One of the Targets of SDG 3; includes achieving Universal Health Care which means that all people and communities receive the health services (e.g., the full spectrum of health services from health promotion to prevention, treatment, rehabilitation and palliative care across the life course) they need and of sufficient quality to be effective while also ensuring that the use of these services does not expose the user to financial hardship" (WHO).
The allocation for Healthcare in Nigeria's 2022 budget was just under 900 billion naira which is 5% of the country’s total annual budget, however if you compare that with the UK which has about 25% of the population of Nigeria. The Budget of the Department of Health & Social care which funds England’s National Health Service (NHS) is 20% of its total budget.
The NHS is a representation of the definition of Universal Health Care, it is not perfect and it is currently facing severe challenges due to severe pressure on the services it provides as a result of an increasing population, increased aging population and also shortage of labour which can be attributed to the limited freedom of movement from an European labour force since the BREXIT decision.
This has however led to a strategy to supplement its workforce by offering health worker immigration schemes to medical personnel from Africa and other Countries.
The Increased pressure on its system has also influenced the recent decision to limit dependents for people immigrating to the UK on study Visas, not what that Nigerian youtuber said on BBC.
The NHS is definitely a pride of Britain, the system continues to adapt and learn to get better year on year for the past 75 years of its existence. Its leaders and decision makers are working very hard to improve not only the health outcomes of its population but also the quality of service it offers.
Despite the challenges with the adequacy of the number of its workforce, the NHS is still the 5th largest employer of labour in the world only ranking below the U.S. Department of Defense, the Chinese People’s Liberation Army, Walmart and McDonald’s. It is also currently rated number 4 in the world’s league table of health care systems among the top richest 11 countries, it used to be number one but due to its challenges in recent years it has fallen behind Norway, the Netherlands and Australia.
Nigeria is still very much in the early stages of achieving anything close to what the NHS offers, while the comparative budget vs population of both nations makes Nigeria look highly inadequate, we must also remember that the NHS is funded mainly by taxes of the UK citizens and residents. There is a high potential that the level of taxation will increase for the NHS to improve the quality of its services and the work life balance of its workforce, but this will be very difficult to do considering the UK is currently dealing with a cost-of-living crises.
While it is easy for us to scoff at Nigeria’s current Healthcare system we must acknowledge that there are many people working very hard towards achieving Universal Health Coverage, The National Health Insurance Authority (NHIA) formerly the NHIS is piloting and proposing different initiatives to provide accessible healthcare to Nigerians and also have plans to address the Vulnerable members of the population as well as those at the much lower end of the wealth pyramid.
We have also seen the emergence in recent years of State-run Health Insurance Services in Lagos, Ekiti and others. While the level of health coverage being offered is still very limited compared to our western counterparts. The example set by the Lagos State Health Management Agency (LASHMA) is commendable. With an annual registration fee of under $10 a year an individual can enjoy a wide range of Health services delivered through both private and public health care organizations in the State.
According the ILERA EKO website the Lagos State Insurance Scheme has 600,000 plus enrollees, comparing that to the total population of Lagos State it may appear very limited however considering that we do not have a mandatory taxation policy fully implemented to fund it, I think what they have been able to achieve so far is commendable and the only way to go from here is up.
President Muhammadu Buhari signed the Mandatory Health care Act in June 2022, and the current President has also committed to achieving UHC for 40% of the population in 2 years. While I am almost certain that Nigeria will not achieve UHC by 2030, I am at least confident that we would be much better off than where we are today. In the same breath I don’t think we will make much progress if most of us (Nigerians) are not making some sort of contribution to the system.
I would appreciate your thoughts, what innovative initiatives do you think Nigeria can adopt to get closer to achieving Universal health Care?
Mayowa Oyeyipo
Internal Public Health Student
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