Nigeria's Health System Reforms Take Root
After a series of delays and stalled starts, Nigeria has finally begun to see movement in the implementation of sweeping health reforms aimed at improving the quality and supply of primary healthcare for its citizens. HP+ has worked to support accelerated rollout of these reforms to ensure that actors at every level—national, state, local government authority, and ward/facility—meets the government’s stringent eligibility requirements and are well-positioned to implement the policies.
Nigeria’s Basic Health Care Provision Fund (BHCPF)
This ground-level support to create a sound foundation for rollout of Nigeria’s Basic Health Care Provision Fund (BHCPF)—a national- and state-level mechanism that aims to extend health insurance coverage and provide a range of free services beyond the public and formal private sectors to the country’s most vulnerable groups—has come to fruition over the past six months. Following rollout of the BHCPF scheme across the six Area Councils of the Federal Capital Territory in August 2019, three states (Abia, Ebonyi, and Osun) and the Federal Capital Territory were able to successfully access 415.3 million naira—approximately US$1.5 million—from the fund to support 689 enlisted primary healthcare facilities in providing quality health services to poor and vulnerable citizens. As of late March, nearly 400,000 individuals have enrolled in the scheme and more than 136,000 people—50,441 men and 85,885 women—have accessed free healthcare services across 320 primary healthcare centers in Osun (the first state to commence service provision to beneficiaries).
HP+ has helped to ensure that primary health services in Nigeria are equitable, sustainable, and affordable. By supporting subnational units to qualify for and implement a health initiative from design to last-mile implementation, the project has successfully helped Nigeria in expanding access to quality healthcare to its people, with particular emphasis on the most vulnerable. In addition, HP+ has continued to aid the Nigerian government to oversee effective health policy reform by supporting the formation and inauguration of the BHCPF Social Accountability Network in the Federal Capital Territory in December 2019.
BHCPF Social Accountability Network (BSAN)
BSAN, a network composed of non-state actors (civil society, community- and faith-based organizations), was created with the intent of supporting and facilitating implementation of the BHCPF by ensuring accountability and transparency by all stakeholders at all levels. One key responsibility of BSAN is to facilitate the grievance redressal mechanism process at the facility level. This system helps to ensure that community feedback related to service delivery reaches the highest levels, ensuring equitable access to quality healthcare.
To support BHCPF rollout, the Federal Capital Territory established a line item in its budget for community engagement, involvement, participation, and social accountability in 2019, of which BSAN is an integral part. By holding regularly scheduled accountability meetings with government leadership, driving community engagement, and supporting domestic resource mobilization efforts, BSAN aims to support the Federal Capital Territory in the successful implementation of the BHCPF—and, ultimately, Nigeria—on its journey to achieving sustainable, equitable healthcare for all.
