Heath is wealth and nobody should be denied access to health on financial grounds as captured in sustainable development goal. Universal health coverage ensures that all people of all ages in all places have access to a full range of health services when and where they need such services.
How close is Nigeria to the goal of universal health coverage? With its vast human and natural resources, achieving universal health coverage should have been achieved in Nigeria. However, since important goals are hardly achieved by mistake, it’s important to examine the milestones necessary to achieve universal health coverage in Nigeria.
What does it take for Nigeria to achieve universal health coverage? Achieving universal health coverage for Nigeria or any other country requires intentional steps targeted at improving health service coverage and health outcomes.
Since health care workers provide healthcare services, an excellent point to start is to look at the availability, accessibility, and capacity of healthcare workers in Nigeria. For example, contrary to the WHO’s minimum recommendation of one doctor to 600 patients, Nigeria’s current one doctor to 2,500 patients shows how far we are from achieving universal health coverage.
No nation can deliver health care services beyond the capacity of her healthcare systems. The unwritten rule behind achieving universal health coverage for Nigeria or any other country therefore depends on health system strengthening. Excellent healthcare costs money and somebody has to pay for it. The overly bloated cost of governance and inadequate attention paid to the informal sector coupled with the populations living in rural communities constitute a hydra-headed challenge militating universal health coverage in Nigeria.
Aside from the inability of large segments of the population to pay for healthcare premiums because of the abject poverty, lies the other side of the coin—unacceptably low government funding of health. As a general rule, government expected to spend between 6 and 7% of the GDP on health services if they intend to achieve universal health coverage. Unfortunately, Nigeria spends less than 4% of its GDP on health services. This is disturbing, but the real trouble is not the difference between recommended spending and the actual spending but problems with fair allocation of health resources in Nigeria.
Beyond funding and equitable distribution, to achieve achieving universal health coverage in developing countries like Nigeria, we must tackle the triple challenge of poor funding of health services, poor management of health resources and poor implementation of healthcare initiatives. Achieving universal health coverage in Nigeria requires a major paradigm shift in the modus operandi of health service delivery. This requires a shift from the straight jacket one-size-fits-all delivery to an integrated patient-centered delivery of Health Services.
Universal health coverage requires a well-managed integration of traditional and modern methods of health services delivery in accordance with the need of benefiting communities. The major threat to integration within Nigeria, however, is quackery—the prevention of which is a responsibility from which most state directorates of medical services are shying away.
So, is achieving universal health coverage possible in Nigeria?
Although anything is possible, with Nigeria’s abysmal 2019 ranking of 159th of 162 countries measured by their relative achievement of the sustainable development goals, it will take hardcore optimism to project that universal health coverage will be achieved in Nigeria anytime soon!
Take-home message: The current indices do not support the wildest optimism! Achieving universal health coverage in Nigeria might remain a mirage until the country grabs the bull by the horn. Strengthening its current health care delivery workforce and systems is needed as a matter of urgency if we are to dream of universal health coverage in the foreseeable future!
