In my role as the Founder-President of The Wellbeing Foundation Africa (WBFA), I have dedicated 13 years to ensuring that mothers and children have full access to the health services and social support that they require; when pregnant, during childbirth and in those critical early days and months once a baby is born.
What has struck me as I meet with thousands of mothers, their babies and their families in my native Nigeria and across sub-Saharan Africa, are the infrastructural deficiencies that still exist in health systems; and the many miles that families must travel to see a doctor, nurse or health worker; the lack of information and education regarding health conditions and health choices.
Many families struggle to access the care they need, and in cases where access is granted, huge financial and social burdens are often incurred by the family.
There is a solution. Universal Health Coverage (UHC).
The WHO defines UHC as a system in which all people and communities can use the promotive, preventive, curative, rehabilitative and palliative health services they need, of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship. As a special adviser to the Independent Advisory Group (IAG) Regional Office for Africa, I support the leadership of the WHO, in particular its first African Director-General Dr Tedros Adhanom Ghebreyesus, which has made UHC a strategic priority.
It is promising to see commitments such as those made by for Mothers last year in support of its mission to reduce maternal mortality. Working in collaboration with the Global Financing Facility, for Mothers announced $10 million in support of the UN Every Woman Every Child initiative, which will help to ensure that key maternal health indicators are met, and that women and children have improved access to healthcare. USAID also announced last year a new development impact bond aimed at reducing maternal and newborn deaths in India. It is interventions like this that are leading the way in the pursuit of UHC, and I hope that others will follow the example set.
UHC is not a concept to be imposed upon a country, however, but rather one that we should develop ourselves – not eschewing the help of partners, but incorporating their support into our own systems. The role of education within UHC is a good example - educating health workers to provide up-to-date information and educating patients to make informed health decisions. Educating and upskilling our nurses, midwives and health workers to deliver improved health services, and providing education to patients accessing services has a domino effect on those who receive it – on individuals, their families and their communities at large. It is for this reason that at the Wellbeing Foundation Africa we developed our own education programmes, comprised of emergency obstetric and newborn care – with our partners at Johnson & Johnson and the Liverpool School of Tropical Medicine further education training for midwives, and antenatal, intrapartum and postpartum education classes for expectant parents. A powerful combination, and one which brings about real change to the lives of women, their babies and the communities which they go on to positively impact.
Primary healthcare presents a critical piece of the puzzle in achieving UHC, and should be prioritised accordingly. In Nigeria, I have a vision to strengthen primary healthcare centres to the standards of medical referral centres, to deliver costed, insured, and funded community health to a high quality for all. An ambitious goal but one which I believe is attainable, and certainly a step in the right direction toward achieving UHC.
We must also recognise the importance of a well-designed civil registration and vital statistics (CRVS) system in order to collect and produce accurate data – and thereby ensure effective delivery, evaluation and monitoring of sustainable, effective public health strategies in Nigeria. At the WBFA we designed the Personal Health Record (PHR), a book in which the medical records of each mother and child are recorded and stored for future reference and analysis. The PHR evolved from a child immunisation and growth record to a comprehensive CRVS tool. Without a centralised health database for many families to rely upon to keep them informed of the necessary health processes in a child’s first thousand days of life, the PHR came as an innovation that placed this knowledge directly into the mothers’ hands, and empowered her to provide, analyze and follow-up on her own data. A comprehensive CRVS system in Nigeria will enable us to deliver health for all as a measurable demographic dividend.
In 2017, Nigeria edged noticeably closer to achieving UHC – for example, the Senate’s resolution to mandate the Committee on Appropriations to include the one percent Consolidated Revenue Fund (CRF) for the Basic Health Care Provision Fund (BHCPF) was ground-breaking.This has heralded positive and sustainable public health improvements in the country, and I hope that this momentum can be maintained and accelerated in 2018. UHC: coming to a village near you.
The content of this blog is solely the responsibility of the author and does not represent the official views of Merck. Merck for Mothers is known as MSD for Mothers outside of the United States and Canada.
As Founder-President of The Wellbeing Foundation Africa (WBFA), Mrs. Toyin Saraki is a Nigerian advocate for women's and children's health and empowerment, with two decades of advocacy covering reproductive, maternal, newborn, child and adolescent health (RMNCAH); ending gender-based discrimination and violence; and improving education, socio-economic empowerment, and community livelihoods in sub-Saharan Africa.
Mrs. Saraki is the inaugural Global Goodwill Ambassador for the International Confederation of Midwives (ICM); special adviser to the Independent Advisory Group (IAG) of the World Health Organization's (WHO) Regional Office for Africa (AFRO), the Save the Children Newborn Health Champion for Nigeria; and a Global Champion for the White Ribbon Alliance for Safe Motherhood. She is also the Wife of the President of the Senate of the Federal Republic of Nigeria.
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