• Chukwu • Alabi
Experts and key stakeholders in health sector have observed that Nigeria could record phenomenal improvement in healthcare delivery and a corresponding rise in the country’s economy if a suitable climate is created for private, public partnerships.
Although the stakeholders are of the view that the government has a critical role to play in creating a suitable template for such partnerships, they are not leaving it to them alone. Consequently, they have decided to ride on existing platforms as created by already existing policies that support such partnerships to advance moves in that direction.
Dr. Wale Alabi, Chief Executive Officer, Global Resources and Project, a Nigeria-based capacity building and medical consultancy firm, who spoke about how a convenient interaction between private sector players and the public health institutions could improve the quality of healthcare as delivered and received in Nigeria, disclosed that experts from within the country and abroad have found a comfortable mix zone for such collaboration in the West African Health Conferences and Exhibition (WAH).
Alabi who is also Project Director of WAH noted that it is in appreciation of the benefits Nigeria as a country and the people could get from PPP in health that the organisers of WAH 2011, the biggest annual health event in West Africa is focusing on Private Public Partnerships (PPP) this year.
“There is so much room for PPP in health for the benefit of the people who are yearning for good health service and the businesses in the sector that are dormant, just as it will ease the government of the huge burden of bearing every brunt of healthcare delivery in the country. We want to use WAH 2011 to bring all of these benefits to everyone,” Alabi said,
Nigeria’s health sector is currently clubbed in a myriad of problems that have caused it to perform far below expectation. This is seen in the horde of calamities that are recorded daily in most hospitals across the country.
From the unborn child to the aged, Nigerians are currently in want of quality healthcare. This dearth of quality health services comes in various shades that have earned Nigeria additional bad reputation to the bad leadership sequence that have trailed the ranks of the country that gained independence for over 50 years now.
Although many may argue that every crucial sector in Nigeria is ailing, stakeholders are of the view that the health sector has seen close to the worst hit of them all.
Only recently, a report in the scientific Journal, Lancet, stated that Nigeria records 42 stillbirths out of 1000 live births recorded per time. This is an appreciation of the deep rooted nature of Nigeria’s health problem, which begins to affect the people right from conception. Worst still is the fact that those who are eventually carried to full term and born are unlikely to live up to their fifth birthday, as records also show that of every 1000 babies born in Nigeria an estimated 91.50 are likely to die before age five.
The situation is not better with Maternal health as the country’s maternal mortality rate (MMR) of 800 per 100,000 live births is regarded as one of the highest in the world.
Experts, however, believe that with strategic private sector engagement in various aspects of healthcare management and service delivery, Nigeria could be saved some of these scary indices.
A recent circular from the Federal Ministry of Health to all parastatals under it indicates that the Federal Government may have began the process of ushering in an increasingly conducive environment for PPP. One of such prominent moves as revealed in the correspondence made available to Daily Independent is the passage of the Infrastructure Concession Regulatory Commission (ICRC) Act 2005.
This Act “provides for the participation of private sector in financing the construction, operation or maintenance of infrastructure or development projects of the Federal Government through concession or contractual arrangements; and the establishment of the Infrasructure Concession Regulatory Commission to regulate, monitor and supervise the contracts on infrastructure or development projects.”
Meanwhile, the headship of the health ministry has realised that for effective coordination and facilitation of PPP Projects in the health sector to be achieved, there is the need to conduct an inventory of proposed, established and ongoing PPP Projects.
To ensure this, the current minister of Health, Professor Onyebuichi Chukwu, has, in a written directive through the Head of PPP Unit at the FMoH, Abuja, Mr. Kemi Showunmi, has given instructions to parastatals to make records of whatever they have available.
“I am directed to request your Parastatal to please forward to the undersigned a list of proposed, established and ongoing PPP Projects in your establishment,” Showunmi stated.
Meanwhile, the minister will be telling a gathering of local and international experts, stakeholders in health about Nigeria’s efforts to merge forces with the private sector to ensure better health for the people.
In a Paper on ‘Public Private Partnership In Health: Nigeria Experience to be presented at the sixth West African Health Exhibition and Conference scheduled for hold on September, 7– 9, 2011 in Lagos, he will attempt to set the tone to advance efforts that have made in this direction in the past.
“Industry players and stakeholders in health will converge on Lagos from September 7-9 for the WAH 2011, where they would show how to make Private Public Partnerships work in Nigeria and other African countries that are desirous of improved healthcare,” Alabi said.
Interestingly, Nigeria has set the course for a perfect PPP for improved healthcare with the promulgation of the National Health Policy and Strategy to achieve health for all Nigerians in 1988, which was revised in 2004 through a several consultative processes, incorporating views from stakeholders and reflecting new realities and trends in the National Health Situation including regional and global initiatives such as NEPAD and the MDGs.
The main thrust of this policy focuses on National Health System and its Management; National Health Cares Resources; National Health Interventions and Services delivery; National Health Information Systems; Partnership for Health Development; Health Research and Health Care Laws.
Dr. Biodun Fatade, Chief Executive Officer at Crest View Diagnostic Centre, Lagos who spoke on the relevance of the private sector in health as it were in Nigeria said, “The government alone cannot do everything, and if we are talking about quality, you realise that there is every need to involve the private sector.”
Fatade who spoke in an interview said the government already has the tools needed to drive a private sector led innovative drive to solving Nigeria’s health problems.
“We know that the government has money to spend, but it must rely on the private sector to bring up innovations that could make the money work otherwise we will just be moving in one cycle as we have seen,” he said.
On how to ensure that the private sector is encouraged to participate in processes that could improve access to quality health services, Fatade said, “As it is done in all parts of the world, the Nigerian government must seek to provide enabling policies for PPP.”
He, however, cautioned that “Proper documentation, well structured agreements, a joint committee that would monitor and evaluate progresses made in any project involving both sector could ensure better implementation.”
Interestingly, some private sector led initiatives domiciled in public health institutions are already thriving in Nigeria.
In diagnostics for instance, Deux Projects, a private Turnkey Diagnostic Centre is currently partnering with Lagos State University Teaching Hospital (LASUTH). Also, Crest View, another X-ray and diagnostic centre in Lagos is in close partnership National Orthopaedic Hospital, Igbobi.
It is worth noting that the University College Hospital (UCH), Ibadan is home to 64 Computerised Tomography equipment installed there through a PPP involving JNC International.
Recall also that Radiology Centre at Ogun State Teaching Hospital, installation of MRI at LUTH and CT equipment at General Hospital, Lagos were carried out through a PPP arrangement with First Foundation.
Another firm that has been involved in very fruitful PPP in Nigeria’s health sector is Mecure Diagnostic Centre. The firm has handled various shades of Turnkey diagnostic projects in partnerships Ondo State government and The Gani Fawehinmi Diagnostic, which is being replicated in various parts of Nigeria.
Meanwhile, the Nigerian government has shown some remarkable disposition to PPP. For instances, in chapter 8 of the National Health Policy, the importance of partnerships and collaborations in health care provisioning was emphasised.
The public-private mix as already outlined, strongly recommends increased role for the private sector in service delivery. The policy permits the participation of the private for profit and not-for-profit including health providers, religious and other voluntary organizations, communal bodies, and individuals in the provision and financing of health care services. It has however been deduced that one of the key factors responsible for the unsatisfactory national health status is weak and ineffective coordination of the numerous stakeholders and active participants in the health sector. Hence, “fostering effective collaboration and partnership among all the health actors” was articulated as one of the seven strategic objectives of the National Health Sector Reform (HSR) programme of Federal Ministry of Health.
Former health minister, Professor Eyitayo Lambo, in his foreword to the 2005 National Policy on Public Private Partnership for Health in Nigeria also noted that, “An appropriate policy framework is required for this partnership and such policy should be crafted based on a consultative process.”
According to him, this approach guided the development of the policy document, for which consultation commenced in March 2005 when stakeholders were brought together, followed by expanded consultation nationwide, after which the draft policy document was prepared.
How interesting PPP for improved health may sounds, it could be dampened by some challenges. One of the key challenges to policy makers is how to form effective partnerships among different players in such a way that health care can be served efficiently, effectively, and equitably.
However, the National Policy on Public Private Partnership for Health in Nigeria stipulates that partnership agreements shall clearly state the rights and obligations of all stakeholders and that such rights and obligations shall be enforceable.
“We would listen to industry players from other countries where PPP has worked perfectly for improved health how they were able to make it work and hope that we could buy, adapt and probably improve on such in Nigeria,” Alabi said, while giving further insight on what to expect from WAH 2011 which has theme focused on PPP for Improved Healthcare.
It is also hoped that current headship of the health ministry and his team would adopt an improved strategy that will spur the private sector to action, while also providing high quality healthcare services to Nigerians at affordable costs.
Nigeria Daily Independent
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