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Universal Health Coverage: Spotlight on Nigeria

Q & A with Dr. Amina Dorayi, Nigeria Country Director

This week, the world is celebrating International Universal Health Coverage Day (UHC Day), an official UN-designated day on 12 December to raise awareness of the need for strong, equitable and resilient health systems and universal health coverage (UHC). This year’s UHC Day theme reminds us of our most urgent priority: Health for all: Protect Everyone. Pathfinder’s Amina Dorayi, Country Director in Nigeria, participated in an interview on this topic.

Q: How does building a safer and healthier future depend on investments in health systems that protect everyone?

A: UHC is important because it is a basic right of every individual. When countries prioritize the health of their citizens, they invest in ensuring no one is left behind. A country is as robust as its health system’s ability to provide for every individual. Furthermore, the COVID-19 pandemic has demonstrated the importance of safeguarding the health of all citizens in mitigating the spread and impact of the virus.

Pathfinder believes that every person, regardless of where they live, has a right to sexual and reproductive health (SRH). To achieve this, we work with governments and communities to improve access to SRH services among those most in need. Our support includes enhancing the capacity of health care workers to improve the quality of care they deliver; mobilizing communities to demand access to quality health care services; and, working with policymakers to prioritize funding for SRH. These efforts align with governments’ UHC plans.

Q: How are sexual and reproductive health and rights (SRHR) an essential element of UHC?

A: SRHR are human rights, at the core of the right to health and of sustainable development, and a necessary precondition for gender equality and non-discrimination.

UHC will not be achieved without the full inclusion of SRHR.

To ensure inclusion of SRHR in countries’ UHC plans, evidence needs to be generated and shared on the value of doing so; policies need  to include SRH in the essential package of health care; health budgets need to prioritize funding for SRH; and, public health programs need to create demand for SRH services.

Q: What is the status of UHC in Nigeria and how does Pathfinder’s work align with the Nigeria’s health priorities?

A: Nigeria just launched revised guidelines for implementing the Basic Health Care Provision Fund (BHCPF). The BHCPF is expected to serve as a sustainable model that guarantees access to a minimum package of essential health services funded through at least 1% of the federal consolidated revenue fund. However, the country is yet to fully implement the BHCPF. The federal government is falling short in meeting its commitments under the Abuja declaration, which allocates at least 15% of the federal budget to the health sector. One challenge faced is the fragmentation of the health system and lack of coordination across the various government agencies managing the BHCPF.

Q: What are your recommendations to the Government of Nigeria in striving to achieve UHC?

A: The highest levels of government should commit to achieving UHC. Considering that the public health system is unable to cope with the current population’s needs, robust partnerships with the private sector needs to be prioritized. The government should also leverage technology and other innovative platforms to reach those most in need of care, without which we will be far from achieving UHC. As part of its top priorities to reaching UHC by 2030, the government should consider meeting the Abuja declaration target, fully implementing the BHCPF, and strengthening accountability and transparency of the health system at national and sub-national levels.

Q: What would achieving UHC mean for Nigeria, in terms of health and well-being, economic growth, women’s empowerment and gender equality, and development generally?

A: UHC is at the core of economic development. Specifically, achieving UHC would ensure women, girls, and young people are able to maintain optimum health and subsequently contribute in a significant way to the development of the nation.

This interview was conducted by Edirin Aderemi, Advocacy and External Engagement Advisor with Pathfinder International.