Country Director for Ipas-Nigeria, Dr. Ejike Oji, is one of those who fought for the passage of the National Health Bill. The reproductive health expert, who has fought for the health rights of women in Nigeria for the past three decades, explains to JOSEPH OKOGHENUN and IBUKUNOLUWA KAYODE that the controversial health bill would benefit other health workers than it would do to medical doctors.HOW important is the National Health Bill'This is the first time we are legislating on health issues, and also putting a mechanism on ground to fund minimum healthcare package for citizens of this country.This bill wants at least two per cent of the consolidated revenue to be used to fund primary healthcare. The bill,which makes available resources for training healthcare personnel working at that level, also makes provisions for money for the purchasing of drugs, equipment, and healthcare maintenance to ensure that the vulnerable in the country -' women and children -' are treated free when necessary.It also prescribes that every accident victim or in an emergency regardless of where the patient is taken to -' private or public healthcare -' should be treated free.For maternal mortality reduction this will be the most important intervention. Women in the rural areas where more than 70 per cent of our population resides would get qualitative maternal services where and when needed. Only 35 per cent of our women have skilled attendants attending them when having a baby. The rest women either deliver themselves or by people who do not have any business doing that delivery. This is the reason we have a very high rate of maternal deaths.We are only second to India in maternal mortality rate (MMR). Mind you, India is 10 times our size with a population of 1.2 billion people. We are about 166 million now by projection.Funding primary care will get healthcare personnel back to the rural areas, thereby increasing the percentage of women who have skilled care during pregnancy and delivery.The genesis of the bill is to have a law that would guide our health plans, put in place measures that would regulate standards and put funding mechanism in place. As of now, we do not have a law guiding what we do in the health sector.Were all stakeholders -' doctors and other health workers -' carried along during the drafting of the National Health Bill'The current bill that has been passed by the National Assembly was in the assembly for about seven years. The bill was even passed at a point and sent to the Presidency for assent. It was later sent back (to the National Assembly) before the immediate past legislative session of the National Assembly passed it. Everyone had fair chance of making inputs into the bill.What could happen if the president does not assent to the bill'The benefits I have outlined will be lost. Our women would continue to die as they are doing now from lack of adequate care during childbirth. Nigerians would be denied the opportunity of a minimum healthcare package that is so important for a society that wants her citizens to have good quality of life and have a chance of surviving when afflicted by disease or traumatised. We are trooping to India right now for treatment. But Nigerians deserve some minimum level of care.Does the bill actually favour medical doctors above other health workers'No, far from that. The headship ofproposed National Tertiary Hospital Commission is the main cause of agitation. There are about 38 agencies to be created out of this bill. The bill prescribes only two commissions to be headed by a medical doctor. The rest is open for anybody.If you look at those to benefit from the bill in terms of professionals, the nurses and pharmacists would be the biggest beneficiaries. Fifty per cent of the funds would be used to provide services at the primary healthcare level. This is where you see mostly nurses and Community Health Extension Workers (CHEWS). Another percentage of the funds would be for training of personnel at the primary healthcare level, which is mostly occupied by nurses. Fifteen percent of the revenue would be for medicines. Pharmacists compound and sell drugs; no other professional is allowed by law to do that.
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