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Implementation of the health law crucial

Posted: Apr 18, 2015 at 12:36 am   /   by   /   comments (0)

By Yinka Shokunbi


“….The absence of a National Health Act to back up the National Health Policy has been a fundamental weakness which needed to be tackled frontally. This weakness means that there is no health legislation describing the national health system and defining the roles and responsibilities of the three tiers of government and other stakeholders in the system. This has led to confusion, duplication of functions and sometimes lapses in the performance of essential public health functions”—Professor Adenike Grange former Minister of Health (2007)


After ten years of been in limbo, on Dec 9 2014, President Goodluck Jonathan finally signed the Health bill into Law ending the long and tortuous journey of giving Nigerians a deserving healthcare system that is backed by legal framework.

DR. Abubakar Jimoh

DR. Abubakar Jimoh

Sharing his thought on the new law, Director, Special Duties, National Agency for Food and Drugs Administration and Control (NAFDAC), Abubakar Jimoh noted: “Prior to the presidential assent, there was no health legislation describing the national health system and defining the roles and responsibilities of three tiers of government and other stakeholders in the health sector. This had led to confusion, duplication of functions and sometimes lapses in the performance of essential public health functions”.

According to jimoh, “it is however a bit of good news that Nigeria’s health sector is finally getting some plausible attention. For pregnant women, under-five children and the elderly in the country that often die as a result of lack of basic health care, the new National Health Bill signed into law on December 9, 2014 by President Jonathan offer a huge relief”.

The Health bill was first drafted as part of the Health Sector Reform Agenda of 2004-2007 by the change agent in support of Pofessor Eyitayo Lambo then health minister’s reform initiative.

It was hoped that by 2005, the bill would transform to a law, but this never happened due to series of administrative bottlenecks at the Assembly.

Subsequently, some sections of the bill drew a lot of disaffection among practitioners and even among some religious bodies especially, the Catholics and Jama’atu Nasril Islam (JNI). The fiduciary aspects of the Bill also had implications for the yearly budgeting process which was of interest to the Federal Ministry of Finance.

Explaining Jimoh said, “The Act establishes a Basic Health Care Provision Fund to be financed from Federal Government Annual Grant of not less than one per cent of its Consolidated Revenue Fund; grants by international donor partners; and funds from any other source.

“Out of the fund, 50% shall be used for the provision of basic minimum package of health services to citizens, in eligible primary/or secondary health care facilities through the National Health Insurance Scheme (NHIS); 20% shall be used to provide essential drugs, vaccines and consumables for eligible primary health care facilities; 15% shall be used for the provision and maintenance of facilities, equipment and transport for eligible primary healthcare facilities; and 10% shall be used for the development of Human Resources for Primary Health Care; 5% of the fund shall be used for Emergency Medical Treatment to be administered by a Committee appointed by the National Council on Health”, Jimoh observed.

The Act equally prohibits a person, entity, government or organization from: establishing, constructing, modifying or acquiring a health establishment, health agency or health technology; increasing the number of beds in, or acquire prescribed health technology at a health establishment or health agency; providing prescribed health services; continuing to operate a health establishment, health agency or health technology after the expiration of 24 months from the date this Act took effect, without being in possession of a certificate of standadisation.

More importantly, the Act prohibits a health care provider, health worker or health establishment from refusing a person on emergency medical treatment for any reason whatsoever, making any person who contravenes this guilty of an offence and liable on conviction to a fine of N100, 000.00 (one hundred thousand naira) or to imprisonment for a period not exceeding six months or to both.

However, except for Psychiatric patients, a health care provider may refuse to treat a user who is physically or verbally abusive or who sexually harasses him or her, and in such a case the health care provider must report the incident to the appropriate authority.

Now that the Health Act has been in place, experts have been calling for its fair implementation by the in-coming administration of General Muhammadu Buhari (Retd) to the best interest of Nigerians.

According to the vice-president, Commonwealth Medical Association (WAR), who was also former president of the Nigerian Medical Association (NMA), Dr Osahon Enabulele, “the leadership of General Buhari GCFR must commit itself in words and action to the strict implementation of the newly enacted National Health Act 2014. This is because the implementation of the Act is critical to the fundamental health rights of Nigerians, as well as the utmost desire of Nigerians for improved Universal Health Coverage and a highly regulated and efficient National Healthcare System”.

Noting, “Despite the alleged insertions of certain provisions that were not in either versions passed by the respective legislative houses of the 7th National Assembly, all Nigerians had patiently agitated for its assent”.Enabulele pointed out: “There is therefore need for a committed, inspirational and knowledgeable leadership to steer the process of implementation, need for the establishment of robust enlightenment and advocacy platforms to enlighten and educate the people about their roles, obligations and benefits.

“There is also need for appropriate stakeholder involvement through the adoption and implementation of an all-embracing and holistic approach that takes into consideration the inputs of all stakeholders in the development of the operational and implementation strategic framework.

“It is necessary to establish an institution for efficient, effective and fair financing framework backed with strong and transparent governance and accountability platforms as well as capacity building and resource development, including the strengthening of the Local Government Administrative system to effectively, efficiently and transparently manage the supply and demand sides”, said Enabulele.

In his words, chairman NMA Lagos branch, Dr Biyi Kufo suggested that the health acts in spite of its inadequacies, “needs to be implemented with the understanding that there’s a leader of the team, which is the doctor.

He told Daily Independent, “Health insurance needs proper management, which should exclude middlemen, such as Health Maintenance Organisations (HMOs). The crisis in the health sector is rooted in a dysfunctional Nigerian society, and will go when that is addressed”, Kufo opined.

In his own submission, president Pharmaceutical Society of Nigeria (PSN), Olumide Akintayo observed, “the harmonised version of the National Health Bill signifies the first time the borders of restriction in healthcare were opened as major Health Professional Associations and Trade Unions are represented in key structures of the new Health Act”.

Akintayo in calling for machinery to implement the law urged the incoming administration to among others; appoint legal drivers of the Act through the various committees as provided for under law.

“There is the need for activation of the full machinery of the National Council of health which is now the highest decision making body in the health sector; the Implementation of the provisions which provide for consolidated health funding to apparatus such as the National Primary Healthcare Development Agency (NPHCDA) and National Health Insurance Scheme (NHIS) as funds are specially designated to purchase essential drugs under this regime. Call for the constitution of the National Tertiary Healthcare Committee to pave way for better regulation of tertiary facilities in Nigeria as well as the proper execution of all strategies geared towards guaranteeing collaborative healthcare practice in Nigeria”, Akintayo told our correspondent.


Yinka Shokunbi, E-mail:, Tel: 08054104719