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NHIS makes me sad — Professor Eyitayo Lambo

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Former Minister of Health, Professor Eyitayo Lambo, who can be described as the father of the National Health Insurance Scheme, NHIS, is not happy about the dwindling fortunes of the initiative.

Speaking at a symposium organised by the Nigeria Academy of Pharmacy in partnership with the Pharmaceutical Society of Nigeria,  Lambo said the primary idea behind the NHIS was to ensure universal access to quality healthcare irrespective of status and to address out-of-pocket payment for healthcare services.

In this chat with Gabriel Olawale, Lambo recounts that 12 years down the line, the  NHIS is yet to achieve it’s purpose of making meaningful impact on the health of Nigerians. Excerpts:

Former Minister of Health, Prof Eyitayo Lambo.

When I came on board in 2003, I wrote a 13-point agenda and the NHIS was No. 1 on my list. I presented it to former President Olusegun Obasanjo and he gave me full support and we launched the NHIS on June 6, 2005. That day was my happiest day as minister.

Former President Obansanjo was in attendance and in my speech I told people that, considering my experience and calculation, all things being equal, we would get to the promised land where there would be Universal Health Coverage by 2025.

But the former President disagreed with me. Rather, he inisisted that by 2015 there would be Universal Health Coverage.

Before we handed over in 2007, we got some level of coverage of about 7 per cent, but 12 years after, the country is below 5 per cent coverage.

Having birthed that baby I feel very sad today, because I know what to do to implement the NHIS, but when you do things and it is not built upon, it makes you sad.

There are three tiers of government, but the function of various levels in respect to health was not spelt out in the constitution. There was nowhere it has been stated that Federal government would do this while the States and Local Governments would do that, so that was why nothing is being done.

The only document that spells out the role of the three levels of government is the National Health Policy developed by Professor Olikoye Ransome-Kuti, which was the first comprehensive policy we ever had in Nigeria that spells out the role of each arm, but there is no legislative backing to enforce it.

When we came on board, we developed a National Health Bill as part of our National Health Reform in 2004 but it took 10 years before it was passed into law in 2014.

It is regrettable to note that three years down the line after it was passed, we are yet to implement the Bill.

Except we revitalise the Primary Healthcare  system, there will be no meaningful progress in healthcare delivery.

Nowadays you see people going to Tertiary Health institutions for diseases like malaria which ordinarily, should  be addressed at PHC level but because our PHCs are not functioning,  people have no other option.

Many people embrace medical tourism because they have lost hope in our system. Assuming the National Health Act were to be implemented, 1 percent of the consolidated revenue would have been devoted to PHC, of which 50 per cent of that will be used in providing minimum basic health service to all Nigerians irrespective of their status. But we have not started implementation.

As an economist, my  neutrality helped to ensure no strike among health professionals.

Throughout my four year tenure, there was no strike because of my neutrality. I threw my doors open for everybody irrespective of your affiliation but there was a time they remembered that government was owing them before I assumed office and they demand for their money I went to Obasanjo and briefed him.

He called the Minister of Finance to make the money available while I supervised its disbursement.

Effective public private partnership is required to achieve quality healthcare delivery.

In Nigeria, about 60 per cent of healthcare providers are in the private sector, 64 per cent of the funding of health in Nigeria is from the private sector, yet there is no effective public and private partnership in Nigeria. When are we going to get to the promised land if the main provider is not incorporated?

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