Debo Adejugbe: The politics and promises of the National Health Bill (Y! Politico)

by Debo Adejugbe

Debo Adejugbe Y! Politico 2

The speed and conviction with which they passed the anti-gay law could have fooled anyone into believing that the National Assembly is proactive… but such vigour is channeled into frivolous causes while the politics is reserved for bills that has the actual promise of benefitting Nigerians…

There are irrefutable indications that the light at the end of the tunnel has been cut off, in Nigeria. When you look around, the signs are ominous and all the sectors of our economy are indicators. One area that has dire effects on us all (irrespective of status) is the health sector. The rich embark on their medical tourism abroad –sister African countries included- while the poor visit their “chemists” or “herb-sellers” to get their shots. Life goes on, except it doesn’t! Thousands are dying as a result of our very inept health system.

The health sector is seriously in need of a revival and some of the health statistics associated with us bears witness to the importance such revival would hold. According to the World health Organization (WHO), our life expectancy at birth is 52years while the probability of dying under five years (in 1000 births) is 124 and the probability of dying between age 15 and 60 is as high as 393 in every population of 1000. The statistics are far worse than could be ever captured, taking our record-keeping into consideration.

Dr Rabiatu Hadi, in a paper titled “Corruption in the Nigerian Health Sector: Time to Right the Wrongs” captures it thus: “In 2000, the World Health Organization ranked the Nigerian health system in 187th place out of 191 countries evaluated. According to UNDP, life expectancy in Nigeria has declined to 43 years (2006) from 47 in 1990.  In contrast, life expectancy in Malaysia, which attained nationhood at the same time as Nigeria, has now reached 70 years. Over 50,000 Nigerian women die from child birth every year (equivalent to a plane carrying 140 people crashing every single day). Nigeria accounts for 10% of the world’s maternal deaths in child birth whereas the country represents 2% of the world’s population. One in five Nigerian children dies before his/her 5th birthday…”

She continued: “About a million Nigerian children die of preventable causes every year. Only 18% of Nigerian children are fully immunized by their first birthday. Malaria kills more Nigerians than any other disease, and yet less than 5% of its population have access to insecticide treated nets proven to be effective in preventing malaria. The Nigerian Government at all levels spends less than 5% of public expenditure on health, despite being signatory to the 2000 Abuja Declaration to increase this to 15%. For crying out loud, Over 75% of the Millennium Development Goals are health related!” That is the grim picture!

Our health sector is faced with very unique problems. The festering corruption in our national life is fully represented in the health sector, poor management and inadequate funding, rivalry between health professionals and the new habit of going on strike to prove a point whenever the government refuses to play ball are other serious issues we must tackle. The dillydallying on the National Health Bill sits high up on the list of problems facing our health sector at present and most of the arguments delaying the passage are flimsy, trivial and at best, a distraction from what the bill seeks to achieve.

The National Health Bill is not a perfect bill; I’ll be the first person to admit that, but it presents a unique opportunity for Nigerians to access quality and structured healthcare service –with primary healthcare given considerable thoughts.

The NHB is best captured in a presentation by Professor Emmanuel Otolorin, titled “The National Health Bill and Its Impact on the Quality Agenda” where he broke it down to its basics and eventually advised the National Assembly to re-pass the bill and the president to give his assent once that is done. The Bill proposes to spend N60 Billion naira on primary healthcare every year, provide free medical care for the most vulnerable amongst us with a promise of providing primary healthcare to 60% of Nigerians living in inaccessible areas.

The basics in the bill are: Establishment of the National Health System (NHS) to “define and provide a framework for standards and regulation of health services” in Nigeria incorporating Village Health Committees and Traditional/Alternative healthcare providers into the mix, effectively involving the grassroots.

It will also bring in the National Tertiary Hospitals Commission to “establish minimum standards to be attained by the various tertiary health facilities in the nation and also to inspect and accredit such facilities”, that section birthed one of the contentious issues in the bill, which says the Executive Chairman of the body “shall be a Medical Director of the status of a Professor with a minimum of ten years working experience in a Teaching Hospital.”

The Establishment of National Primary Health Care Development Fund (NPHCDF) is one of the highlights of the bill and one area where the average Nigerian (particularly of interest to me) would benefit if this bill becomes law. The bill also seek to make emergency medical treatment a must for all healthcare professionals whenever such cases are brought to them and suggested punitive measures in the form of prison, fine or both for offenders: “A health care provider, health worker or health establishment shall not refuse a person emergency medical treatment for any reason”

Another area of interest is in Part 5 section 47 of the bill that states: “…no public officer of the government of the federation or any part thereof shall be sponsored for medical investigation or treatment abroad at public expense except in exceptional cases…”, it is a good place to start. It further seek to standardize and regulate the medical profession by enforcing that all health personnel wishing to establish health agencies, acquire prescribed health technology, provide prescribed health services or planning to continue to operate a health facility (after 24 months of signing the bill into law) must obtain a “Certificate of Standards”.

The bill offers much more than I can capture in this piece. It is highly unfathomable that the senate and bickering health professionals have allowed a bill that offers much more than the rhetoric Nigerians get fed every day to go un-passed for such a long a time (we have been on this since 2006). It wouldn’t be out of place if a temporary provision that suits all the parties replaces the contentious clauses, which would be further debated and incorporated into subsequent amendments.

The speed and conviction with which they passed the anti-gay law could have fooled anyone into believing that the National Assembly is proactive, attentive and inventive; but such vigour is channeled into frivolous causes while the politics is reserved for bills that has the actual promise of benefitting Nigerians – the tribe of disenfranchised populace who bear the brunt of their misrule.


Debo Adejugbe is a trained Telecommunications/Electronics Engineer and a certified IT professional living in Lagos. Dad to amazing Hailey and an advocate against Sexual and Domestic Abuses. Debo has political sympathy for the Labour Party. He tweets from @deboadejugbe


Op-ed pieces and contributions are the opinions of the writers only and do not represent the opinions of Y!/YNaija.

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