Buhari on Healthcare

Awareness

The Maternal death rate of Nigeria is higher than the average for Sub-Saharan Africa so in one respect by formulating policy on maternal healthcare the CPC has acknowledged the problem. But in another respect they could have gone further to link such a high maternal mortality rate to the prevalence of under-age brides in certain parts of the country. The manifesto also acknowledges the importance of infant healthcare and regular and reliable drug supply. Also by mentioning the need for health insurance there is a nod to the issue of funding the healthcare system.

Beyond this the Buhari/Bakare manifesto could have gone further and highlighted the human resource problems facing the healthcare sector, the need for infrastructure and how the issues of health tie in with other issues such as education, sanitation etc.

Ambititon

The plan to extend free healthcare to pregnant women, children under the age of 18, the elderly over the age of 70 and people suffering from infectious diseases such as TB and HIV/AIDS has to be seen as very ambitious. In essence he (Buhari) is extending free healthcare to the majority of people who will need it in Nigeria (if the policy was extended to include malaria in the infectious diseases then he would be granting free healthcare to virtually all who need it). It will be an enormous task to train and equip enough people to do it and to ensure that the institutions built will be adequately funded and staffed.

Detail

Two of the policies in this section are well outlined. To be fair they are very blanket policies of free healthcare to a number of people and introducing a better drug management system. However, there is no information as to when they are likely to be implemented, how they will be funded and how they will be monitored. The policy to reform and strengthen the health insurance scheme is very vague, there is no indication which direction the reform will take and there is definitely no measureable goal against which its achievement can be measured.

My View

Firstly a promise to provide almost universal free healthcare doesn’t sit well with the principles of liberalism and free market economics that is stated in the mission section of the document. Secondly I think that rather than scaling up state involvement in healthcare, we should be scaling it down. The same way the state is committed to universal basic education; it should be committed to universal basic healthcare and nothing more. The state should ensure that everyone has access to a minimal but evenly distributed level of healthcare and after that the private sector should be allowed to do the rest. The issues of maternal/infant mortality and infectious diseases can be better tackled in cheaper ways such as through better education, better sanitation and better primary healthcare to detect issues before they go too far. Also any real discussion of maternal health in Nigeria cannot be had without a discussion of child brides particularly in Northern Nigeria, were state legislatures have been reluctant to pass laws restricting marriage to minors. As with this Manifesto’s section on education, if you believe that the problem with healthcare in Nigeria is not with the system but rather with the performance of the system then this is a very ambitious and good plan. But as with education, I do not believe this.

Scores (out of 5)

Awareness: 3.0

Ambition: 4.0

Detail: 1.5

My View: 2.25

Ribadu on Women

Awareness
The plan seems very aware, at least in terms of rhetoric, of the importance of women to society, but fails to acknowledge why women are so important: their role in child education, their role in primary healthcare, their role in household saving and small enterprise. It also ignores how the treatment of women varies according to region, religion, wealth and socio economic status.

Ambition
The implementation of the Beijing Declaration, the World Summit Declaration, The Ouagadougou Plan of action and the MDGs may on the surface seem ambitious, but is difficult to say. The MDG was to remove disparity in primary education by 2005 and at all levels by 2015, if it aims at full implementation of the target perhaps it should be seen as ambitious as the 2005 targets haven't been met. The Beijing declaration set targets for 2000 and its targets haven't been met yet either.

Detail
There is no detail given as to what is going to be done in order to meet the internationally agreed goal. It doesn't say how much will be spent or how it would be funded. There is no mention of any concrete policy as to how to increase female participation in politics or increase the value of women's health, security or safety. In fact there is not one single policy statement in the this section.

My view
In the 21st Century, 'women issues' are acknowledged as a key component of any development plan. It however seems hard to formulate and implement policies that would have real effects on the fortune of women and 'girl-children'. However, I feel that the plan could have been more explicit in a commitment to fight child marriage and perhaps introduce an education programme that is part-time for young mothers. That said, the male dominance and the mentality of Nigerian society makes the discussion of women issues difficult, so Team Ribadu must be commended for their awareness of the problem

Scores (Out of 5)
Awareness: 2.5
Ambition: 3.0
Detail: 0.5
My View: 3.0