Health Policy Plus Catalyzes Universal Health Coverage Reforms in Nigeria
Since 2017, the Health Policy Plus (HP+) project, funded by the U.S. Agency for International Development (USAID), has worked with the Nigerian government to advance its health policy priorities. On Thursday May 19, HP+ held its end-of-project event in Abuja and online to showcase policy, advocacy, financing, and governance results for improved health outcomes. The gathering combined knowledge sharing and discussions of how to sustain gains in locally led development, equity for health services, and improved access to care in family planning, reproductive health, maternal and child health, HIV, and tuberculosis across Nigeria. The agenda included posters, panel discussions, and multiple presentations highlighting successes.
Among the more than 70 people attending were representatives of the Federal Ministry of Health (FMOH), the National Agency for Control of AIDS, the National Health Insurance Scheme, the National Primary Health Care Development Board, and the chairman of the Senate Committee on Primary Health Care and Communicable Diseases. Lagos State dignitaries included representatives from the Lagos State Health Management Agency, the Lagos State AIDS Control Agency, and implementing partners, civil society and private sector organizations, Katie Donohoe, USAID deputy mission director, and the media.
Like Oliver Twist, the FMOH wants more support from the HP+ team and the project director and an expansion of the scope of work in Nigeria beyond the current state to help the Ministry of Health build a stronger health system and work towards meeting the country’s health goals.
Dr. Ngozi Azodoh, director of the Planning, Research and Statistics Department, Federal Ministry of Health
Presentations were highlighted by a keynote address delivered by Dr. Suneeta Sharma, the HP+ director and Palladium vice president, who travelled from Washington, DC. Dr. Sharma reminded the gathering that policy is the backbone of the HP+ project and is the way to secure well-financed and functioning health systems, high-quality services, equitable access, improved outcomes, and transparency of information and data. She applauded the work undertaken with the government of Nigeria—marked by a willingness to listen, learn, adapt, and ensure alignment with government health priorities.
Dr. Ngozi Azodoh of FMOH said that HP+ had advanced significant universal healthcare reforms and financing, such as revitalizing the primary healthcare system, implementation of the Basic Health Care Provision Fund (BHCPF), and expanding insurance coverage. The HP+ Nigeria country director, Dr. Frances Ilika, was applauded for her leadership and support to the government.
During HP+’s tenure, Nigeria’s National Health Insurance Scheme expanded enrolment, improved staff capacity, and strengthened its financial management and guidelines on benefits and premiums. HP+ also supported the National Agency for Control of AIDS to implement reforms such as the National Blueprint for HIV Integration into state health insurance and a Domestic Resource Mobilization and Sustainability Strategy that could mobilize over US$662 million for HIV.
HP+ supported the development and pilot of a BHCPF training curricula for trainers at the facility and community levels, with over 230 trainers trained and over 3,200 primary healthcare staff and ward development committees members trained. This support accelerated BHCPF implementation and facility readiness to provide quality healthcare to enrollees. Representatives from the National Primary Health Care Development Board and National Health Insurance Scheme, along with several civil society organization representatives, spoke highly of HP+’s capacity development techniques and skills—especially mentioning the lasting effects on their staffs and that the trainings are being scaled across other states, with some techniques being used in other trainings.
Stakeholders mentioned HP+ support in strengthening the primary healthcare system—engaging each state to reposition primary healthcare under the authority of their state primary healthcare development agency. HP+ successfully advocated for establishing local government health authorities, built their capacities, and strengthened ward development committees, which led to improved governance and performance of state primary healthcare—at least 43 percent improved in HP+-supported states against a national average of 23 percent.