kick against privatization of public health services

By Gabriel Ewepu – Abuja

As Nigeria joins the rest of the world to mark 2020 International Public Services Day, ActionAid Nigeria, AAN, Nigeria Labour Congress, NLC, and Public Services International, PSI, Nigeria, Tuesday, urged the government on adequate financing of public health to boost women and girls’ life.

This was the position of AAN, NLC, and PSI in a joint statement at the Launch of Research Report with the theme ‘Who Cares for the Future; Finance Gender Responsive Public Services’ held in Abuja.

It will be recalled in December 2019, AAN commissioned a national policy scoping research to generate relevant evidence on government spending, policy engagements, and campaigns on Sexual and Reproductive Health and Rights in the last four years.

According to AAN the Research was aimed at generating evidence to support the development of the policy change agenda on gender-responsive public services focusing on the health sector (health and Sexual and Reproductive Health and Rights (SRHR) of women).

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The report further stated that Nigeria has one of the highest out of pocket health expenditures in the world (currently over 75 per cent). Other than the poor funding of the health care sector by the government, limited supervision of healthcare providers in the private and public sector undermines the government’s intention to rapidly scale up access to quality health care for Nigerians, women, and girls inclusive.

The report also raised fears that from all indications, COVID-19 will have a dramatic impact on public finances in the short and medium-term in Nigeria, which is also acknowledged that this is an especially intense period for Nigeria Government as it tries to secure resources for desperately needed services in a difficult environment, because the pandemic has made the rebuilding of public finances for public health and other public services crucial, and should be considered an opportunity for some fundamental system change and transformation, as the government looks for structural solutions and new ways forward.

While speaking on COVID-19 pandemic and its challenges in the health sector, they said, “The COVID-19 crisis has revealed the extent to which public services have been under-funded for a generation across Nigeria, with women in the poorest communities often having to take the strain and fill the gaps through unpaid care and domestic work.

“From the report of the Gender Responsive Public Service (GRPS) research conducted in the North Central and Southern regions of Nigeria, healthcare centers were found to be suffering a severe lack of care and maintenance and were grossly under-funded.

“Health workers in these centers were found to be underpaid and overburdened. Doctors and nurses do not get posted by the government to grassroots health care centers, and health extension workers who were employed by the government were untrained and ill-equipped lacking their basic needs like transport and food.

However, the organizations while recognizing the constraints currently faced by the government, recommended that revenue from increased finance flow for the government should be channeled to providing a safety net for women and girls especially in increasing access to gender-responsive public services.

They said: “The Government of the Federal Republic of Nigeria through its agencies to Coordinate with other countries to suspend, or where possible cancel, all debt payments through to the end of 2021 and work actively to renegotiate debt servicing beyond that point so that debt payments never exceed more than 12 per cent of national revenues. Exceeding this level is likely to lead to cuts in public services;

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“Set an ambitious target to increase the tax to GDP ratio in a fair and progressive way by five per cent over five years. This means setting a plan for expanding the tax to Gross Domestic Product, GDP, ratio from its present ratio of six per cent to 15 per cent in 2030.

That would more than double the present national revenue. It should enable you to double present spending on essential public services, making them truly universal, of decent quality and gender-responsive (see the recent report Who Cares for the Future)’

“Remove the present constraints on public sector wage bills which are blocking the recruitment and decent pay of all workers, especially health workers, nurses, care workers, teachers, and other essential frontline staff.

As we understand it, our present agreement with the IMF/current policy advice from the IMF suggests that public sector wage bills should be only modestly increased but achieving a national recovery from COVID 19 and setting a serious course for the achievement of the SDGs will require major new investment in public sector workers.”

Meanwhile, the organizations kicked against any aid or loan that would be for privatizing public health facilities but advised that the government strategise on ways to finance public health facilities and services.

“Reject any aid or loans from the World Bank and other multilateral development banks that support privatization of public-private partnerships. There is an increasingly ideological agenda being attached to loans and grants, particularly pushing the privatization of public services.

“Governments should insist that available and potential resources mobilized for post-COVID-19 are earmarked for public services and for rebuilding sustainable public financing. This crisis has made the crucial role of public services clearer than ever and must not be used as an excuse to accelerate privatization”, they pointed.

Meanwhile, they expressed commitment and readiness to join the government to ensure sustainable health sector financing is worked out.

“We are committed to working together with our government to ensure that COVID-19 marks a turning point for our country, moving us towards a more sustainable economy and society that care for both people and the planet.

“We are ready to join force with Government to ensure a revaluing of frontline public sector workers as the foundation for a more sustainable economic future”, they assured.

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