central coordination for financing uhc in nigeria: progress and next steps
TRANSCRIPT
Dr. Francis Ukwuije
Head, Healthcare Financing Equity & Investment, HSS, DHPR&S FMOH
27 June , 2016
Federal Ministry of Health
Central Coordination for Financing UHC in Nigeria: Progress & Next Steps
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Background
Need for Strong Govt Leadership
Central National Coordination for UHC
Opportunities
The National Health Act 2014
President’s Pledge on Health
What We’ve Started Doing
Summary/Conclusion 2
Presentation Outline
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BACKGROUND
Federal Ministry of Health 4
NIGERIA
• Population Over 180M
• Federal system of government • Federal, States, LGAs
• 36 states & Federal Capital Territory (FCT) • 774 LGAs
• 3 levels of health care delivery
• tertiary, secondary and primary
• About 70% of Nigerians live in rural areas (LGAs) and there are over 20, 000 PHCs in Nigeria
Federal Ministry of Health 5
NSHDP 2010-2015 Goal » UHC
Source: NDHS 2003, 2008 & 2014
Indicator (%) 2003 2008 2013 Modern Contraceptive Prevalence Rates
8.2 9.7 9.8
Total Fertility Rate 5.7 5.7 5.5 Antenatal Care Coverage 60.1 58 61 Delivery in a Health Facility 32.6 35 36 Skilled Birth Attendance 41.8 39 38.1 DPT3 Coverage 20.1 35.4 38 Measles Coverage 31.4 41.4 42
• Maternal deaths 576 per 100,000 live births
• U-5 child mortality 128 per 1,000 live births (2013)
• Poverty: 61% < $1/day • 5-7% Insurance Coverage • Over 60% OOPS
What Was the Situation?
Federal Ministry of Health 6
Total health expenditure (THE)
was 6.7% of GDP in 2009
(>4-5% Benchmark)
5-7% population covered by pre-
payment and risk pooling schemes
(< 90% Benchmark )
< 2% coverage of population with social
assistance and safety-net progs
(< !00% Benchmark)
Out-of-pocket spending >60% of
total health expenditure
(>30-40% Benchmark)
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Nigeria Was Not on Track Towards UHC
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Need for Clear & Strong Government Leadership &
Commitment
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Presidential Declaration on UHC; March 10,
2014
Federal Ministry of Health 9 9
Central National Coordination for UHC
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HEALTHCARE FINANCING EQUITY & INVESTMENT (HCFE&I) BRANCH,
LOCATION: Health Systems Support (HSS) Division,
DHPRS, FMOH
MANDATE: Provide overall policy and strategic
direction towards achieving the Presidential mandate and deliver Nigeria’s UHC
targets in line with the NHAct 2014 and SDGs
through leveraging existing resources and building
appropriate partnerships
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UHC
Quality of Care NAFDAC,
Regulatory Bodies, Other
MDAs & Partners
Physical Access
NPHCDA, MSS, SURE-P, GF, GAVI, Others
Risk Protection
NHIS, CBHIS, PHI, Free
Health Schemes,
Others
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OPPORTUNITIES
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THE NHAct 2014: VEHICLE FOR ACHIEVING UHC
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3 Main Sources
FG Grant at Least 1% of CRF
Donor Funding
Other Sources including Private
Sector
BHCPF
Distribution
50% for BMHCP through
Insurance 45% for Primary
Healthcare
5% for Emergency
Care
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Basic Healthcare Provision Fund (BHCPF)
Federal Ministry of Health 15
review policy to ensure efficient and effective management of our health system with focus on
prevention
Ensure that no Nigerian will have any reason to go outside the country for medical treatment
Guarantee financial sustainability to the health sector and minimum basic healthcare for all
Review occupational health laws and immediately commence enforcement of the provisions to reduce hazards in the work
place
Partner with state Governments and development partners to ensure all round implementation of our primary health plans by
expanding access to health insurance for rural communities
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The President’s Pledge for Health
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WHAT WE’VE STARTED DOING
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Wide Strategic
Stakeholder Engagement UHC/HCF&E
Roadmap
Domestic Resource
Mobilization (DRM);
Global Financing Facility (GFF); Joint Learning
Networks (JLN);
National & State Coordination
Platforms-HCFE&I Units,
TWG, JLN Priority Setting;
UHC Impact
Analysis & Investment
case
National HCFE&I Policy &
Implementation Strategy
Operationalization of the National
Health Act 2014; SHIS & SPHCDAs
National Health Policy Review & Review of NSHDP1 for
NSHDP2
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SUMMARY
Federal Ministry of Health 19
• Even though Nigeria was not on track towards UHC
• Presidential Declaration of UHC March 10 2014, and the NHAct 2014 became the game-changers within the context of NSHDP to establish strong political commitment and leadership
• Institutional Structures in place at the HCFE&I FMOH for central coordination of UHC
• Process of Review/Development of Policies and Guidelines on-going
• Urgent need to accelerate establishment of State Health financing Units, TWG, SHIS, and SPHCDA towards strong coordination and implementation of UHC at sub-national levels.
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THANK YOU
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