MBIASE AND THE HEALTH CARE CRISIS IN NIGERIA
The National Health Insurance Scheme (NHIS) Decree (1999) provides voluntary comprehensive coverage for inpatient, outpatient, dental, vision, cancer and dialysis at primary, secondary and tertiary facilities. The National Health Act of 2014 mandates establishment of the Basic Health Care Provision Fund (BHCPF) to finance all Nigerians receiving a Basic Minimum Package of Health Services covering family planning, selected antenatal, delivery, postnatal and child care, adult malaria and non-communicable diseases. Initial focus is on poor rural populations.
The 20:2020 National Plan and Economic Recovery and Growth Plan goal is for Nigeria to join the Top 20 global economies. Its position as the biggest oil exporter and natural gas reserves in Africa, and its 182 million people would seem to make this possible. Making a demographic transition (a shift from high mortality and fertility to low mortality and fertility) via its health care is crucial to this goal, resulting in 50% GDP increase, 15 – 30% increase in per capita income, and 32 million less people in poverty.
NHIS participation is only 4.2%. The BHCPF has not been funded.
Government revenue from natural resources and GDP has dropped to only 4.8% (lowest in the world) due to weak oil prices, failure to diversify resources, and especially poor efficiency in tax collection due to lack of enforcement. This resulted in debt service increasing to 66.4 % of revenue in 2016, severely affecting in economic and social sectors, especially health care.
The World Health Organization (WHO) advises that neglected tropical diseases (dracunculiasis, human African trypanosomiasis, buruli ulcer, lymphatic filariasis, onchocerciasis, schistosomiasis and leprosy), despite cost effective means of prevention and control, cause immense suffering and often life-long disabilities for the rural poor in Nigeria. Tuberculosis, malaria, HIV/AIDS, diphtheria, diabetes, unattended births, malnutrition, lack of maternal and child health all contribute to misery. One in eight children die by the age of 5. Making the situation worse, healthcare workers don not always follow clinical guidelines, and have poor diagnostic accuracy for diarrhea, pneumonia, diabetes, tuberculosis, malaria, post-partum hemorrhage and birth asphyxia.
The majority of patients pay out of pocket, and the high cost of medicine, and problems with drug distribution, unauthorized retailing, poor quality and counterfeit medicines, the availability of good quality, efficacious and safe medicines is limited. Healthcare personnel often take medicine destined for rural primary health centers to their own clinics, depriving patients of the care due them.
Help for Mbiase
The Our Family Circle Foundation (OFCF) corporation was founded in 1989, at Seton Hall University in South Orange, NJ. As a 501(c) 3 not-for-profit corporation, it is focused on educational, healthcare and community development initiatives, among others. The OFCF is developing a plan to directly help Nigerians in Mbiase. The Mbaise citizens have donated a hospital building for OFCF use, and the President and Founder of OFCF, Mr. John Kemakolam, must arrange funding for hospital renovation, energy (generator or solar), housing for doctors, teachers and nurses, medical equipment, personnel, medicine and expenses to make the hospital operational. The plan is to fulfill the promises of the Nigerian healthcare acts directly, avoiding the pitfalls described above. Initially there will be a School of Nursing (Hansel-Essoka Health Career College) at the Hospital (Lumina Mother Child Hospital), which will evolve to become part of Lumina University. Funding plans are to contact philanthropic institutions and use GoFundMe to raise the estimated $500,00 required to open both the Hospital and Nursing school, and to run them until they become self-sustaining. Donations may be made to Lumina University Development Fund in care of City National Bank, 900 Broad Street, Newark, NJ 07102
Information for this document was obtained from “Nigeria Health Financing System Assessment”, Reem Hafez, World Bank Publications, The World Bank Group, 1818 H Street NW, Washington, DC 20433 The document may be viewed online at: http://documents.worldbank.org/curated/en/782821529683086336/pdf/127519-WP-PUBLIC-add-series-NigeriaHFSAFINAL.pdf