In what looks like a setback to the avowed responsibility of each government tier to the welfare of its citizens, the Minister of Health, Dr Osagie Ehanire, recently said government could not afford free healthcare for the country’s youth.
At a public hearing conducted by the House of Representatives’ Committee on Healthcare Services on March 23, the minister dismissed attempts to pass a law to provide free medical treatment to children aged zero to 18.
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The minister, who was represented by the Director/Head of Department, Complementary and Alternative Medicine, Zainab Shariff, said: “There should be more public enlightenment to get every child enrolled in the National Health Insurance Scheme, the Community Based Health Insurance Scheme, the State Health Insurance Scheme which provide healthcare service at subsidised rates”. He added that given the economic realities of the government, it would be impossible to finance such a programme.
The house is currently considering a bill that would make government provide free healthcare to children aged zero to 18. Sponsored by Bello Ka’oje (APC-Kebbi), the bill provides that hospitals should be mandated to provide free medical services for children including diagnosis, treatment, prevention of physical and mental illnesses in children. It will mandate the Ministry of Health to come up with definite procedures, guidelines as well as monitor and implement provisions of the bill. We welcome this bill and urge the House of Representatives and the Senate to speed up processes that will transform it into law.
It is indeed shocking that the minister took this stand as it contradicts the main purpose of a government. It is the government’s responsibility to provide for the welfare of its citizens which includes provision of quality healthcare. With 72 deaths per 1,000 live births, Nigeria has the highest mortality rates for children under five years, according to most recent data by the World Bank. Only Sierra Leone (80) and Somalia (73) have worse infant mortality rates than Nigeria. And for Nigeria, poverty, particularly rural, is the major cause of the mortality rates since many parents are unable to afford basic healthcare for their children. This often leads to patronage of herbal centres and unregistered medical outfits, usually with terrible consequences. Therefore, for many parents, free healthcare for children as proposed in this bill will lift the huge burden of paying out of pocket.
The minister argued that the National Health Insurance Scheme (NHIS) will serve the purpose of the bill. This is a gross understatement. The government’s health insurance scheme is still at its infancy, due largely to the nonchalant attitude of both federal and state governments over its implementation. It is a fact that only a negligible number of the population have so far been registered. To date, just about eight out 10 Nigerians are not enrolled on the health insurance scheme, a figure that makes a mockery of any notion of universal health service. Worse still, only those employed in the formal sector are enrolled, leaving out large sections of Nigerians who eke out a living outside the formal public and private sectors. The community aspect of the scheme has also so far been less successful.
It is therefore insensitive of the federal government to openly oppose a legislative initiative for free medical care for children since all over the world, nations give priority to the education and health of their young generations to assure a prosperous future for all. Nigeria is a signatory to many international mechanisms that affirm and emphasise the need to ensure the well-being of the future generation by providing education and healthcare to them. It is sad that Nigeria is not keen on implementing such programmes. Moreover, in a country where elites spend over 1 billion annually on medical tourism to attend to their own medical needs in foreign hospitals, the government’s position will also be insensitive to the living conditions of the poor. It reinforces the argument that Nigerian elites believe only in their welfare and that of the families.
We believe that this programme can succeed once there is the political will to see it through. Government has at its disposal various avenues to finance the delivery of quality healthcare to this group only if it can get its priorities right. For example, it can deploy the revenues it will get from the removal of subsidy on electricity and petroleum products to financing the programme. Again, the federal government can insist on shared responsibility in the implementation of the programme. Since healthcare delivery is the responsibility of all tiers of government, it only takes each tier to take its share of responsibility.
We urge the National Assembly to ensure the passage of the bill while all well-meaning citizens and non-governmental organisations should pressurise the government to make it a reality. Nigeria’s future depends on the education and health of its youth. That cannot be too expensive.
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