The two leading Nigerian presidential candidates for the 2019 general elections released their manifestoes to widespread reception across the nation. In the documents, both parties spelt out action plans for the next four years.
Given the centrality of health to the development agenda of any nation and the wellbeing of its population, the importance of examining these documents in light of the global health framework cannot be overemphasized.
Across the world, Universal Health Coverage (UHC) is the overarching goal for health systems all over and it is important to evaluate the campaign promises of Nigeria’s presidential candidates in terms of how they propose to improve every Nigerian’s access, coverage and financial protection for quality health care.
UHC is achieved when ‘all people can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.’
Governments that hope to improve quality of life of the average Nigerian must therefore commit to seek UHC.
Achieving UHC in Nigeria cannot be achieved with investments in the health sector alone.
There are many social determinants that are responsible for health inequities and poor access. There are economic factors that result in financial hardship. There are structural problems within the health system including corruption, human resource deficits and lack of basic and sophisticated equipment required for proper care.
Action plans that tackle these multifaceted problems, especially with a Health in All Policies approach, will do better at achieving UHC.
In this regard, both manifestoes address social, economic and infrastructural gaps in the country.
The Atiku manifesto
Titled ‘Get Nigeria Working Again’, the manifesto of the presidential candidate of the Peoples Democratic Party (PDP) Atiku Abubakar identifies the expanding healthcare worker deficit in the country, the increasing rate of medical tourism, the lingering water and sanitation problem resulting in outbreaks and the importance of access to preventive and curative care.
He stated in his manifesto: “Our policy thrust will be all embracing and targeted towards a preventive care strategy by creating a clean environment, modernizing living conditions, carrying out enlightenment campaigns on healthy living, and supporting with curative care through the provision of state-of-the-art healthcare facilities in hospitals and in rural clinics.
“Ensure universal access to basic maternal and child health, reproductive health, immunization and mental health as well as effective therapies.
“Government will position itself to deal proactively with emergency epidemics like Ebola, Lassa and others which occasionally afflict the people.”
He however outlined a very vague action plan but with his keenness on job creation and stimulating the private sector, the most interesting ideas to watch out for would be his plan to boost domestic pharmaceutical industries and the private sector in the health sector.
Buhari’s Next Level manifesto
In his manifesto for reelection, President Muhammadu Buhari picked core areas of achieving UHC with his focus on giving more Nigerians financial protection by increasing health insurance coverage including the poorest Nigerians who will be excluded from co-payments, boosting coverage by increasing the proportion of Nigerians with access to Primary health care from 12.6% to 40%, paying young doctors to work in rural areas, and a continuing commitment to disburse the 1% CRF for funding the Basic Health Care Provision Fund for primary health care.
The consensus
The largely vague nature of both candidates’ policies on UHC suggested both do not consider health an important part of their work for the next four years as they both seem to lack the level of details needed if health were a front-burner issue.
On one hand, both manifestoes are replete with policies that effectively tackle deficits in education and job provision and may thus lead to improved socioeconomic conditions for Nigerians, this eventually trickles down to better health.
On the other hand, the health system in Nigeria is in such a state as to require greater prioritization of UHC in terms of heavier and direct investments, both of which both candidates do not seem to bring.
Have you read their manifestoes? What are your thoughts and whose plan is more likely to deliver UHC to Nigerians?