By Sola Ogundipe & Chioma Obinna
One of the major advances  the Nigerian health sector has witnessed recent times,  is the enactment of the National Health Bill as well as repositioning of Primary Health Care as vehicle for health care delivery in the country.

Although the Bill is awaiting  accent by President Umar Yar’Adua, it  has been passed and harmonised by the chambers of the National Assembly. Federal Ministry of Health sources told Good Health Weekly  that when this Bill comes into being, it will ensure that 2 per cent of the national consolidated budget allocated to health is  shared between primary health care and the National Health Insurance Scheme (NHIS).

As part of effort towards  reinforcing Federal government attention to reposition primary health care as major vehicle for health care delivery in the country,  roles and responsibilities of all tiers of  government are being harmonised. Towards this end the Federal Ministry of Health is  engaging the Governors’ Forum to underscore coordination of health within the political system should be with the states.

Closely allied to this is the repositioning of the National Primary Health Care Development Agency (NPHCDA) and the encouragement for states to establish corresponding agencies or boards to ensure that there is some traction and enable resources reach down to the people and improve access to health.

Evolution of the National Health Strategic Plan is another important activity being witnessed by the  health industry.  It is being put together  through a bottoms-up approach involving the 36 States making their own plans and integrating with the Federal plan  to evolve  into the National plan.

Federal Ministry of Health sources noted that in the two months the Strategic Plan will be launched, it will form the basis for planning, budgeting and coordination of the nation’s  international development partners which will ensure a policy for optimal utilisation of resources.

But by far the most important advancement are the current efforts to increase child survival through programmes aimed at enhancing  public education about preventable diseases that affect children particularly those that are vaccine preventable. Good Health Weekly gathered that the drive to increase the uptake of immunisation has continued through innovative actions such as involvement of  Emirs and Community leaders in the North.

The move led by the Sultan of Sokoto  has yeilded dividend, leading to local and international acknowledgement of the nation’s polio eradication efforts. For instance, at the last ERC meeting, Nigeria was commended for advances made polio eradication.

The country’s approval to include in  its immunisation portfolio vaccines for pneumonia and rotavirus which causes diarrhoeal diseases in children is also significant. According to sources from the apex health ministry, this will enable  improvement of chances of child survival and reduce infant mortality.

Closely allied to this is the employment and posting of over 2,000 midwives to the  rural areas to increase  deliveries by skilled attendants and thereby reduce maternal mortality. This is in addition to establishment of the national blood transfusion services for a coordinated effort between Federal and State governments to provide  safe blood to those who need it.

Meanwhile, the NHIS platform continues to grow with intervention focused on the community insurance scheme which provides free services to pregnant women and children below five. The effort  is currently on in 12 States but ultimately the entire country is to be covered.

With one of the largest  comprehensive malaria control programmes in the world, Nigeria is committed to distribution of two insecticide treated nets per household and ACTs, prophylaxis for pregnant women and indoor residual spraying and introduction of larvicides to reduce  mosquito population are interventions expected  to reduce  morbidity and mortality of malaria by half by the end of 2010.

To date, 14 Teaching Hospitals and seven specialty hospitals have been upgraded.  The process  is continuous and next in line are the Ahmadu Bello University Teaching Hospital (ABUTH); the University College Hospital (UCH); the University of Nigeria Teaching Hospital (UNTH) and the National Hospital, Abuja.