20th May 2021 | The annual Legislative Summit on Health is a product of the Legislative Network for Universal Health Coverage. The Network consists primarily of legislators (National and States) with members of the Executive Arm of Government (State and National) and non-state actors collaborating to provide institutional contexts focused on the health sector. It is convened annually to provide a platform for Nigerian Legislators to confer to resolve matters pertaining to the resilience of the health sector to provide equitable, quality care to citizens.
The overall objective of setting up the Legislative Network was to effectively leverage statutory functions of the Legislature in Nigeria for improved health financing, toward effective and efficient utilization of the resources for Universal Health Coverage. The specific objectives were:
- To achieve improved appropriation to health sector by deepening the knowledge of legislators on economic, social, health and political benefit of improved health funding towards UHC;
- To ensure prompt and adequate release of allocated funds by working with the lawmakers to make relevant central budget agencies accountable for fund releases;
- To ensure timely passage of relevant high quality health laws especially the legal framework for State Supported Health Insurance Scheme (SSHIS);
- To leverage oversight and accountability functions of the lawmakers to assess and improve quality and efficiency of implemented health projects irrespective of the funding sources;
- To enhance sustained learning and among legislators across states and between state law makers and their federal counterparts.
Thus, the Summit is one of the tools used by legislators to collectively strategise on how to achieve these objectives. Every year since the first Summit was convened in July 2017 (except 2020 because of COVID-19), Legislators have gathered with this singular purpose. To rub minds, to discuss, to analyse health situations in the country, to make decisions and take a stand on the way forward to solve whatever challenges that each State may face, within respective contexts. What ensures success and nationwide reach is the fact that it includes all states. It identifies the role every stakeholder needs to play and leverages these to achieve identified objectives. A major output of these meetings is a strategic framework called the Legislative Health Agenda, an actionable work-plan developed by each State to address existing challenges in respective health sectors by applying their statutory functions of Legislation, (appropriation), Oversight, (accountability), and Representation.
This actions by the Legislature have become critically necessary as the country’s mortality indices have remained extremely high with minimal improvements, despite the magnitude of resources contributed to improve the statistics. For instance, the National Demographic Health Survey (2018) findings revealed that in the seven years preceding the survey, infant mortality rate was 67 deaths per 1,000 live births; under-5 mortality was 132 deaths per 1,000 live births; and Maternal mortality ratio, 512 deaths per 100,000 live births. Similar dismal indices are recorded across different health indicators and call for accelerated responses like this one, across different spheres of stakeholders to address the challenges giving rise to these.
The Summits have contributed a large portion to the following achievements in the sector:
- Accountability for implementation of the Basic Health Care Provision Fund (BHCPF) guideline in line with the National Health Act;
- Achieving the earmarking of the BHCPF from service-wide vote to first line charge
- Annual fiscal appropriations inclusive of the BHCPF (one percent of the Consolidated Revenue Fund) to provide a minimum package of basic health services to all Nigerians since the first Summit was convened;
- Deliberate actions by legislators on health and nutrition resulting in increased budgetary releases to the health sector in some states;
- 34 of 36 states have enacted legal frameworks to provide financial risk protection on healthcare;
- Effective collaboration of the National and State Legislatures in the response to COVID-19 and epidemics preparedness;
- A high percentage of legislators across the country now keenly aware of how to apply themselves and their statutory functions towards healthcare financing reforms; and
- Capacity building of legislators in five geo-political zones of the country to harness and align their statutory functions to achieve UHC goals and nutrition objectives;
Although the country is making attempts to take giant strides in its pursuit of Universal Health Coverage (UHC); these efforts and whatever achievements have been recorded could be quickly eroded if health security is not prioritized. This is obvious in the effect of the currently ravaging COVID-19 pandemic and other disease outbreaks that have greatly impacted the health system negatively. The approaches to ensure that health security is prioritized and at the same time the country’s UHC pursuit is not hindered is the focus of our discussions at this year’s 4th Annual Legislative Summit on Health that will hold from May 23rd to 25th, 2021 in Abuja. Its theme aptly describes the purpose: Universal Health Coverage (UHC) and Health Security (HS): Two Sides of a Coin for an Efficient Health System.
We will review the State of the health of the nation and the national health system; the role of adequate financing as the nexus for UHC and health security in Nigeria, and what opportunities exist for the Health Sector to leverage; and leveraging lessons from COVID-19 national and subnational responses to improve the health security landscape. It is our sincere hope that this year’s Summit to build on past successes to impact positively on the health sector and Nigeria as a whole.
The Summits have continued to be a rallying point of learning, interaction and agenda setting for legislators and other key actors in the health sector across the country. They have helped achieve laudable accomplishments in the provision of equitable and affordable healthcare in the country and will continue to be used to this end, with the continued assistance of our partners including the World Health Organisation, European Union, World Bank, United States Agency for International Development, Foreign Commonwealth and Development Office, Bill and Melinda Gates Foundation, Health Systems Consult Limited (HSCL); Christian Aid, the West African Academy of Public Health, Nigeria Health Watch, PharmAccess, Stop TB Partnership, International Society for Media in Public Health, HERFON, Health Sector Reform Coalition, GHAI-RTSL, LISDEL, and DGI consult to mention a few. We acknowledge and appreciate your continued contribution and partnership overtime in health systems reform and to the Legislative Network for Universal Health Coverage.
Thank you and God bless the Federal Republic of Nigeria.
DISTINGUISHED SENATOR IBRAHIM OLORIEGBE
CHAIRMAN, SENATE COMMITTEE ON HEALTH