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Welcome to the 2019 National Health Dialogue.

PREMIUM TIMES will bring you live updates of this annual event that holds Tuesday and Wednesday.

About 500 participants from Nigeria and other parts of Africa are converging at the Nicon Luxury Hotel in Abuja to advance conversations initiated in the maiden edition of the annual conference two years ago.

Organised by Premium Times Centre for Investigative Journalism (PTCIJ), the Project for Advocacy in Child and Family Health, PACFaH@Scale, the Project Pink Blue and the Nigerian Governor’s Forum (NGF), this event promises to lock citizens and stakeholders in a lively debate that will drive the quest for Universal Health Coverage (UHC) in Nigeria.

Those attending include health practitioners and advocates, as well as political, religious and traditional leaders. The public and private sector and the media will be at the event.

They will discuss the most pressing issues affecting the health sector and co-create home-grown solutions.

READ ALSO: #HealthDialogue: Osinbajo, Gombe Emir, other stakeholders to address Universal Health Coverage in Nigeria

The dialogue intends to raise questions on implications of not positioning health financing as an investment.

Participants will have an opportunity to ask critical questions on various government programmes, policies, laws, and structures with regards to health funding and service delivery.

Ahead of the event, PREMIUM TIMES presented six things participants should expect from the dialogue.

Keep refreshing this page to stay updated!

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10:30 a.m. – Event Commences Proper

“Good morning ladies and gentlemen. I will be your anchor for this epic event. My name is Mo…”, the ageless voice of Moji Makanjuola echoes through the walls of the 600 seater conference hall filled to the brim by participants, special guests, panelists and the media.

Mrs Makanjuola, a renowned broadcaster who held her audience spellbound in her 35-year stint at the Nigerian Television Authority (NTA) – with her style of presentation and charisma – is the MC of this year’s annual health dialogue.

Her career rolled off with journalism having trained in Lagos in 1977 and the NTA TV College, Jos, in 1983.

With further training at Voice of America Training School in 1998, she proceeded to American Heritage University of Southern California, USA, where she obtained a BA in media studies.

Though she has retired from active practice, Mrs Makanjuola has continued to contribute significantly to the improvement and developments of journalism in Nigeria, especially in the area of health reporting.

A day before the event, Mrs Makanjuola expressed delight that the media is championing this dialogue to improve health services in Nigeria.

“Who best to do it than the media”, she had told this reporter. “The media has become a strategic tool to improve, investigate and track health interventions.”

After her self-introduction which perhaps was unnecessary, the awestruck audience was left gushing – especially those who knew her in her days.

The soft-spoken veteran then proceeded to ask the audience to stand for the national anthem before the national pledge was recited.

She gives an insight into what brought about the national health dialogue.

She acknowledges several challenges bedeviling the health sector. The moderator believes that there is an urgent need for health prioritization in Nigeria.

Mrs Makanjuola calls on Dapo Olorunyonmi to give his welcome address.

10:52 a.m. – Dapo Olorunyonmi’s welcome address.

Mr Olorunyomi, a frontline journalist, is the publisher of PREMIUM TIMES newspaper.

Dapo OlorunyonmiDapo Olorunyonmi
Dapo Olorunyonmi

‘Dapsy’ as his fondly called is formerly a policy director and the chief of staff to the EFCC, Nigeria’s graft agency where he led the Commission’s crimes prevention and education policy development initiatives on corruption.

He had worked and still working with various media organization across Africa where he has continued to champion the course of journalism.
Mr Olorunyomi starts his remark by acknowledging the partners of PREMIUM TIMES in organising this event.

He thanked them for working tirelessly to ensure the success of the event.

He specifically appreciates the efforts of the Nigeria’s Governors Forum (NGF); PTCIJ; PACFAH@scale and Project Pink Blue.

He believes no nation can attain greatness if they don’t stand on the evidence of healthy citizens.

He eulogizes Stella Adedevoh who died as a “result of her sacrifice when Nigeria was under the scourge of Ebola Virus”.

Ameyo Stella Adadevoh was the Lead Consultant Physician and Endocrinologist at a private hospital in Lagos, Nigeria where she worked for 21 years. She had never seen Ebola before but was able to diagnose and contain Nigeria’s first-ever Ebola patient in July 2014. When threatened by Liberian officials who wanted the patient to be discharged to attend a conference, she resisted the pressure and said, “for the greater public good” she would not release him.

Since Nigeria’s health system was not prepared for an outbreak at the time, she contracted Ebola and died alongside 3 of her colleagues. Her heroic efforts prevented a major outbreak in the most populous African country and served as the catalyst for successful government action to contain the spread of what would have been a major outbreak in a country of more than 190 million people.

Mr Olorunyomi said her birthday is coming up in October 21 and charged Nigerian to celebrate her heroic efforts.

The journalist said late Adedevoh’s bravely should be emulated in the drive for Universal Health Coverage which is the theme of this event.

He said online petition has started in honor of the death of Adedovoh. he said PREMIUM TIMES has subscribed to the petition, urging ever one else to so.

11:00 a.m. – Goodwill Messages

The Ambassador of Japan to Nigeria, Yukuta Kikuta, is the first to deliver a goodwill message.

Ambassador of Japan to Nigeria, Yukuta KikutaAmbassador of Japan to Nigeria, Yukuta Kikuta
Yukuta Kikuta, Ambassador of Japan to Nigeria

He appreciates the effort of the organisers of the event.

He gives an insight into the Nigeria-Japan partnership in strengthening the health sector.

He explains how the Nigerian President Muhammadu Buhari shared his belief in strengthening the health sector during the Tokyo International Conference on African Development (TICAD7).

He said UHC is a “quintessential example of brand Japan” at TICAD7. He said the government of Japan pledged to bring UHC to 3 million recipients in Africa.

A representative of the NGF, Musa Ukaru, said the forum is delighted to play a part in the dialogue.

He describes the health indicators in the country as “shameful and disturbing.”

He mentions malaria, mortality rate, HIV and other indices where Nigeria is sitting at the bottom.

Hence, he believes it is important that state and non-state actors spring to action as the theme of the event suggests.

He said UHC is a top priority of the NGF. He announces that the forum is in the process of developing a dashboard that would aid the improvement of access to accelerate UHC.

11:20 a.m. – Lecture by Chiedo Nwankwo – Journey towards achieving SDG 3.8 (UHC) and the paths to achieving success

Africa is falling behind in achieving Sustainable Development Goal (SDG) Three, one of the 17 goals set by the United Nations General Assembly in 2015 for the year 2030.

Chiedo NwankwoChiedo Nwankwo
Chiedo Nwankwo

Achieving UHC by 2030 is the central target of SDG 3.8.

Targets of SDG 3 includes ending preventable deaths of newborns and children under five years of age by 2030.

However, five children under five years of age are still dying from preventable causes every five minutes in Africa, according to the World Health Organisation (WHO).

Nigeria’s national health dialogue, now in its second edition, arose from the need for home-grown solutions, innovations, political commitments and lessons from successes and setbacks of other African countries in achieving affordable health for all.

Mr Nwankwo, a medical doctor, and writer starts her lecture by reeling the various challenges preventing Nigeria from achieving UHC.

She bemoans how the country seems to have neglected its collective role in healthy wellbeing in the country.

Mrs Nwanwko said the vulnerable groups need to be covered by the appreciable amount of health subsidies and insurance.

She said the poor and vulnerable groups should be carried along. “They should not spend the liitle they have and get improvershed in their quest for quality health care”

The health experts begin to dish out statistics on how Nigeria has failed to provide adequate funding for health.

She said Nigeria has failed to meet the 15 per cent Abuja declaration of 2001.

It is the realisation of shortfalls in their health systems that made African governments commit in April 2001 to dedicate at least 15 per cent of their annual budgets to the health sector in what is now known as the ‘Abuja Declaration’.

Sixteen years later, only about seven countries — Rwanda, Botswana, Niger, Zambia, Malawi and Burkina Faso, Togo — have met the Abuja target. In 60 per cent of the countries, the health sector share of total government expenditure is below 10 per cent.

Nigeria that hosted the conference has never voted more than six per cent of its annual budget to the health sector.

The highest percentage since the declaration was in 2012 when 5.95 per cent of the budget was allocated to health.

She said the poor spending on health has huge repercussions on the poor people of the country.

“Nigeria is one of the worst places for maternal, newborn child care in the world”, she said. “The figures are startling”.

She said the bright side to the gloomy situation is noted in the heroic sacrifices made by some health workers in the country.

“Today, we remember late Stella Adadevoh for what she did during the Ebola crisis. Her sacrifices should not be forgotten.”

She mentions other health workers who have positively impacted the health sector.

She, however, alludes that more is needed to be done especially by state and non-state actors in the country.

She reaffirms her initial opinion that for UHC to be achieved, the informal sector needs to be adequately covered.

She says the state has a huge role to play in covering this group.

She concludes her lecture by urging the state to take a bold step in driving change in the health sector.

Mrs Nwankwo admonished others in the private sector to emulate from PREMIUM TIMES in the quest for improvement in the health sector.

Keynote Address by Muhammad Dogo, Former NHIS chairman – Achieving UHC in Nigeria – How feasible is 2030?
Muhammad Dogo, Former NHIS chairman - Achieving UHC in NigeriaMuhammad Dogo, Former NHIS chairman - Achieving UHC in Nigeria
Muhammad Dogo, Former NHIS chairman – Achieving UHC in Nigeria

Mr Dogo starts by reeling out various statistics showing that Nigeria is already offtrack in achieving the SDG goals for 2030.
Achieving UHC by 2030 is the central target of SDG 3.8, one of the 17 goals set by the United Nations General Assembly in 2015 for the year 2030.
Targets of SDG 3 include ending preventable deaths of newborns and children under five years of age by 2030.

“Nigeria is already offtrack”, Mr Dogo said.

Challenges stopping Nigeria from Achieving UHC by 2030

He explains how UHC was brought on board to change the landscape of health funding and service delivery in Nigeria.

The medical doctor said achieving UHC under the current situation in Nigeria is most challenging.

He highlights various challenges to attaining UHC by 2030 in Nigeria.

Implementation: He said various program that would have helped in achieving UHC is mostly not being implemented.

Constitutional Bottlenecks: He said the legal Provisions that should guide the various health policies and interventions have to be reviewed.
“In particular the Nigeria Constitution does not define the place of Health in either concurrent or the exclusive list. Thus, the issues of health are not having a strong constitutional backing.

“This gives way to the 3 tiers of government not adhering to Declarations relating to health matters ie the 2001 Abuja Declaration for the allocation of 15% of the annual budget to health has never been attained eighteen years after. Even the annual budgetary allocations for health across the 3 tiers of government are inadequately cash-backed. This brings us to the issue of funding for health.”

Weak Funding Model: The health expert said the funding models as they are now have failed to give support to the health system that could work for us.
“Thus, the health system has remained very weak over the years. Currently Out-of-Pocket (OOP) contributes around 72.8% with attendant consequences to households as in many cases it pushes families into poverty. Budgetary allocations as earlier discussed are inadequate ie the federal government allocated only 3.8% to health in 2018.

“The health insurance which should collect contributions, pool and purchase services stands at around 5%. The forth model being donations from international development partners is unpredictable, uncoordinated and there is high administrative cost. Additionally, there is donor fatigue.”

other challenges mentioned by the keynote speaker include population overgrowth; Unreliable/inadequate data; high leadership turnover; corruption among others.

Conclusion

Nigeria as the giant of Africa has all it takes to be a major player in the global space. It has its challenges, just like any developing nation. However, the human resource and other resources at its disposal is adequate enough if properly deployed to achieve UHC by 2030.

Recommendations

1) Repeal the current NHIS Act 1999 and enact the NHIC Act 2019.

2) Political will/commitment

3) Increase funding by attaining 15% budgetary allocation by the 3 tiers of government, earmark mobile phone levy and other innovative ways of financing

4) Stabilize the leadership sourcing of CEOs through Due Process

5) Create more public awareness

6) Strengthen the health system through upgrading facilities, improving the welfare of human resource for health

7) Improve the purchasing power of the populace through human capital development and enterpreunueship

8) Look at other non-health issues that have bearing on health through improving intra- and inter- ministerial collaboration

9) Monitoring and Evaluation to capture quality data for health and assess the impact of interventions and outcomes

Other Recommendations: –

Mr. President to assent to the National Health Insurance Commission Act 2019

Advocacy to: – a) Political class at all 3 tiers of government

b) Traditional leaders

c) Religious leaders

Paper presented by Emir of Gombe, Abubakar Shehu Abubakar 111: The role of traditional institutions in achieving UHC for women and children
Emir of Gombe, Alhaji (Dr) Abubakar Shehu Abubakar IIIEmir of Gombe, Alhaji (Dr) Abubakar Shehu Abubakar III
Emir of Gombe, Alhaji (Dr) Abubakar Shehu Abubakar III

The traditional ruler starts by saying his paper will be looking at the concept of UHC vis-a-vis the broader health issues affecting women and examine roles played by traditional rulers in the past and presently.

He explains how the British and other colonialists used traditional rulers in administering, which further helped in improving the health sector.
He said traditional rulers have an advocacy role to play in driving UHC.

Nigeria’s vice president, Yemi Osinbajo, represented by Nicholas Audiferren, his chief personal physician, declares the national health dialogue open.

12:30 p.m. – Tea Break

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