Our land soaked in blood, gloom, South-East Bishops wail

As key stakeholders brainstorm on raising accountability framework on health care financing

By Joseph Erunke

ABUJA– The federal government has disclosed that Nigeria was losing about 2,800 under-five year olds and 110 women of childbearing age daily.

Government said the regrettable development had made the country the second largest contributor to the under–five and maternal mortality rate in the world.

The revelation came as stakeholders brainstormed on raising accountability framework on health care financing in the country. According to them,to achieve proper health care financing and delivery system, there must be increased monitoring and accountability.

Sharing an experience on the accountability arrangement while executing the Basic Healthcare Provision Fund, BHCPF, at a two-day workshop, tagged:”Stakeholders Forum on Raising the Health Sector Accountability Bar”, organised by the Health Reform Foundation, HERFUN,Dr Dogara Okara, who represented the Federal Ministry of Health, said the ministry identified that. “Every single day, Nigeria loses about 2,800 under-five year olds and 110 women of childbearing age.”

“This makes the country the second largest contributor to the under–five and maternal mortality rate in the world,”he said.

 Dr Okara further said, “It is estimated that Nigeria records 39 deaths for every 1000 persons annually.”

Açcording to him,” what informed the BHCPF were low health expenditure, which stood at less than 5%, “high rate of out-of-pocket spending (~75%), low rate of health insurance coverage (~4%), poorly resourced primary healthcare system and life expectancy of (53%).”

Dr Celestine Okorie, the Executive Secretary of HERFUN,while speaking, said proper accountability will “reposition the healthcare financing and go along way to solve the inefficiencies in the health financing landscape.

“This workshop is geared towards addressing this key element, and there would not have been a better time to meet and strategize best ways to raise the accountability framework,” he said.

He explained that the discovery led to the appropriation of funds by the federal government for the first time in 2018 and the development of implementation manual in the subsequent year.

Dr Priscilla Ibekwe, Director Special Duties from the Centre For Disease Control, CDC, identified that the country is at risk of infectious diseases outbreak and called for the conduction of Joint External Evaluations of Internal Health Regulations core capacities.

Açcording to him, there must be a “development of a multi-sectoral National Action Plan for Health Security (NAPHS 2018- 2022) to address gaps, with goal of preventing, detecting and responding to public health threats.”

The stakeholders aggregated the essence of the workshop and arrived at key decisions that must be implemented to move the sector forward.

The forum agreed to work together with key stakeholders to raise the accountability bar in order to reposition the Nigeria health financing landscape  just as it called for the harmonisation of the existing accountability framework and conduct the mapping of stakeholders at all level

It identified the importance of building capacity of stakeholders on accountability framework implementation and agreed to work with partners to build capacity of the stakeholders for effective actions in the sector. 

While agreeing that there must be coordinated efforts to strengthen the coordination arrangement and build institutional capacity for accountability framework deployment, it also agreed to work with other stakeholders to develop a technology enabled data visualization system so that all Nigerian can have access to BHCPF data and use such data for decision making.

“The forum will also develop effective knowledge management system including learning agenda, success stories and policy briefs” and that “HSRC and HERFON will continue to work with all relevant stakeholders to build on the gains of this Forum to further raise the accountability bar to achieve more money for health and more health for the money,” said Okorie.

The health financing accountability forum appraised the existing health financing landscape in Nigeria and noted that there is sub-optimal funding for health and inefficiencies in the health sector.

“We have resolved that there is need to improve efficiency in the utilisation of public funds spent in the health sector through the development and  operationalization of an accountability framework

“The Forum underscores the centrality of raising the accountability bar to reposition the Nigeria Health Financing Landscape. There is need for “Collective Leadership” where all stakeholders will come together in a collaborative relationship to ensure that the objectives of the BHCPF are actualised,”the resolution of the forum read.

It read further:”The Forum notes the current efforts geared toward raising the accountability bar for BHCPF and health financing by different stakeholders.

We note that these stakeholders are developing different accountability frameworks.

“We have resolved that it is important to “harmonise” or “integrate” or rather “consolidate” the existing accountability frameworks into one framework that can work for all of us….

HSRC and HERFON with the support of partners will facilitate the development of such a citizens-led framework from the proceedings of this forum.

Such a framework needs to involve all stakeholders and validated at the highest level.

“There is need to conduct the mapping of stakeholders at all level…..and build their capacity on accountability framework implementation as no one can monitor what he does not know.

This Forum will therefore continue to work with partners to build capacity of the stakeholders.

“The HSRC and HERFON will also work with stakeholders to strengthen the coordination mechanism and build institutional capacity for accountability framework deployment.”


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