Interview: Pieter Slabberts
In what ways can increased investment in Nigeria’s health care sector benefit the country?
PIETER SLABBERTS: Increased investment in Nigeria’s health care infrastructure has the potential to solve two of Nigeria’s immediate challenges: unemployment and insecurity. A high number of gainfully employed Nigerians will likely diminish the recruitment pool for crime and terrorism, transforming the security landscape. Additionally, improving health care investment is necessary for prosperity as healthier people are more productive in their prime working years. Moreover, investing in child health care will create the entrepreneurs and skilled workers of the future.
To catalyse health care investment, it is imperative that Nigeria’s exchange rate policy be explicit and stable. While health care investment necessitates a longterm approach and an acute awareness of inherent risks, every investor desires clarity of economic policies in their target markets. Macroeconomic variables are the key drivers of investment; hence, the federal government must be proactive, transparent and ensure relative stability to ensure that the sector remains attractive for investment inflows.
How can mandatory health insurance contribute towards attaining universal health coverage by 2030?
SLABBERTS: The National Health Insurance Scheme (NHIS) is a step in the right direction towards achieving universal coverage by 2030. Prior to the NHIS, access to affordable health care was a challenge for most Nigerians due to high levels of poverty and reliance on out-of-pocket payments. Nigeria’s health insurance coverage was insufficient relative to the country’s increasing population. However, with the inception of the universal health care system, 90% of citizens in the formal sector are now covered, and countless others have benefited from affordable and quality health care.
The challenges could be addressed legislatively to decentralise the scheme to permit state ownership. Liberalisation would help foster accountability at the grassroots level and enable effective communication synergy between all relevant stakeholders. If each state runs its own scheme, effective governance, monitoring, and prompt and efficient reimbursements will become easier to achieve. Furthermore, the implementation of a co-payment system by both the government and enrollees will boost funding, which will help to address the issue of pricing.
What challenges do private hospitals see in the supply and maintenance of medical equipment?
SLABBERTS: The lack of transparent import regulatory control is one of the main challenges to the supply and maintenance of medical equipment in private hospitals. Ideally, the import of medical equipment, especially machines used in critical situations, should be exempt from tariffs to widen access to affordable medical equipment and health care services. The continuous and unpredictable rise of the US dollar against the naira is somewhat discouraging, implying that prices are very unstable. Furthermore, the difficulty in sourcing parts for high-end equipment in the local market increases equipment downtime. Robust policy enactment and implementation, encompassing the import of medical equipment and stability of the exchange rate, will help to overcome these challenges.
To what extent can taxes and funds help to close the health care funding gap?
SLABBERTS: Increasing the sugar-sweetened beverages levy to at least 20% and mobilising the Basic Health care Provision Fund can play a positive role in narrowing Nigeria’s substantial health care spending gap. However, more diversified sources of investment are needed to sustain the health care sector. These include increased budget allocation, international donor funding, participation of the organised private sector and funding initiatives by high net-worth individuals.
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