Wednesday 26 January 2022

CONFLICT PREVENTION VIA UNIVERSAL HEALTH COVERAGE

My niche, conflict transformation, informs the perspective from which I see events around me. I was consistent as regards the prism through which I perceived the summit held in Abuja on the 16th of December, 2021. The theme of the parley was 'Universal health coverage (UHC): Putting health & the health sector on the political front burner'. Chief (Mrs) Moji Makanjuola, MFR, Chair, UHC 2023 Forum, was the convener. Since her sojourn at the Nigeria Television Authority (NTA), anchoring 'Health Reports' and other programmes, ('Bridges' post retirement), I knew she was up to something formidable like the UHC 2023 Forum.

My take is that if inclusiveness is the watchword as regards UHC, then vulnerable groups, which include women, children, the aged, persons living with disabilities (PLWDs) would be captured. When the critical mass of the citizenry is healthy, then they can function at maximum capacity in the society. When citizens can function maximally, then the level of productivity in all sectors of the society is enhanced. When productivity is enhanced, then the volume of the 'cake' baked at all levels is pleasing -  scarcity, hunger and dis-affection may then be effectively tackled. This could lead to greater harmony and indeed less conflict in the society. Hopefully, then, no one would be left behind...or at least, majority of the populace would have been enclosed in the safety net of UHC...

                                                           The banner for the Summit

Did I digress earlier? Apologies. Back to the summit. The following are the Summit themes:

*Putting health and  health security on the political front burner: What we have learned, what can we do differently?
-Taking advantage of the election period to advance health policy thrusts: What has international experience taught us?
-A critical appraisal of Nigeria's health challenges & promising policy options.
-Towards articulating a health agenda & obtaining commitments for enhanced prioritisation of health in Nigeria

*Subsidising health cost in Nigeria: Successes, gaps & the next frontier.
-Implementation of the BHCPF: How far have we gone? What else should we do?
-Expanding health insurance coverage to the poor through equity fund: Accomplishments & impediments.
-Using donor funds to subsidise health cost: The Christian Aid experience.
-Subsidisation for financial protection: What do we want from the political class?

*Forging consensus & building a coalition towards putting health on the political front burner.
-The role of donors, the media & civil society in putting health and health security on the political front burner.

Some of the participants are:

*Senator Bukola Saraki - President, 8th Senate, Nigeria
*Rep. Gov. Abdullahi Sule - Governor, Nasarawa state
*Rob Yates - Director, Global Health Programme/ED Centre for Universal Health, Chatam House
*Prof. Aliko Ahmed - Associate Fellow, Global Health Programme,Chattam House
*Sen. Dr. Ibrahim Oloriegbe - Chair, Senate Committee on Health
*Mrs. Moji Makanjuola - Chair, UHC 2023 Forum/Summit Convener
*Rep. Gov. Okowa - Governor, Delta state
*Dr. Olumide Okunola - World Bank/IFC
*Prof. Nasir Sambo - ES, NHIS
*Dr. Amina Dorayi - Country Director, Pathfinder
*Dr. Sam Agbo - FCDO
*Dr. Yusuf Yusufari - Bill & Melinda Gates Foundation
*Dr. Dayo Oluyemi-Kusa - Independent Conflict Transformation Strategist, Abuja
*Prof. Alli Mohammed
*Otun Adewale - Well-being Foundation
*Ms. Ene Ede - VAPP Coordinator, FCT
*Anu Rotimi - Rep. CSOs
 
Some of the highlights of the animated discussion are:

UHC can be used to address poverty. Nigeria is low to medium UHC. There should evolve a clear pathway for UHC. We need to end maternal and new born deaths via UHC. Primary Health Care (PHC) is critical to UHC. Less than 2% of the population covered under the NHIS in Nigeria. Any child born in Nigeria has approximately 36% productivity. Vulnerable groups fund & NHIS Authority Bill are being discussed. There should be effective linkage between primary, secondary and tertiary  health systems. Democratic nation-states have citizens with longer life span. Your vote affects how long you and members of your family live. Politics is a normative and subjective enterprise that affects health security. Free and fair elections have a positive effect on life expectancy.

Civil society needs to generate political commitment for UHC. Expertise on how to launch and sustain UHC reforms required. We need to share experiences from successful models. More public events, fora, etc. like UHC 2023 Forum need to spring up to call attention to the need for UHC. The political strategy to enhance UHC should also include round tables, briefings, media engagement, etc. We should use Chattam House rules in meetings, so that individuals can express themselves freely. We need to talk to incumbent governments and the opposition also. We should use the power of ideas to influence the idea of power. In Nigeria, population has out-paced economic growth. Public spending is constrained by insufficient funds. In a recession or pandemic, countries are forced to spend more on health. We need to block the health benefit black hole. The proposed 'Sugar Tax' should be given to he health sector. 

In my intervention, I called attention to the fact that health security is only a part of the whole gamut of human security, which is beyond perimeter fencing. We keep brandishing the concept of 'political will', but I know that we cannot have political will without 'political pressure' to do the needful as regards UHC. As a Political Scientist, I am particularly interested in the political economy of health care. Also as a Conflict Transformation Strategist, I strongly believe that some conflicts can be prevented in the society if we have inclusive UHC...

The NHIS boss reiterated the fact that the overall objective of the BHCPF is to ensure the provision of a basic minimum package of health services (BMPHS) to all Nigerians. But there are a number of challenges: Poor PHC facilities, advocacy, political will as regards the equity fund, financial management, Epidemiology, accreditation, digital technology, data/demographics, quality assurance, monitoring & evaluation, information/education/communication (IEC), enrollment, etc. UHC entails population/service/insurance coverage.

What then is to be done?

*There should be prompt release of BHCPF for sustainability.
*Advocacy to support SSHIAs beyond BHCPF wanted.
*Mandatory health insurance (HI).
*Increase in percentage disbursement to BHCPF.
*Massive creation of awareness about NHIS to the public.

What then are the policy options?

*We should strategically use the political season to call attention to the importance of UHC while soliciting the buy in of  politicians.
*UHC could be actualised via the NHIS.
*Digital technology is crucial.
*The political class has a crucial role to play. Investment in health should be increased. A minimum of 15% of the annual budget should go to the health sector.
*Civil society should continue to advocate for UHC.
*We should leverage socio-cultural nuances while calling attention to the importance of UHC. The role of traditional leaders as regards advocacy is crucial.
*A lobby group should constantly liaise with the National Assembly, Governors' Forum, etc.
*The cooperation of the mass media should be solicited for UHC advocacy.

Next steps

*The recommendations should be converted into a road map for the UHC Forum.
*An engagement strategy should be formulated.
*A draft template (Manifesto) should be written. This should include what we want to see in the health sector as regards UHC...

Impressive! The UHC 2023 Forum is definitely off to a terrific start. The tempo needs to be sustained. On my part, I am committed to advocacy for conflict prevention via UHC. Bravo to Mrs. Moji Makanjuola and her fabulous team...


Related Links

*How to build Africa's health care defense system by Akinwunmi Adesina   http://guardian.ng/news/how-to-build-africas-health-care-defense-system-akinwunmi-adesina/



 
  


Tuesday 25 January 2022

WHAT WOMEN IN POLITICS WANT: MUSINGS FROM THE PROGRESSIVE WOMEN's CONFERENCE

The National Progressive Women's Conference was held at the International Conference Centre, Abuja, between the 18th and 19th of January, 2022. It was indeed an impressive spectacle to behold, a carnival of sorts, where 'sisters in politics' did not lose the essence of their gathering in one venue to discuss, analyse and proffer viable solutions to the numerous problems bedeviling women. The theme of the conference was: One voice, women uniting for progress. Why has the number of women in elective positions been on the downward spiral since 1999? There were many high profile delegates from the geo-political zones of Nigeria. Some of the dignitaries present are:

*Prof. Yemi Osinbajo - VP Nigeria

*Dr. Jewel Taylor - VP Liberia/Keynote Speaker

*Dr. (Mrs) Aisha Muhammadu-Buhari - First Lady, Nigeria

*Hon Stella Okotete - Convener

*Dr. Tijani Aliyu - Minister of State, FCT

*Dame Pauline Tallen - Minister for Women Affairs

*Hon. Umar Farouk - Minister of Humanitarian Affairs

*Barr. Sharon Ikeazor - Minister of State for the Environment

*Mrs. Titilayo Laoye-Tomori - Fmr. Dep. Governor, Osun State

*Sen. Florence Ita-Giwa

*Dr. Hajo Sani - Nigeria's Ambassador to UNESCO

*Senator Binta Masi Garba

*Mrs.Nchita Asabe - DG National Centre for Women Development (NCWD)

 *Senator Grace Bent

*Erelu Bisi Adeleye-Fayemi - First Lady, Ekiti State

*Mrs. Chioma Uzodinma - First Lady,

*Dr. Zainab Bagudu - First Lady,

*Dr. (Mrs) Ayade - First Lady, Cross River State

*Hon. Nkeiruka Onyejeocha - Deputy Chief Whip, House of Reps

*Hon. Olubunmi Ette - Fmr. Speaker House of Reps/1st & only female Speaker to date

*Dr. Justina Mutalele - Chair, JM Foundation

The objectives are:

*Embed gender mainstreaming in Party processes at the national, zonal and state levels.

*Amplify collective concerns for strategic positioning of women for political office.

*Converge Progressive Women into a unified voice for women's security & political growth.

*Educate, enlighten & empower (3 Es) Nigerian women for maximum utilisation of skills acquisition through a digital learning platform (DLP)

*Launch Progressive Women's Academy - a foremost digital learning platform.

*Attract a culturally diverse group of progressive women who will connect, educate, inspire and empower one another via mentoring and personal growth for collective development.

The high point of the conference was the unveiling of the 'Progressive Women's Academy' on a 'Free Learning Platform for Nigerian & African Women' by the wife of the President, Dr. Aisha Buhari. The aim is to train at least 20 million women in two years!

The themes are:

*Women political leaders in Nigeria: Leveraging networks to transform the political space.

*It's time to represent: Getting women elected into office

*Fiscal policies & interventions for women's economic empowerment

*One voice: Overcoming the challenges

*Embracing diversity & empowering the next female generation

*Defining women in the political space in a new decade 

*The role of women in security, governance & development

*The African woman, a beacon of hope

*Giving voice to women's visibility

*Overcoming adversity, obstacles & barriers

The Charter of demands from the conference was eloquently elucidated in the communique:

*There should be institutional reforms which take cognisance of the concerns of women.

*Fora for the interaction of women for progress are necessary.

*Mentorship for the next generation of female politicians needed.

*The 'Progressive Women's Trust Fund (PWTF)'should be set up to address the critical issue of feminisation of poverty and non-availability of campaign funds for women in politics.

*Consitution review committee should be set up. Affirmative action for women should be top on the agenda.

*A 'Lobby Group of Women' should be set up.

*There should be inclusivity for women at all levels.

*There should be at least 35% of all posts for women.

*There should be an increase in the number of women in the Board of Trustees (BOT) of the Party.

*There should be a comprehensive review of the APC Constitution.

Wow! What an ambitious basket of demands. From what I witnessed at the conference, these women are up to the task. Keep pushing ahead, ladies...

AFFIRMATIVE ACTION FOR WOMEN: LEGISLATION IS KEY

 On the 24th of January 2022, I was in the Studio of Boss 95.5FM, Asokoro, Abuja, to discuss what women want and how to enhance the participation/visibility of women in politics. At the outset, Itold my interviewers that the playing field in politics in Nigeria is not level. It is skewed in favour of men for many reasons.

                                  Dr. Dayo Oluyemi-Kusa (middle) with the Boss FM95.5 'crew'
 

I zeroed in on the reasons why statistics show that the number of women in elective and appointive posts has been declining since 1999. To be sure, the 2019 elections were the worst for women, in terms of the number who got into elective positions. Why is this so? Some of the reasons I gave were:

*Feminisation of poverty. Poverty seems to have a feminine face. Most women cannot afford the following for nomination forms: Presidential - N45m, Governorship - N22.5m, Senate - N7m, House of Representatives - N3m. You might say some Parties have reduced the cost of the forms or given it free to female aspirants. But the feelers I'm getting from the field is that these monetary concessions for women are in reality a liability. They are looked down upon within the Party because they got their forms free! They do not have a strong voice when important decisions are being taken. Many female politicians now say they would rather pay in full for the nomination forms in order to have a 'proper seat' at the table!

*Lack of internal Party democracy (IPD).

*Tokenism for women. The most prominent woman in the Party is usually the 'Women Leader'. Why can't a woman be the Chairman of the Party, VP, Publicity Secretary, etc?

*Stereotyping: Women often take care of welfare, including the food. Why does such such 'welfare' include' women as Financial Secretaries?

*Violence against women in politics (VAWiP). Physical violence is not the only form of VAW. There is verbal violence, violence via exclusion, etc.

*Patriarchy: This is the elephant in the room! We cannot wish patriarchy away overnight, it takes time for men to accept that women should also be seen and heard...

*The socialisation of girls into the society is limited by patriarchal values.

*Lack of legislation on affirmative action (AA). Legislation is necessary to give 'teeth' to AA. In order to attain 35% AA and go beyond this to parity, we need relevant legislation. This is where the initiative of Hon. Nkeiruka Onyejeocha, Deputy Chief Whip, House of Representatives comes in: 'A Bill for an Act to alter the provisions of the Constitution of the Federal Republic of Nigeria, 1999, to create additional special seats for women in the National Assembly'. I would slightly adjust the Bill because the average annual budget of the NASS is already humongous - N134b yearly! I would not support additional seats, but I would rather have the seats 'carved out' of the existing seats in the NASS.  

*There should be more safe spaces for women and girls at all levels of the society.

*The VAPP Act needs to be implemented more vigorously beyond the FCT.

The statistics are not impressive for Nigeria as regards the level of participation of women in politics:

-National average (Nigeria) - 6.7%

-Global average - 22.5%

-Africa regional average - 23.4%

-West Africa sub-regional average - 15%

With the numerous obstacles in the way of women in politics in Nigeria, the discussion would get more heated towards the 2023 elections...