Ahead of Kigali meet­ing: What lessons for Nige­ria?

Daily Trust - - HEALTH -

The Mem­ber State Ex­perts meet­ing in Nd­ja­mena, Chad, dur­ing the first week of July was very in­sight­ful and served as a rider to the is­sues that will be tabled and de­lib­er­ated upon when the African Heads of State meet in Kigali, Rwanda to­wards end of July 2016.

A press state­ment at the end of the Chad meet­ing em­pha­sised that the “African coun­tries set the stage to end AIDS, TB and Malaria by 2030” and also adopted Africa Score­card on Do­mes­tic Fi­nanc­ing for Health.

The meet­ing fol­lowed the adoption of the Africa Health Strat­egy and the Cat­alytic Frame­work to End AIDS, TB and Elim­i­nate Malaria in Africa by 2030.

Hon. As­sane Nguead­oum, Min­is­ter of Health of the Repub­lic of Chad dur­ing the meet­ing ob­served that “AIDS, TB and Malaria re­main key chal­lenges for the de­vel­op­ment of our con­ti­nent. The Africa Health Strat­egy and the Cat­alytic frame­work to end AIDS, TB and Elim­i­nate Malaria by 2030 pro­vide a clear pol­icy di­rec­tion for the con­ti­nent. Our coun­tries should con­tinue on the path set by the Abuja Dec­la­ra­tion to in­crease the bud­get al­lo­cated to health.”

With re­spect to the Africa Health Strat­egy and Cat­alytic Frame­work to end AIDS, TB and Malaria, the meet­ing briefed the ex­perts on Africa’s new health pol­icy ar­chi­tec­ture that will be en­dorsed by the Kigali Sum­mit.

The re­vised African Health Strat­egy pro­vides the over­ar­ch­ing su­per­struc­ture to ad­dress Africa’s broad health and de­vel­op­ment agenda in the next 15 years. The state­ment has pro­vided fur­ther in­sight on the Cat­alytic Frame­work that serves as a busi­ness model for in­vest­ing for im­pact to end AIDS, TB and Elim­i­nate Malaria in Africa by 2030.

The frame­work fo­cuses on three strate­gic in­vest­ment ar­eas, each with clear cat­alytic ac­tions. These ar­eas are health sys­tems strength­en­ing, gen­er­a­tion and use of ev­i­dence for pol­icy and pro­gramme in­ter­ven­tions and ad­vo­cacy and ca­pac­ity build­ing. The frame­work pro­vides bold and am­bi­tious tar­gets to end the three dis­eases by 2030.

The 2nd item dis­cussed dur­ing the ex­perts meet­ing was the Africa Score­card as a tool for fi­nan­cial plan­ning and health sec­tor per­for­mance mon­i­tor­ing. The state­ment ob­served that ac­cord­ing to var­i­ous es­ti­mates, coun­tries should spend be­tween $75 and $100 per per­son on health.

It is in this con­text that the African Union has de­vel­oped the Africa Score­card on Do­mes­tic Fi­nanc­ing for Health as a man­age­ment tool for gov­ern­ments. The score­card will help with fi­nan­cial plan­ning for the health sec­tor and with mon­i­tor­ing per­for­mance. The score­card that will be pre­pared an­nu­ally in­cludes five in­di­ca­tors that mea­sure progress to­wards meet­ing do­mes­tic and ex­ter­nal health fi­nanc­ing com­mit­ments.

The ac­cu­racy of the data on the score­card will re­quire coun­tries to up­date the Na­tional Health Ac­counts reg­u­larly; African Heads of State com­mit­ted in the Ma­puto Plan of Ac­tion (2006) to in­sti­tu­tion­alise the Sys­tem of Na­tional Health Ac­counts (NHA). Progress has been slow in im­ple­ment­ing this com­mit­ment.

The 3rd item dis­cussed was on ex­pand­ing the fis­cal space to fi­nance health. The ex­perts meet­ing re­viewed an AU com­mis­sioned study on In­no­va­tive and Do­mes­tic Fi­nanc­ing for Health. Ac­cord­ing to the study, while in­no­va­tive fi­nanc­ing can pro­vide a steady, sus­tain­able and eq­ui­table way of gen­er­at­ing small amounts of ad­di­tional re­sources, it is not a panacea for Africa’s health fi­nanc­ing re­source chal­lenges.

The study points out that in­no­va­tive health fi­nanc­ing can be use­ful where it is able to cre­ate room in the bud­get for ad­di­tional spend­ing while not jeop­ar­diz­ing the fis­cal sta­bil­ity of the econ­omy. Over­all, in­no­va­tive health fi­nanc­ing com­ple­ment tra­di­tional gov­ern­ment rev­enue gen­er­a­tion and only as a short-term so­lu­tion to fund­ing needs while gov­ern­ments work to ex­pand the tax base.

What lessons could Nige­ria learn from this Nd­ja­mena meet­ing as Pres­i­dent Buhari and his team pre­pare to at­tend the Heads of State Sum­mit in Kigali at the end of this month?

1. 1st and fore­most the signed 2016 bud­get has over­all pro­vi­sion of N6.06 tril­lion. The health sec­tor got a to­tal of N250.06 bil­lion - roughly the health sec­tor bud­get is about 4.16% of the to­tal bud­get. With 4.16% of the bud­get to health which is far from Abuja dec­la­ra­tion tar­get, Nige­ria hasn’t shown much com­mit­ment re­gard­ing do­mes­tic fi­nanc­ing.

2. With re­spect to us­ing the Na­tional Health Ac­counts and in­sti­tu­tion­al­iz­ing the Sys­tem of Na­tional Health Ac­counts (NHA) as a means of per­for­mance mon­i­tor­ing of the Africa Score­card, Nige­ria is far from join­ing other African coun­tries as the coun­try is yet to grasp the ben­e­fit of NHA not to talk of in­sti­tu­tion­al­is­ing it as part of its rou­tine data col­lec­tion sys­tem.

3. For ex­pand­ing fis­cal space for health. It is also an­other long shot as the 2014 signed Na­tional Health Act that com­mit­ted the coun­try to al­lo­cate 1% of its con­sol­i­dated rev­enue fund is yet to be­come op­er­a­tional as guide­lines are still awaited.

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

It is in this con­text that the African Union has de­vel­oped the Africa Score­card on Do­mes­tic Fi­nanc­ing for Health as a man­age­ment tool for gov­ern­ments

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