UNIVERSAL HEALTH COVERAGE AND THE 2030 AGENDA

In a recent discussion on universal health coverage and Nigeria’s progress toward the 2030 Agenda, Paul A. Obi emphasizes the urgency of strengthening the nation’s health ecosystem. Quoting Dr. Margaret Chan, former Director-General of the World Health Organization, he underscores that “universal health coverage is one of the most powerful social equalizers among all policy options.”

Health economists and social scientists often cite affordable and universal healthcare access as a crucial benchmark for achieving significant social change. The importance of state intervention in healthcare delivery is clear when considering how many citizens can access free services across various healthcare levels. This connection between universal health coverage and overall global well-being highlights the critical role of Sustainable Development Goal (SDG) three, which focuses on good health and well-being. It serves as a vital measure for assessing a country’s healthcare service delivery and socio-economic health.

In Nigeria, the federal government’s policy framework is closely linked to the SDGs, particularly in achieving universal health coverage by 2030. However, despite these efforts, the National Bureau of Statistics reports that only about 1% of the population currently has health insurance coverage. This statistic reveals a significant gap in essential health service coverage, indicating that Nigeria faces considerable challenges on the road to universal health coverage. Additionally, according to the United Nations SDGs Report, nearly 382 million people worldwide have been pushed into poverty due to out-of-pocket healthcare expenses, further complicating Nigeria’s situation, particularly for its socio-economically disadvantaged citizens.

The journey toward universal health coverage in Nigeria began with the establishment of the National Health Insurance Authority (NHIA) in 2005, but the necessary legislation to mandate health coverage was not realized until 2022. This lag in political will and effective policy implementation poses substantial obstacles to meeting the 2030 Agenda. Nevertheless, Coordinating Minister of Health and Social Welfare, Prof. Muhammad Ali Pate, expresses confidence that the federal government, along with regional partners, can achieve these goals.

During the International Universal Health Coverage Day event last December, Pate asserted that universal health coverage must address the needs of all citizens, regardless of their income, location, or other differences. He highlighted the importance of collaboration between the government and development partners to significantly increase the percentage of Nigerians covered by the NHIA while alleviating the financial burden of healthcare.

Earlier this year, Pate stressed the necessity for a more robust governance structure and defined guidelines to enhance access to health services, particularly for vulnerable populations. He noted the goal of reducing long travel distances for care, thereby improving the overall health and well-being of Nigerians.

Minister of State for Health, Dr. Tunji Alausa, added that the segmentation of coverage is key to addressing Nigeria’s healthcare challenges. He outlined various coverage plans, including essential services like cesarean sections, designed to meet different healthcare needs based on chosen plans.

Despite these positive strides, the ongoing lack of synergy among federal, state, and local governments hampers the implementation of universal health coverage and the 2030 Agenda. Initiatives launched at the federal level often fail to translate effectively to local communities, and many states have not yet established functional health insurance agencies. The NHIA’s Director General, Dr. Kelechi Ohiri, remains determined to push forward with UHC, reporting an increase in coverage schemes to 18.7 million in 2024, up from 16 million in late 2023.

However, with a national population of approximately 220 million, this figure represents only a small fraction of those needing coverage. The complexities of implementing universal health coverage in a country striving for economic recovery cannot be overlooked, as effective UHC has the potential to enhance citizen income and improve healthcare services.

With leaders like Pate, Alausa, and Ohiri at the forefront of Nigeria’s healthcare strategy, universal health coverage should become a central policy aim. As International Universal Health Coverage Day approaches on December 12, the path to achieving the 2030 Agenda may seem daunting, but proactive planning and collaboration can keep the dream of better healthcare alive.