… Call for appointment of Pharma services Adviser, implementation of NH-ACT 2014
Pharmacists under auspices of the Association of Community Pharmacists of Nigeria, ACPN, has petitioned President Bola Tinubu to urgently revitalise Nigeria’s Healthcare through reforms that will pave the way for the appointment of Adviser Pharmaceutical Services/Chairman Reforms on Drug Distribution.
The ACPN also called for urgent reforms in three areas which include; full Implementation of the National Health Act 2014, defining and articulating the full potential of Primary Healthcare in Nigeria, and running the National Health Insurance project in alignment with due process in the public interest.
The pharmacists in the letter dated 3rd July 2023, entitled: “Attaining universal health coverage through urgent reforms in pharmacy and healthcare practice” explained that the appointed adviser for Pharmaceutical Services/Chairman Reforms on Drug Distribution endeavours will champion the resuscitation of drug distribution generally with a specific mandate on all the three agenda items.
The letter addressed to the President, Bola Tinubu, and jointly signed by the ACPN National Chairman, Adewale Oladigbolu, and National Secretary, Pharm Ezeh Ambrose, reads in parts, “In contemporary times, the ACPN has continued to monitor the evolving and progressive strides of the Bola Tinubu Presidency which is gradually beginning to engender a season of fulfilment in national life.
“It is in the light of this ray of hope that the ACPN wishes to canvass urgent reforms in Pharmacy and healthcare that can birth fruitfulness in the Health Sector as well as activate sustainable Universal Health Coverage, UHC. “Full Implementation of the National Health Act 2014, NH2014, ordinarily ought to be the supreme legislation in healthcare in Nigeria. It is a product of twists and turns spanning over a decade before it was eventually enacted as an Act of Parliament. One of the most positive reflections of this Act is the creation of a Basic National Healthcare Provision Fund which is meant to be an accrual of 1 percent from the Consolidated Revenue Fund.
“This proviso of the law, if well implemented, will make healthcare more impactful as it will guarantee better funding of the Health Sector which groans under both a paucity of funds and gross mismanagement of budgeted funds often bordering on an average of just about 5 percent relative to the 13 percent prescribed by Heads of Government that facilitated the Abuja declaration of 2021.
“The BNHPF remains a major tool to drive the actualisation of UHC as it lawfully provides that the BNHPF should fund Social Health Insurance to the tune of 50 percent of dedicated funds, while 30 percent of these funds be devoted to the procurement of essential drugs and vaccines, 15 percent of the funds will be employed to undertake the training of health personnel and 5 percent will be used to cater for National Emergency Health Services.
“A synopsis of the areas covered above indicates that if experienced and transparent Managers are made to run the MDAs in the Health Sector, we might just begin to reverse some seemingly irreversible indices in our sinking health system.”
They added that one of the landmark reforms in the NH-2014 was the proviso in law that changed the advisory status of the National Council on Health to the Health Minister to that of a decision-making body which was structured to involve all the frontline professional bodies in healthcare for detailed input in the spirit of a true democratic order.
They alleged that the Federal Ministry of Health, FMOH, in the last nine years has deliberately truncated the section of the law as most professional bodies are never part of the NCH meetings.
ACPN further lamented that the interpretation clauses of the NH2014 list the categories of professional practices officially designated as Health Facilities in Nigeria including Pharmacies, Clinics, Hospitals, Medical Laboratories, PhysioClinics, and among others.
“It is a major irony however that the health authorities have oftentimes failed to explore the proximity of Community-based health practices in the logistics and protocol designed for a rendition of all cadre of services which is a major reason for systemic failure in Nigeria’s fumbling health system.
ACPN further noted that for so long, health policy chiefs and advisers have negated Primary care services for pecuniary interests or other normal professional gains.
They pointed out that the quest for UCH will continue to be a ruse if it is not grounded on a well-worked primary healthcare concept.
They noted that the National Primary Healthcare Development Agency, NPHDA, should be empowered to go full throttle as it designates Community Pharmacies as immunisation Centres for all clinical disease states, adding that it will pave the way for routine immunisation as opposed to the presently imposed National Immunisation Days (NID) with a propensity to improve coverage rate in vaccination.
“Nigeria can substantially reduce infant and maternal mortality albeit significantly if we encourage the setting up of Community Pharmacy-based ante-natal clinics as we see in some climes.”
On running the National Health Insurance Project in Alignment with due process in the public interest, they stressed that one of the biggest monumental failures recorded in the healthcare sector remains the uninspiring nature of the Social Health Insurance portfolio in our nation.
“For over 13 years of the 18 years of the establishment of Social Health Insurance in Nigeria, it has been anchored by extremely inexperienced Physicians with attendant corruption and undiluted failure. The highlights of the failure are hinged on factors including unlawful payment mechanisms and indiscriminate capitation payment.
ACPN stated that to smoothen administrative convenience, the NHIA Secretariat continues to employ an unlawful payment mechanism called global capitation to compensate providers of Social Health Insurance.
“In Nigeria, Social Health Insurance has become a public sector-driven concept rather than a private sector-oriented agenda which is one of the main reasons it does not inspire confidence in enrolees.
“As of 8 years ago, the coverage rate in social health insurance dropped from almost 10 percent to 1.72 percent with a chance that it might drop even further. If the gains of social health insurance will be ever reaped in Nigeria, it becomes expedient that a seasoned Actuarist or Insurer be engaged to save the remains of the scheme while also allowing professionalism through separation of roles to be built into the ailing project in the professional and public interest.”
The ACPN scribes pledged its willingness to collaborate with the Government as it targets a revival of dead structures across the board in all sectors of the Nigerian economy including Health in the months ahead.