The Universal Health Coverage: Why It Must Count for Women and Girls
Nigeria is the biggest country in West Africa with diverse people and cultures. Nigeria’s Universal Health Coverage is one of the many areas the country is working to keep pace with leading countries in the world. To close the existing gap in health care for women and girls is therefore critical towards achieving SDG goal 3:7. Currently, only about 5% of Nigerians have prepaid health care through the National Health Insurance Scheme (NHIS). The large majority of Nigerians (95%) are without any form of coverage. Among the 95% are women and girls.
Nigeria has the third highest infant mortality rate in the world and also is the largest contributor to global mortality rate. The rates are high not because the diseases leading to death cannot be cured or prevented, Women, girls and children are dying from preventable and treatable sexual health complications as a result of entrenched resistance to women’s autonomy and control over their bodies. This is often justified on the basis of culture and/or religion. Poor health care systems and weak policy implementation add to women’s risk of death. The target of the National Health Insurance Scheme was to provide universal coverage for all Nigerians by 2015. Unfortunately this target is nowhere near being met.
The recently released NDHS 2018 data in the country states that unmet need for family planning declined from 20% in 2008 to 16% in 2013 before increasing to 19% in 2018. 10% of maternal deaths in Nigeria are due to unsafe abortion. Access to safe abortion is restricted in Nigeria. A 2015 national study of abortion incidence in Nigeria reveals the challenges that remain to improve conditions for Nigerian women and girls. Only 16 percent of all women of reproductive age use any contraceptive and an even lower percentage of 11 percent use a modern method, which results in almost 10 million unintended pregnancies, of which more than half end in an induced abortion.
The slogan of leaving no one behind CAN only be achieved if government health plan target those most in need of it; women, girls and children. There is need for universal access to quality and affordable comprehensive sexual and reproductive health information, education, including comprehensive sexuality education, and health services.
There is no doubt that Nigeria’s health care system is deficient and in urgent need for redemption. The National Strategic Health Development Plan 2018-2022 recognises this need, that is why one of its pillar is to promote universal access to comprehensive quality sexual and reproductive health services throughout the life cycle and reduce maternal, neonatal, child and adolescent morbidity and mortality in Nigeria. The Second National Strategic Health Development Plan is the country’s road map that will ensure overall improvement of health of Nigerians through five strategic pillars and 15 priority areas. In the 2018 budget, the government allocated 1% of the consolidated revenue fund tagged Basic health care provisions Funds. In the 2019 budget proposal, President Muhammad Buhari allocated =N=340.45 billion to the health sector, which is 3.9 percent of the =N=8.73 trillion expenditure plan. Political will is required to achieve the implementation of these health commitments which must target women and girls whose health needs remain unmet.
Central to women and adolescents health and well-being is the realization of their human rights, including their sexual and reproductive rights. If we are to achieve the SDGs and UHC, we have to pay special attention to women, children and adolescent health needs. We must remove obstacles such as negative abortion laws and provide access and ownership to women and girls in health care delivery.
Majority of Nigerians who cannot afford quality health care rely on quacks, some resort to self-medication. In order to ensure implementation of the Health Scheme, the federal government needs to invest substantially into the Scheme and seek partnership with private sector and civil society groups as part of their responsibility to the society. Every Nigerian has right to access quality health care. We must move from words to action. The remaining 95% of Nigerians should be covered; with women and girls in the fore front as they are particularly affected by abuse and violence, including sexual and gender-based violence. The Universal Health Coverage Must Count for Women and Girls.
Vision Spring Initiatives, Lagos Nigeria.
As the world celebrates the International Peace Day today with the theme RIGHT TO PEACE, we at Vision Spring Initiative joins the world in celebration. Peace as abundant as it should have been is not so in Nigeria, particularly in the Northern part.
Nigeria suffers a variety of complex political problems including inequality, corruption, oil disputes, national disunity, and the Boko Haram insurgency. This eight year conflict and humanitarian crisis in the north has killed 20,000 and displaced 2.6 million people. Boko Haram mostly use women and girls as suicide bombers, forcing them to detonate bombs in urban canters. According to the UN Children’s Fund, UNICEF, 83 children were used as suicide bombers since January: 55 girls and 27 boys, one was a baby strapped to a girl. The group abducted 67 women and children in 2017. The plight of refugees fleeing the violence is also worsening with the current severe drought and impending famine across northeast Nigeria.
In May, after negotiations brokered by Switzerland and the International Committee for the Red Cross, 82 Chibok schoolgirls were released. Boko Haram fighters had abducted 276 schoolgirls from Chibok, Borno state, in April 2014. More than 100 of the girls and hundreds other captives, including over 500 children from Damasak, Borno, remained in Boko Haram captivity.
Violence has also intensified in the MiddleBelt between Fulani herdsmen and farmers amid claims of trespassing and sabotage. At the end of April 2018, President Trump met with Nigerian President Muhammadu Buhari. It was a very important meeting as President Buhari was the first president from sub-Saharan Africa to visit President Trump at the White House. President Trump was reportedly very interested in the conflict between Fulani herdsmen and farmers in Nigeria’s Middle Belt.
The Niger Delta has also been the scene of serious violence. Between 2006 and 2009 a militant group named MEND protested against the poverty of the region despite the oil wealth it produced. In 2009, a general amnesty was accepted by these militants. However, in 2016, President Buhari’s 70% cut to the amnesty program prompted further unrest. Since 2016, attacks have largely been carried out by the NDA, targeting major pipelines, and provoking huge economic consequences.
Another element in Nigeria’s political status-quo is the legacy of the Biafran civil war (1967-1970) which saw the defeat of Biafran separatists by federal forces and the death of a million people. Grievances in the Igbo community were reignited in 2015 in protests by Igbo youth. The Nigerian government has since been accused of using excessive force, killing 150 protestors from August 2015-2016.
In spite of these violence and conflicts, Nigeria has remained immune to war and secession. We must therefore continue to thrive and maintain peace across the country, especially where it has been deprived for a long time.
Every human being has the RIGHT TO PEACE.
Every Local Government Area has the RIGHT TO PEACE.
Every state has the RIGHT TO PEACE.
Our country has the RIGHT TO PEACE.
We should endeavor to always advocate for peace in every sector and in all tiers of the government. The government, most especially the incoming one should be pressured in ensuring adequate budget is allocated to security and enough effort is concentrated in the Middle Belt and North. Also, the government should ensure that the perpetrators of peace are rightfully impeded.
Our children and women are not suicide bombers and sex toys. A girl child should not be deprived education. A boy child should not be taught to repress his emotions. A woman should not be controlled by laws and stereotypes. A man should not be controlled by laws and stereotypes.
Let’s rise above complex political problems including inequality, corruption, oil disputes, national disunity, gender stereotypes, religion and cultural disunity that has handicapped our progress, growth and development as a country. We have the RIGHT TO PEACE.
“An eye for an eye will only make the whole world blind.”
― Mahatma Gandhi
Vision Spring Initiative
Unsafe abortions are one of the most significant and preventable contributions of maternal mortality and morbidity in Nigeria. Research carried out by the Guttmacher Institute in partnership with the university of Ibadan, reported that 1.25 million induced abortions occurred in 2012 alone. On the other hand, evidence from a consultant OB/GYN at the University Teaching Hospital in Gwagwalada reported that unsafe abortions contribute to at least 13% of maternal deaths in the country yearly. He also reported that over 450,000 unsafe abortions were carried out yearly in Nigeria.
In the light of this discovery, vision spring initiative and the beneficiaries of its Sexual and Reproductive Health Rights (SRHR) training launched the #mybodymyright on the 8th of March, to commemorate the international women’s’ day celebration. We had two print media teams and one radio media present.
We had the honour of having the Chairman of Nigerian Union Journalists (NUJ), Dr. Qasim Akinreti. In his words he said womanhood is our pride. He salutes our courage and steadfastness in the pursuit of eradicating ancient laws that has handicapped our progress in the area of sexual and reproductive rights for women and girls in our country. He promised to partner with us to ensure the #mybodymyright reaches a wider range of girls and women in the country.
The press release statement was read by Imisi Johnson, one of the SRHR beneficiaries, she stated clearly the demands the campaign centres on and what is expected from the government after the campaign. Few of demands included:
- Improved access to safe SRHR services by removing legal restrictions and ensuring that services are safe and accessible to all women who need them in a timely manner.
- Address in a systematic way the various forms of abuse faced by the adolescent girl in the home and society.