bud­get is never above 8%, far from the 15% Abuja dec­la­ra­tion and our per capita spend­ing on health an­nu­ally isn’t up to half of the stan­dard re­quire­ment of $86. What will the nom­i­nees do dif­fer­ently to re­verse this trend?

Also the re­cent 2013 Abuja+12 Dec­la­ra­tion had demon­strated re­newed lead­er­ship on health. As Africa’s health pol­icy in­stru­ments ex­pire in 2015 co­in­cid­ing with the end of the Mil­len­nium De­vel­op­ment Goals, the African Union has started the process of con­sul­ta­tions to come up with cat­alytic ac­tions to end AIDS, TB and Malaria by 2030.

African Heads of State and gov­ern­ments de­cided at the Johannesburg sum­mit in June this year, to ex­tend the AU Roadmap to 2020 to en­sure that it is fully im­ple­mented. What will the nom­i­nees do to en­sure we raise do­mes­tic fi­nances to fund our health sec­tor?

The PMB gov­ern­ment had al­ready un­der­stood the is­sues to tackle if mean­ing­ful progress will be made in the health sec­tor. In the APC di­a­logue re­port the chap­ter ‘Achiev­ing Qual­i­ta­tive & Af­ford­able Healthcare’ high­lighted that “Nige­ria’s healthcare sec­tor is in need of re­form. Lack­lus­ter in­fra­struc­ture, in­equal­ity in ac­cess to ser­vices, poor med­i­cal per­son­nel train­ing and equip­ment, ram­pant cor­rup­tion and fail­ure to pass and im­ple­ment cru­cial re­forms has re­sulted in Nige­ria’s healthcare sys­tem lag­ging be­hind most coun­tries on key health in­di­ca­tors and neg­a­tively im­pact­ing Nige­ria’s po­ten­tial growth.

As a first ini­tia­tive, im­prov­ing ac­cess, ac­cu­racy and avail­abil­ity of health re­lated data is re­quired to es­tab­lish a base­line for tar­get set­ting and re­sults track­ing.” Are the nom­i­nees aware of this im­por­tant pol­icy doc­u­ment? Have they read it and how do they in­tend to turn it from pa­per to ac­tion?

The re­port also in­di­cated that the PMB is aware that Nige­ria has a low life ex­pectancy of 53 years vs 71 years in Egypt and a high in­fant mor­tal­ity of 85 per thou­sand live births vs 15-20 in Egypt. And also is fully aware of the key chal­lenges in the health sec­tor as iden­ti­fied by the di­a­logue as fol­lows; In­suf­fi­cient fund­ing, health ex­pen­di­ture ac­counts only for 3% of GDP vs. 11% for South Africa, US$400M re­quired to fund vac­ci­na­tions per year, but cur­rently FG does not have re­sources for that.

Can these chal­lenges be ad­dressed by the nom­i­nees? How? What are their strate­gies to im­ple­ment the Na­tional Health Act and other pol­icy doc­u­ments?

I wish the se­nate and the nom­i­nees all the best.

All com­ments to Dr Aminu Ma­gashi , Pub­lisher Health Re­porters (health­weekly@ya­hoo.com)

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