The Universal Health Coverage (UCH) Day was marked last year exactly when the world had just adopted the Sustainable Development Goals, including UCH as a target.
Barely one year after its adoption, there has been global agreement on how exactly progress towards UHC will be measured.
For Universal Health Coverage to be meaningful, the global agreement says, “all people should have access to the health services they need, and at a price they can afford.”
To this effect, the SDGs will now measure concrete progress towards both of these aspects of UHC. Each country will be evaluated on service coverage – measuring the proportion of the population which has access to 16 essential health services.
This include financial protection – measuring the proportion of households which spend too much of their budget on healthcare costs.
In view of this, Dr. Opeyemi Odedere, MNCH Adviser, Save the Children International, has called on the Federal and state governments in the country to show more commitment and investment in Universal Health Coverage (UHC) by building universal, reproductive, maternal, newborn child and adolescent health services at primary health care level.
Dr. Odedere who spoke at a briefing organised by Save the Children International to mark the Universal Health Coverage Day in Lagos recently said the call had become necessary to reduce high maternal and child mortality in Nigeria.
The Universal Health Coverage Day is celebrated on December 12 year, to mark the anniversary of the United Nations’ historic and unanimous endorsement of universal health coverage in 2012. Since then it had become the annual rallying point for the growing movement for health for all.
The Universal Health Coverage (UHC) is a programme mooted to ensure that everyone has access to quality health services without financial hardship. It is a global consensus that UHC is a smart and achievable investment goal in which countries of the world have been committed themselves through their endorsement of the Sustainable Development Goals. This is clearly shown in the Target 3.8, under Goal 3 of the UCH.
UHC is key to ensuring that everyone has access to essential healthcare. Without a commitment to UHC, the poorest and most disadvantaged populations would continue to be left behind. Governments should increase public spending on healthcare to at least five per cent of GDP and reach the recommended minimum of $86 per capita of domestic financing for health.
Dr. Odedere said that the governments must demonstrate political and financial commitment to universal health coverage through increased public spending on healthcare by ensuring mandatory, pre-paid and pooled funding mechanisms for health instead of relying on private and out of pocket expenditure.
The maternal newborn child(MNCH) Adviser, said that the Nigerian health system relied heavily on Community Health Workers, who operate over two thirds of Primary Health Centres (PHCs) even when they often lack the necessary skills for quality healthcare delivery.
He therefore called for improved primary healthcare delivery in Nigeria, adding that Nigeria loses 109 children Under-five per 1,000 live births.
In Nigeria, under-five mortality rate is 109 per 1,000 live births; newborn mortality- 34/1,000 (UNICEF State of the World’s Children, 2016), 62 per cent of deliveries happen without the presence of a skilled birth attendant.
There are two skilled health workers for every 1,000 people (and NDHS, 2013) in 2014, instead of the recommended 15 per cent recommended by the Abuja declaration. While eight per cent of the government’s budget was spent on health, out of pocket expenditure on health is high by 72 per cent of total health expenditure.
At the global front, Save the Children had been at the cutting-edge of the Every Woman Every Child (EWEC) global campaign that has been pushing for increased national commitment to investment in UHC by building universal, reproductive, maternal, newborn, child and adolescent health services (RMNCAH) at the primary health care level as the first priority and prioritising the poorest and most marginalised groups.
Save the Children had been driven by a passion to see that no child dies from preventable causes and has continued to collaborate with the governments of Lagos, Gombe and Kaduna states on a number of interventions, including the Health Workers Capacity Building (HCB) project.
HCB is a three-year project, spanning from June 2015 to May 2018, focused on building the capacity of health workers in Lagos through several bouquet of trainings including Essential Newborn Care, Injections and Vaccines Management Training, Integrated Management of Childhood Illnesses (IMCI), among others.
The HCB is also committed to creating an enabling policy environment for the delivery of improved Maternal Newborn and Child Health (MNCH) services in Lagos State.
Roy Chikwem, Area Operations Manager for Save the Children Nigeria in Lagos State, said: “We need to do more to improve health care delivery for mothers and children in the country as the figures reflect high numbers of deaths among under-fives.”
Chikwem said: “Save the Children is calling for increased national commitment and investment towards UHC, by building RMNCAH services at primary health care level as a first priority and prioritising access for the poorest and most marginalised and excluded groups.
“Our call to governments, donors, development partners and all stakeholders is to guarantee an essential package of RMNCAH services as the first priority for UHC; free at the point of use and accessible to all; establish time-bound equity targets for accelerated progress among the poorest and most marginalised and excluded people, so no one is left behind.
“We also call for increase in public spending on healthcare to at least recommend minimum levels; improve quality and promote respectful and dignified care in health facilities and fully implement the National Health Act,” the Area Operations Manager said.
The HCB project is funded with support from GlaxoSmithKline and the Save the Children is known world-wide as a rallying voice for child survival, development and participation.
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