Reducing Out-of-Pocket Health Expenditure a Panacea to Universal Health Coverage [press release]

"I recall growing up in a comfortable home and lacking nothing until my father fell ill in 2010. I was in secondary school when his sickness started. He was a farmer and businessman who sell cocoa in Ondo state, southwest Nigeria, says Adetutu Ibironke, a mother of one residing in Abuja, Nigeria.

She says her father's sickness started like malaria and seems to be no cause for alarm until he began frequenting the hospital.

"He was not getting better and was debilitating. Doctors referred him to various hospitals until he was diagnosed with colon cancer. His treatment affected our finance because my parent changed our school and began selling their properties His illness got worse and my parent sold all their properties.

We started depending on relatives, friends and the goodwill of people. He still died in April 2012 and we are yet to recoup our finances", she says.

Reducing out-of-pocket expenditure

Noting that out-of-pocket payment (OOP) for health services is one of the responsible factors pushing billions into poverty, the World Health Organization (WHO) advocates for Universal Health Coverage (UCH), where everyone, everywhere can access the quality health services they need, without financial hardship.

Achieving UHC, including financial risk protection, access to quality essential healthcare services and access to safe, effective, quality and affordable essential medicine and vaccines for all, is the third Sustainable Development Goal (SDG 3.8). This is firmly rooted in the 1948 WHO Constitution, which declares health a fundamental human right and commits to ensuring the highest attainable level of health for all.

Consequently, December 12 every year has been designated by the United Nations for governments to renew their commitment while providing a unique opportunity for advocates to raise their voices in demand for smarter investments in health towards UHC.

The 2022 UHC day theme is: "Build the world we want: A healthy future for all,"

Health insurance key to health services

In commemoration of this year's UHC Day, the Nigerian Minister of Health, Dr Osagie Ehanire in a press conference in Abuja says Nigeria can achieve UHC and reduce OOP if everyone subscribes to the health insurance packet provided by the National Health Insurance Authority (NHIA) agency.

Dr Ehanire said this year's theme calls on all individuals to play their part in the goal to achieve a resilient health system, that can provide quality services without impoverishing anyone.

"Citizens have the responsibility to hold us accountable and demand better services from the health facilities, owned by the Local Councils, State & Federal Governments. Citizens should insist on better health investments from those who govern them at all levels.

I wish to again draw the attention of Nigerians to the NHIA law that makes it mandatory for everyone to subscribe to a health insurance package. This will reduce the proportion of persons spending Out-Of-Pocket for health, he says.

Dr Ehanire further applauded stakeholders including WHO, who have supported the efforts of the Government to help Nigeria inch closer to UHC.

"I am certain that with collective action, we can build the national health system we want; a health system that guarantees a healthy future for all, he added.

In her statement, the WHO Officer-in-Charge, Dr Mie Okamura says it is the vision of WHO that everyone, everywhere has access to quality healthcare whenever they need it, without suffering financial hardship.

Dr Okamura congratulated Nigeria for the recently enacted National Health Insurance Authority (NHIA) Act and the Basic Health Care Provision Fund (BHCPF), which are commendable critical steps taken by the government towards reducing catastrophic out-of-pocket expenditure.

"WHO has continued to provide technical support to the government of Nigeria towards UHC to lift people out of poverty, especially the vulnerable, promote the well-being of families and communities, and protect against public health crises.

"I take this opportunity of the 2022 Universal Health Coverage Day commemoration to renew WHO's commitment to walking with Nigeria as we take this critical journey towards the reorientation of the country's health systems towards primary health care, as the foundation of universal health coverage.

Furthermore, she called on the government of Nigeria to update national health plans and ensure public budgetary resources remain at the core of financing for UHC; strengthen health systems by reprioritizing PHC, public and private capital investments that are 'green', improve tax administration, reduce unnecessary, potentially economic, harmful subsidies; and ensure coordinated, pooled donor funds as needed in support of the national plan.

The highlight of the day was an awareness walk in Abuja to sensitize the public about the importance of achieving UHC in Nigeria. The walk was attended by the top management of the Federal Ministry of Health, health personnel, development partners, CSOs, and the media.