Without Health We Have Nothing 1

Gabriel Oke

By Gabriel Oke

There is no Universal Health Coverage without Strong Political will

World Health Organisation: Universal Health Coverage

Beyond legislative action, there is executive action

Excellent Leadership is needed to achieve Universal Health Coverage (UHC). The countries that have achieved UHC — like Australia, Austria, Bahrain, and Belgium — all raised strong political will before establishing the technicalities needed. Forging consensus and a coalition of critical stakeholders for UHC is good, but for a country’s healthcare system to be efficient, leaders have to place health reforms ahead of other priorities. This can then be followed by utilizing models that suit the population’s context.

International Alliance of Patients' Organisations: Universal Health Coverage


Beyond laws and acts approved in the constitution for healthcare provision, implementation is key. Nigeria has laws that support health provision and mandate certain levels of effort to deliver healthcare, but what is lacking is implementation. The executive arm of the government needs to implement these laws to achieve fruition of their potential benefit.

National Health Act and Basic Healthcare Provision Fund

One of these laws is the National Health Act (NHAct) and the Basic Healthcare Provision Fund (BHCPF).

World Health Organisation: Universal Health Coverage day

The October 31, 2014 National Health Act is meant to improve national health indices, and consequently, to improve economic productivity. It was meant to provide a legal framework for the regulation, development, and management of Nigeria’s Health System. 


The Basic Healthcare Provision Fund is component of the NHAct. It is a federal and state-funded initiative aimed at better investment within the health sector. The BHCPF‘s overall objective is to ensure the provision of a basic minimum package of health services to all Nigerians, by strengthening the primary health care system (PHC) and provision of emergency medical treatment.

Universal Health Coverage by 2030

In 2015, the Member States of the United Nations agreed upon and set out an agenda for a safer, fairer, and healthier world by 2030. They based this on the principle that all individuals and communities should have access to quality essential health services without suffering financial hardship. The agreed-upon approach was to focus on health systems strengthening. Achieving this goal requires coordinated effort from all stakeholders, across the private and public sectors, at global, country, and local levels. This includes exploring diverse voices and perspectives to enhance political and financial commitments for UHC.


Extreme unmet needs currently affect Nigeria’s healthcare system and require urgent attention. The country cannot depend solely on donor-dependent funds and donor-derived approaches alone. Nigeria needs to work on generating local funding to sponsor healthcare provision. The country needs to make more, positive political choices in various geopolitical zones and ensure firm commitments from political leaders.


Political leadership and the health of people are inseparable. Political leaders need to understand the political benefits of the Universal Health Coverage, including benefiting the people — their voters — and beyond that, becoming UHC heroes themselves, on a global stage.

Nigeria Health Watch: Universal Health Coverage


  • Professional bodies of healthcare workers must sponsor representatives to the legislative and executive arms of government, to bring the interests of healthcare workers and stakeholders to the forefront.
  • Stakeholders involved in the actualization of UHC need to establish a good measuring and monitoring system for UHC. This will make it easy to track impact and show accountability for past collaborations, sponsorships, and partnerships.
  • The public should be engaged so that they can own various health programs and solutions. For example, insurance schemes can increase coverage when community dwellers share their experiences. 
  • Funds meant for the Nigeria Primary Healthcare Development Agency and BHCPF should be provided and well-monitored, because there is no UHC without Primary Healthcare and quality emergency medicine. For example, a lot of PHCs are not functional, and therefore people must visit tertiary healthcare centres even for general care that should be received at PHCs. Tertiary healthcare should be reserved for tertiary healthcare provision and not distracted by the rendering of primary healthcare services.
  • Stakeholders need to keep advocating for the impact of the voting system on healthcare and for the need for health equity.


When people are healthy they can work and pay their taxes. The healthcare services in Nigeria are still largely funded by out-of-pocket expenditures. This has a huge impact on health indices in the country.

It is more imminent than ever that leaders take bolds steps so that Nigeria can enjoy the economic benefits of investing in health.


1. Ifeanyi Nsofor: Without Health, we have nothing (TedxOguiRoad, 2018). Available at: https://www.youtube.com/watch?v=u4r_0TLTBQw

Like what you read?

More from Gabriel Oke here.

Stay Connected with Gabriel Oke