A defining moment for Nigeria’s health sector

BY HENRY ANIBE AGBONIKA

Population health is at the heart of any nation’s progress and can be a cause and consequence of human development. In Nigeria, the “Renewed Hope Agenda” espoused by President Bola Ahmed Tinubu is promising to vastly improve population health using a multisector, whole-of-government approach for equitable, affordable, and accessible healthcare system. 

Central to the president’s plan is the will to transform Nigeria’s healthcare system underpinned by the concept of universal health coverage (UHC), to ensure that quality health is produced for all Nigerians without financial hardship. UHC is not only a fundamental human right, but it is also an essential investment in Nigeria’s long-term national security and economic development. By making healthcare accessible to everyone, the Renewed Hope health agenda seeks to create a new social compact that boosts productivity, creates jobs and reduces poverty.

The agenda also recognises the importance of health sector governance and leadership as it proposes to implement political and institutional reforms that will improve coordination between the federal, state, and local governments, and ensure that healthcare services are delivered in a standardized, equitable and accountable manner. This is a critical step forward, as fragmentation in the health sector funding and governance has been a major hindrance to progress in the past. By empowering communities to take ownership of their healthcare services, the Renewed Hope Health Agenda will ensure that all Nigerians have access to the care they need, regardless of where they live.

In demonstration of his unwavering commitment to this agenda, and an understanding of the criticality of health sector governance and leadership in the new scheme of things, President Tinubu took it upon himself, as Nigerians are all aware, to convince Mohammad Ali Pate who was already on his way to resume as the CEO of GAVI – the Global Vaccine Alliance to return home and serve.

With recent developments, however, it is glaring that Pate’s appointment was a sign of things to come. The appointments of Muyi Aina and Kelechi Ohiri to lead the National Primary Health Care Development Agency (NPHCDA) and the National Health Insurance Authority (NHIA) are strategic steps in delivering on the Renewed Hope Health agenda. These leaders, like the coordinating minister, have a proven track record of success in improving health outcomes and transforming healthcare systems. Their appointments signal the Tinubu administration’s commitment to transforming Nigeria’s healthcare system. 

That the NPHCDA plays a critical role in coordinating and implementing primary healthcare services across Nigeria is not news. Under Aina’s leadership, the agency will however be poised to strengthen primary healthcare delivery and make it more accessible to all Nigerians. He will lead the charge towards strengthening primary healthcare, improving maternal and child health outcomes, and increasing immunisation coverage, among others.

Specifically, the NPHCDA under Aina could potentially drive an increase in primary healthcare utilisation by at least 20%, increase the number of people accessing primary healthcare services from 5,748,982 to 6,898,778 by 2027, and achieve a 50% increase in patient satisfaction with primary healthcare services within four years, in line with the ministerial deliverables.

He also has the opportunity to engineer a reduction in maternal mortality rate by 20% and the under-five mortality rate by 15% over the next four years, while working with states to improve health infrastructure, train 100,000 frontline health workers in four years, and achieve a 10% increase in coverage of immunization. It is envisaged that with this leadership, no Nigerian will live more than 3 kilometres or a 30-minute walk from a primary healthcare facility. This will improve healthcare access, empower communities, and serve as a critical early warning system for emerging health threats.

Similarly, the NHIA under Ohiri’s leadership, is expected to expand coverage and improve the quality of care provided to enrollees. For an agency responsible for administering the National Health Insurance program, which should translate to health insurance coverage to millions of Nigerians, Ohiri has his job cut out. Also, considering that Nigeria has one of the lowest health insurance coverage rates in the world, with less than 10% of the population covered, business as usual is not an option, and neither is complacency.

The general expectation among stakeholders is that under his watch,  the percentage of the population enrolled in any form of health insurance should increase by 20% within the next four years, from a current baseline of 16,797,451 to at least 20,156,941 by 2027. This is a critical expectation, as it is essential to reduce out-of-pocket expenses for healthcare services and ensure that all Nigerians have access to quality healthcare.

Not surprisingly, both Aina and Ohiri have impressive academic and professional backgrounds. While Aina has a master’s in public health from Harvard University and a doctorate from Johns Hopkins University, in addition to his medical certification from the University of Ilorin in Nigeria, Ohiri has a master’s in public health from Harvard University and a master’s in public policy from Harvard’s Kennedy School of Government, in addition to his medical certification from the University of Lagos in Nigeria.

They also have extensive experience working in the global health sector with Aina working at the World Health Organization and the African Development Bank, while Ohiri has worked with the World Bank, McKinsey & Company, and the National Health Service (NHS) of the United Kingdom.

The heart of the matter is clear: these appointments have the potential to significantly drive the realisation of increased health outcomes for Nigerians. Each appointment is a crucial puzzle piece in the complex mosaic of the healthcare sector. Pate’s international experience and leadership acument, Muyi Aina’s focus on primary healthcare, and Kelechi Ohiri’s efforts in health insurance harmoniously align with the president’s vision for healthcare reform. These leaders, with their diverse backgrounds and experiences, are positioned to address Nigeria’s most pressing healthcare challenges, improve infrastructure, access to healthcare, and healthcare financing, and position Nigeria as a global leader in health security and services.

The implications of these appointments are profound and far-reaching, setting the stage for a new dawn in Nigeria’s healthcare sector. The synergy and collaboration among these leaders, driven by a commitment to service and a common vision, can catalyse a healthcare transformation that will benefit all Nigerians. As we witness these changes unfold, it is crucial for the public, healthcare professionals, and stakeholders to offer their support and maintain a united front. Confidence in the healthcare system is paramount, and through accountability and transparency, the nation can navigate the challenges and obstacles that lie ahead. 

Glaringly, President Tinubu’s strategic healthcare appointments are not just a change in personnel; they are a commitment to a brighter and healthier future for Nigeria. With these leaders at the helm, we are at the cusp of a new era in Nigerian healthcare, where the healthcare agenda’s promise of accessible and affordable healthcare for all may become a reality. Could this be the long-awaited moment?

Henry Anibe Agbonika, a policy and governance reforms consultant, writes from Abuja, Nigeria. He can be reached via henry.agbonika@gmail.com