Nigeria's health sector reform
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Vision, Objectives and Strategic partners
The seed for the current health sector reform underway in Nige-
ria was sowed sometime back in year 2000 in the early days of
President Obasanjo's first term in office. For reasons not en-
tirely clear, the reform could not be initiated during the
president's first term.
Vision:
The vision for the health sector reform was "to improve the
health status of all Nigerians, and to attain a level of health
care that would permit all Nigerians to live a socially and eco-
nomically productive life." This vision as enunciated in a Draft
Plan of Action 2000-2002 prepared for the UK Department for In-
ternational Development (DFID) identified thirteen (13) reform
objectives for realization as follows:
Objectives of the reform:
Objective 1 - Expand and strengthen primary health care services
throughout the country.
Objective 2 - Eradicate, eliminate and control childhood and
other vaccine preventable diseases through adequate routine im-
munisation activities.
Objective 3 - Integrate and strengthen all disease control ef-
forts and health promotion activities into health care at pri-
mary care level.
Objective 4 Address the demographic problems through the pro-
vision of family and reproductive health services including the
necessary services to reduce the incidence of STD and HIV infec-
tion.
Objective 5 - Reduce environmental and occupational health re-
lated morbidity and mortality.
Objective 6 - Rapidly resuscitate and improve the services of
secondary health care to serve as an effective referral for PHC.
Objective 7 - Improve investigative, diagnostic and treatment
capability of tertiary health facilities to serve as an effec-
tive apex referral system to all health facilities in the coun-
try.
Objective 8 Ensure the attainment of the goals and objectives
of the National Drug Policy (NDP), which focuses on self-
reliance in essential drugs, vaccines and biologicals through
local manufacture and an effective drug administration and con-
trol system.
Objective 9 Protect the public from the harmful effects of
fake drugs, unregistered medicines and processed foods.
Objective 10 - Ensure that the support given by donors, NGOs and
UN agencies is provided within the framework of the national
health policy and plans.
Objective 11 - Broaden financing options to expand and improve
access to affordable and adequate health care to a majority of
Nigerians.
Objective 12 - Strengthen policy formulation, general manage-
ment, financial management, and planning capacity of the Federal
Ministry of Health and parastatals.
Objective 13 - Strengthen the capacity to develop, implement,
monitor and evaluate evidence-based national health policy,
planning, programmes and activities.
Perhaps to accommodate the interests of new parties to the re-
form, the following set of new objectives has been added:
Objective 14 - Institutionalize managed competition, public-
private partnerships and National Health Accounts.
These fourteen objectives now form the core of Nigeria's 2004-
2007 health sector reform agenda.
Key reform roles were earmarked for the following strategic
partners:
A. UK Department for International Development (DFID)
As the 'engineer' of the reform, DFID's roles include among oth-
ers:
(i) Institutional strengthening of identified basic health pro-
vider systems like the Christian Health Association of Nigeria
(CHAN).
(ii) Support for selected State Health Fund projects (e.g., Be-
nue, Anambra, Ekiti and Osun states: The goal here is to improve
essential health services in target LGAs, hospitals and communi-
ties.
(iii) Engagement in Contraceptive Social Marketing for purposes
of increasing knowledge, access and use of modern contraception
for prevention of STDs, HIV/AIDS and unplanned pregnancy, with
major focus on HIV prevention.
(iv) Implementation of strategy for HIV and AIDS prevention,
care and support especially in high risk groups including sur-
veillance, HIV testing, life planning education and counseling.
(v) Support for strengthening of Federal and State health sys-
tems and building capacities to improve health services and out-
comes.
(vi) Implementation of rapid impact programmes that will focus