By Aziza Uko
“One of my favorite stories of 2014: In just one year, Nigeria went from 50 polio cases to 6.” – That was a tweet by world’s richest man Bill Gates as the year 2014 was winding down. It bore testimony to the feats being recorded in the health industry.
President Goodluck Jonathan is no stranger to the importance of quality healthcare and the potential dangers associated with childbirth. Tragically, his mother lost a few babies before he was born and even had issues with prolonged labour. Furthermore, since he became the President, he had lost a brother and sister to death. When it came to Jonathan’s birth, his mother said she delivered him as soon as she went into labor and viewed that as extraordinary. His father stated, “I called him Goodluck because although life was hard for me when he was born, I had this feeling that this boy would bring me good luck.”
Nigeria and the Millennium Development Goals
The United Nations had set up Millennium Development Goals with the target date of 2015. Their quest is to reduce poverty rates and disease and improve the quality of life for those in a variety of countries. The MGDs have spurred unprecedented action in a variety of countries including Nigeria.
In keeping with this agenda, President Jonathan seeks to ensure people have access to quality care by 2015 and has made substantial progress moving the country towards these goals.
Millennium Development goals involving the health sector include:
- Improving maternal health
- Combating diseases including HIV/AIDS
- Reducing child mortality rates
- Ending extreme hunger
In the 2014 report of the country’s progress towards the goals, President Jonathan wrote: “Nigeria recognises that the MDGs together constitute a resilient framework for development that makes a real and measurable difference in the lives of people. The government views every one of the goals as strategically important for the advancement of human development. Both infant mortality and under-five mortality rates (Goal 4) show some trends towards their targets, though deserve to be fast-tracked.”
Issues like disease control and prevention/vaccination have finally been given the attention they deserve. Already impressive results have been noted due to President Jonathan’s efforts, like the drop in polio cases that Bill Gates testified about.
A Focus on Improving Infrastructure
The Ministry of Health under President Jonathan has also focused on boosting the overall health infrastructure in the country. 1500 healthcare facilities have dramatically improved since the President has been in office. Furthermore, the President has established rehab centres, teaching hospitals and medical centres.
He also recruited 11,300 frontline health workers. These individuals were then deployed to under-served communities across the country with the goal of improving health conditions.
SURE-P (The Subsidy Reinvestment and Empowerment Programme
In February 2012, Jonathan introduced the Subsidy Reinvestment and Empowerment Programme or SURE-P. This program is dedicated to investing money the government has raised from reducing subsidies on petroleum product into initiatives to create a better life for Nigerians in many ways. SURE-P focuses on achieving a variety of targets; the goals include everything from developing infrastructure to boosting employment rates.
This initiative includes a SURE-P Maternal and Child Health Project, which focuses on under-served communities. The goal of this project is to reduce both maternal and newborn deaths. The programme expressly states: “We believe no woman should die while birthing new life.” Happily, maternal mortality has dropped from 545/100,000 to 350/100,000 in four years under Jonathan.
This agenda also directly ties into helping the country reach Millennium Development Goal 4 and Goal 5.
Saving One Million Lives Initiative
The “Saving One Million Lives” initiative was also initiated by President Jonathan with the goal of literally saving a million lives by the end of 2015. This program began in October 2012 and builds on previously existing policies. The idea is “to focus on outcomes, through strengthening the execution and delivery of Nigeria’s existing health services by setting clear, ambitious targets for real impact; and a simple, yet laser-focused system of performance management to achieve them.”
This program includes a variety of sectors including increasing routine immunizations and access to essential medications and improving private sector engagement. Since malnutrition is the cause of approximately 50% of fatalities of children under the age of 5, this program also strongly focuses on nutrition. There are 6 million underweight children in the country. Currently, nutrition stakeholders are working to improve programs. Targets by 2015 include curing 75% of children who are admitted for acute malnutrition and a death rate of less than 10%.
Past Nigerian statistics include 1 million children failing to live until age 5. This issue reflects a major health crisis. The current goal is to reduce the neonatal mortality rate from 40/1,000 live births to 14/1,000 live births.
Plans include having 5000 upgraded healthcare facilities in the country rather than the 1000 sites that were in existence in 2002. Improving access to skilled birth attendants is also an essential part of the equation.
To date, through the work of President Jonathan and “Saving One Million Lives” initiative, the infant mortality rate has already been substantially lowered. The under-5 mortality rate has changed from 157 out of 1,000 live births to 94 out of 1,000 live births.
Training of Paramedics
Under Jonathan, in 2014 the “Training of Paramedics” curriculum began with the goal of improving health delivery. The Curriculum for National Diploma in Paramedics Technology Programme in collaboration with National Board for Technical Education are working together as part of the efforts to improve health delivery in the country.
Experts speculate that many deaths are a direct result of delayed access to emergency care and treatment. Former Minister of Health, Prof. Onyebuchi Chukwu noted: “A lot of preventable deaths in the country are caused by delayed access to emergency care. A significant number of lives are lost daily in road traffic injuries, plane crashes, ethno-religious crises, political and electoral violence, bomb blasts, insurgency etc.”
The Training of Paramedics curriculum was the first type of programme in the country’s history. It takes about 2 years for individuals to complete their training in preparation to be sent out in the field to assist with emergency situations.
Presidential Summit on Universal Health Coverage
In the first quarter of 2014, the President held a week-long Presidential Summit on Universal Health Coverage, with the aim of boosting efforts to provide access to affordable, high quality healthcare for every Nigerian. This summit sought to strategize about the processes and roadmap involved with instigating a Universal Health Coverage policy. At this event, the President stated that health insurance must be compulsory for citizens.
In December 2014, he signed into law a major National Health Bill. This bill includes a Basic Health Care Provision Fund that provides all citizens with access to basic health care. Many see this bill as the Nigerian version of Obamacare.
The goal is to create a national health system. This includes a Basic Health Care Provision Fund that provides all citizens with access to basic health care. In particular, a large amount is given to the National Health Insurance Scheme, which helps pregnant women, children, disabled people and the elderly. The other half is used for necessary vaccinations and PCH centres and resources. Previously the country allocated less than 5% of its budget to health.
Another major benefit of this new law is that it regulates health facilities’ acceptance throughout the country of people in accidents or emergency situations. Nigerian officials and civil servants cannot use these public funds for their own medical treatment out of the country.
Success Rates under President Jonathan
Due to President Jonathan’s work and SURE-P in particular, there has already been a 26% decrease in the maternal mortality rate and a 22% decrease in neonatal mortality rate. From the Saving One Million Lives initiative, over 433,650 lives have been saved in a remarkably short period –November 2012 to June 2013. Infant mortality rates in Nigeria have historically been among the worst throughout the globe, but the President has done a remarkable amount to change this equation for the better.
When one remembers that in 2014, Nigeria was certified guinea worm-free as well as Ebola-free, that would help one to understand the type of milestones that have been recorded.
These achievements mark just a small part of the progress that this President has made in his relatively first term in office. It is clear that if given another chance, he would do more.