On December 9, 2014, Nigerian President Goodluck Jonathan signed into law the National Health Bill, which was approved by the Nigerian Senate earlier this year.  The new law is intended to provide a framework for the regulation, development, and management of a national health system in Nigeria.

What the Act does

The National Health Act creates a Basic Health Care Provision Fund to provide Nigerians with access to basic health care services.  Fifty percent of this fund will be allocated to the National Health Insurance Scheme to provide health coverage for pregnant women, children under the age of five, the elderly, and persons who are physically challenged.  The other half of the Fund will be used to provide essential vaccines and consumables for eligible primary healthcare centers (“PHC”), maintenance of facilities, equipment, and transport for PHC facilities, and development of human resources for PHCs with a goal of extending primary healthcare to Nigerians living in hard-to-reach rural communities.  The Fund will be subsidized from 1% of Nigeria’s Consolidated Revenue Fund as well as contributions from state and local governments.

The law also requires universal acceptance of accident and other emergency cases by all health facilities (public and private), provides for improved standards and quality of healthcare in health facilities, and prohibits the use of public funds by Nigerian public office holders and civil servants seeking medical treatment abroad.

It is hoped that the bill will help Nigeria reduce mortality rates in the country and move more quickly toward achieving its Millennium Development Goals.

Implementation

Nigerian health care advocates have lauded President Jonathan for signing the bill, noting that it is a significant step towards providing universal health coverage for all Nigerians.  The challenge now will be implementing the various programs outlined in the bill.  Given the past problems in implementing other acts of Parliament, a coalition of non-governmental organizations working on health systems issues — the Health Sector Reform Coalition (“HSRC”) — has called upon Nigerians to join forces with other stakeholders to ensure the full implementation of Act.  In particular, the HSRC has taken it upon itself to compel state governments to provide their counterpart funding for the Basic Health Care Provision Fund.  Other civil society organizations — such as the White Ribbon Alliance for Safe Motherhood — have called for the establishment of an implementation committee to ensure the effective and transparent implementation of the Act.

While it remains to be seen whether the objectives of the National Health Act will be achieved, it is hoped that Nigeria will serve as a good example to other countries in Africa with respect to creating a sound health care sector.