by Manny Ita
As the euphoria of winning the 2015 presidential polls waned, it became obvious that President Muhammadu Buhari had a herculean task ahead of him considering the thin thread which held the various interests that interplayed to give him victory at the polls.
While the president may have persistently kept faith with someday emerging the number one citizen from noble intentions, it cannot be said with strict certainty that all those in his train who aided his victory could also have been so nobly informed.
Now that the chips are down however, the buck stops at the president’s table with how the country turns out after Nigerians defied all inconveniences to go out and vote him into power; with the magic word “CHANGE” playing the wand that even core pessimists had to tarry and consider.
The evils of Boko Haram, unemployment, wobbling economy and corruption still stare at us defiantly in the face even as we believe it must be a bit unsettling for Mr. President who intended or intends to hit the ground running. Moreso in the context of the embarrassing manner in which the 8th republic took off with parliamentarians squabbling over which party should produce what leaders and also with what their remunerations and other financial packages ought to be.
So much for Change indeed.
The enormity of issues on the president’s plate would no doubt require the Wisdom of Solomon and perhaps the decisiveness of former US president Harry Truman, with whom the president shares a few likes. But then, Great leaders are decisive and set priorities.
The visit to the United States of America by President Muhammadu Buhari has deservedly generated a lot of interest and raised high expectations for quick and sharp results, especially in taming the monster of Boko Haram and opening economic opportunities for Nigeria’s teeming youths.
Securenigeria365 findings show that President Buhari’s visit to the US will also include the discussion of a wide variety of subjects, mainly anchored on three clear platforms: the Africa Growth Opportunity Act (AGOA), the Trade and Investment Framework Agreement (TIFA) and the Nigeria-US Bi-National Commission (BNC).
One of the major platforms is the Nigeria-US Bi-National Commission set up upon the signing of an agreement between both nations in April 2010 with four main areas of focus. The focus areas and working groups, which have met several times in Nigeria and in the United States, are Good Governance, Transparency and Integrity; Energy and Investment; Agriculture and Food Security and Niger Delta and Regional Security.
Ahead of the visit, President Muhammadu Buhari himself disclosed that core issues of security and economy would feature prominently in his talks with President Barack Obama.
However, Securenigeria365 is of the belief that corruption is the single biggest threat to Nigeria as a nation since without an almost corrupt-free society, nothing meaningful can be achieved.
Before he became President, Buhari was known to have very strong passion for anti-corruption; an angle which counted tremendously on his march to Aso Rock. Nigerians therefore believe that he is determined to fight and would go a long way in doing so as corruption is a very endemic issue in our society. This single factor has always thrown spanners into the works of every good economic policy successive governments have often come up with and until corruption is no more handled with kid gloves, securenigeria365 strongly believe almost every effort at navigating the country out of its murky waters will not only be counter-productive but would also set the path for novel ways of thievery and diversion; unless like Truman, the president is most decisive about this national opprobrium upon which all other evils bedeviling the nation is tethered. This goes beyond engaging the US to recover stolen funds.
Big question is; can the president muster the spunk to step on toes perpetually considered too big to be stepped upon? People who have their grubby fingers on every national pie; the oil sector, the power sector, administration of the Nigerian polity and so on, even in the light of the fact that a good number of this stock aided his victory at the polls?
Truth is; President Buhari must be decisive in tackling this menace no matter how closely related, how loving and good natured these monsters have been to him especially in the light of his ascension to the presidency. The president must also be insightful enough to distance himself from sycophants who love to weave every issue around party politics to score cheap goals.
And with a clergyman as his right hand man, the hopes of Nigerians for the real meaning of the word CHANGE to be manifested in their lives is indeed fearfully palpable.
Overall, it is in the best interest of both Nigeria and the US that a mutually beneficial relation is deepened and sustained regardless of the fear being expressed in some quarters in the country that the US may try to influence Nigeria to change its strong stance against same-sex marriage.
EDITORIAL: Healthcare Reforms in Nigeria; A Mere Political Statement Lacking Commitment
By Manny Ita
Nigeria has since her independence in 1960 had a very robust verbiage or policies by successive gobernments on health reforms but with very little progress or success recorded in what might well be a lack of political will in reforming the health sector.
Over 90% of the Nigerian population are without health insurance coverage. The inability to effectively address the country’s numerous public health challenges has contributed to the persistent and high level of poverty and weakness of the health system.
Political instability, corruption, limited institutional capacity and an unstable economy have also been major factors responsible for the poor development of health services in Nigeria. Households and individuals in Nigeria bear the burden of a dysfunctional and inequitable health system – delaying or not seeking health care and having to pay out of pocket for health care services that are not affordable.
The health challenges of the country include:
National Health Insurance Scheme (NHIS),
National Immunisation Coverage Scheme (NICS),
Midwives Service Scheme (MSS)
Nigerian Pay for Performance scheme
After many attempts at implementing legislation on health insurance since 1960, NHIS, although established in 1999, was eventually launched only in 2005 with the goals to ensure access to quality health care services, provide financial risk protection, reduce rising costs of health care services and ensure efficiency in health care through programmes such as the: Formal Sector Social Health Insurance Programme (FSSHIP), Mobile Health, Voluntary Contributors Social Health Insurance Programme (VCSHIP), Tertiary Institution Social Health Insurance Programme (TISHIP), Community Based Social Health Insurance Programme (CBSHIP), Public Primary Pupils Social Health Insurance Programme (PPPSHIP), and the provision of health care services for children under 5 years, prison inmates, disabled persons, retirees and the elderly.
The NHIS was expected to provide social and financial risk protection by reducing the cost of health care and providing equitable access to basic health services with the most vulnerable populations in Nigeria including children, pregnant women, people living with disabilities, elderly, displaced, unemployed, retirees and the sick.
Free health care services and exemption mechanisms are expected to provide financial risk protection for the most vulnerable populations but evidence suggest that they are ineffective and have failed to achieve this aim.
The maternal mortality ratio for Nigeria remain quite high at 814 per 100000 live births according to 2016 World Health Statistics. Across the country, pregnant women and children under five years are generally charged fees when accessing health care services, despite the federal government’s declaration of free health for pregnant women and children under five years in 2005.
The Minister of Health, Professor Isaac Adewole in 2016 announced the Federal Government’s plan to provide free health services to 100 million Nigerians in the next two years. Under this new health agenda, pregnant women across Nigeria are expected to enjoy free maternal and delivery services at the primary health care (PHC) level.
Unfortunately, Free health care services and exemption mechanisms often arise as campaign promises of political actors to the electorate and fall short in meeting the health needs of the most vulnerable populations. According to Nigeria Demographic Health Survey (NDHS) in 2013, over 60% of pregnant women aged 15-49 deliver their babies at home without any antenatal care visits. In rural areas, this value reaches 76.9%. The situation is critical in North East and North West regions of Nigeria where over 79% of pregnant women age 15-49 deliver their babies at home. Over 60% of pregnant women in Bayelsa, Plateau and Niger deliver at home rather than a health facility.
The cost of health care and the low quality of care by the public have been argued to be the reason for the poor utilisation of maternal and child health services in Nigeria.
In addition, health spending in Nigeria is low and this is responsible for the over-reliance on out of pocket payments for health care services.
Despite its launch in 2005, NHIS covers less than 10% of the Nigerian population leaving the most vulnerable populations at the mercy of health care services that are not affordable. This means the most vulnerable populations in Nigeria are not provided with social and financial risk protection. Poor people constitutes about 70% of the Nigerian population. They lack access to basic health services, which social and financial risk protection should provide, because they cannot afford it.
CBSHIP was expected to meet their health needs as well as provide social and financial risk protection to this group, which mostly reside in rural areas. As evidenced in the high rate of out of pocket payments for health care services , poor people financially contribute more to health care than official care and funds programmes in Nigeria. Out of pocket payments for health care services limit the poor from accessing and utilising basic health care services.
The quality of health care services delivered is poor and remains a huge source of concern. Most of the PHC facilities that are supposed to meet the health needs of the poor and rural dwellers are in a poor state due to poor budgetary allocation.
In trying to solve these issues, healthcare in the country must be tackled headlong in order to stem the detyeriorating development therein, which could portend grave danger for citizens of the country in the no-ditant future.
Policy makers and political actors need to devise health care reforms to address the lack of social and financial protection for the poor and vulnerable populations. Part of this reform is the expansion of the NHIS. States should be mandated to provide health insurance coverage to all residents. Making health insurance optional for states over the years has affected the ability of the NHIS to increase the level of coverage for the people.
While the mandatory CBHI scheme is being scaled-up as a supplementary measure, state governments should enrol poor residents in a private health insurance plan and bear the responsibility of paying the monthly premium per person to Health Maintenance Organisations (HMOs). It is not enough to have a national health insurance policy, it is important to ensure that health insurance coverage is provided to the poor and most vulnerable populations as a matter of the human right to health.
Although the NHIS Act made provision for children, who constitute the largest population in Nigeria, many children still have to pay for health care services in spite of being born into poor families that do not have the ability to pay for health care services and suffer financial hardship as a consequence. The free health policies and exemption mechanisms provided by some states, targeted at children, pregnant women and the elderly, are not social and financial risk protection policies, as these groups are largely responsible for the cost of health care with the free health care programme barely covering their basic health care services.
Another way of providing social and financial risk protection for poor and vulnerable populations is by establishing a legislative framework for a UHC scheme and setting aside funds for it. Evidence from Thailand has shown the effect of UHC schemes through PHC on expanding access to health care for the poor and vulnerable populations.
Political actors, policy makers and all stakeholders in the health sector should establish a government funded social and financial risk protection scheme through a general tax financing system for the poor and vulnerable, and invest in basic infrastructure for health care in rural areas for quality health care service delivery. UHC schemes are important in addressing the problem of poor coverage, limited access to health care, and poor quality of health care services.
Nigeria is yet to adopt innovative ways to protect the poor and vulnerable populations against financial risk of ill health. It is important to guarantee by law the right to health care of all citizens in Nigeria. Although the National Health Act (NHA) that was signed into law in 2014 stated that all Nigerians are entitled to basic minimum package of health care services, it is not clear if the provisions made in the NHA are capable of achieving UHC in Nigeria. In addition, the NHA is yet to be implemented over two years after its signage into law.
Some low- and middle-income countries (LMICs) have been able to provide social and financial risk protection schemes for poor and vulnerable populations as a matter of the human right to health. Therefore, there is a need to provide social health protection schemes targeted at these groups in Nigeria. The poor and vulnerable populations should not become impoverished because of failure to obtain much needed health care services. Governments must reduce out of pocket payments for health care services by households through the adoption of a tax financed non-contributory UHC scheme.
SARS Is The Most Successful Unit On The Force….IG
The Acting Inspector General (IG) of Police, Mohammed Adamu, said in Benin City on Monday that the Special Anti-Robbery Squad (SARS) has contributed up to 80 per cent of the successes recorded by the Nigeria Police Force.
Adamu made the remark at the commencement of a three-day Human Rights Training Programme for officers of SARS in Edo.
The IG, represented by CP Abiodun Odube, Commissioner of Police in charge of Training and Development, said this was in spite of the protests by Nigerians against the activities of SARS.
He noted that one area of conflict between the public and SARS was in the area of human rights.
The IG said the training was, therefore, a holistic approach to enhance the performance of the squad.
He also said that the force was committed to the training and re-training of its officers and men across the country to respect the human rights of the citizens.
According to him, the training seeks to improve professionalism of officers, who are expected to take the training down to their subordinates and the rank-and-file.
He stressed that the training was part of a holistic reform to get police personnel adequately equipped to discharge their duties and win the trust of Nigerians.
Kano CP Apologises To NBA Over illegal Arrest
The Kano state Commissioner of Police, Mohammed Wakili has on Thursday apologised to the Nigerian Bar Association (NBA) over molestation and unlawful arrest of its members by policemen.
The apology came barely 24 hours to expiration of a 48-hour ultimatum by the Kano NBA to Wakili.
The Nation reports the NBA in a statement on Wednesday said armed policemen had molested and arrested its members working at an election petition secretariat.
The association also accused Wakili of being partisan in the discharge of his duty.
However, on receiving the information about the ultimatum, the commissioner appeared at the NBA secretariat on today to tender an unreserved apology.
Speaking to newsmen after the visit, Wakili said he decided to come by himself to say sorry after he investigated the incident that led to the arrest and detention of two lawyers.
“After receiving the complaint and even heard it through the media, I launched an investigation and found that they were unlawfully arrested.
“Therefore, I deemed it fit to go there myself and tender my apology. I am a Police man who discharges his duty within the concept of law,” he said.
The CP also urged the association and other people to challenge him whenever he goes contrary to law.
The state secretary of the association, Mujtaba Adamu-Ameen, commended the CP for the gesture, describing him as a professional and ethical cop.
“As you can see, the CP abided by our ultimatum. He came here and apologised. This show that he is a professional and disciplined Corp,” he said
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