Thread by @toluogunlesi

Some pretty remarkable healthcare initiatives have taken off in #Nigeria in last few years. (If you’re interested in discussing what has NOT been done maybe don’t bother, this particular thread is about what’s BEEN done).

As always implementation & Monitoring/Oversight are key.

At the very top of the list I’d put the BASIC HEALTHCARE PROVISION FUND. Stipulated by the National Health Act of 2014, but not implemented until 2018 budget. 1% of Consolidated Revenue Fund (CRF), to go into a special Fund for Primary Health Care. In 2018 that 1% came to ~N55bn.

When it comes to Primary Health Care - the FG has only supporting/supervisory roles. The real actors are LGAs and their ‘parents’, the States. So the BHCPF money isn’t being spent by/inAbuja, it’s going to PHC facilities nationwide — as Opex budgets & Reimbursements.

In addition to the 50+ billion Naira appropriated in 2018 budget (as I said for the first time since NHA passed in 2014), the BHCPF has also got funding commitments from Int’l partners: @theGFF ($20m); @gatesfoundation ($75m, over 5 years); and @DFID_UK (£60m). It’s a big deal.

So how does the Basic Healthcare Provision Fund (BHCPF) work? It makes funding available to accredited public and private primary and secondary healthcare facilities, for them to deliver a ‘Basic Minimum Package of Health Services (BMPHS)’ to Nigerians (More on that later).

By Prog design, the BHCPF money goes from a dedicated Federal TSA Account (in CBN) to State TSA Accounts, & from there to commercial bank accts held by each participating healthcare facility and dedicated to BHCPF. There are inbuilt mechanisms for tracking the flow of the money.

I’m told that the amounts released to each State and to each participating facility will be made public, to aid efficient use of the resources. The facilities are meant to use the money to improve service delivery and also reimburse the cost of delivering the BMPHS.

That Basic Minimum Package of Health Services (BMPHS) that BHCPF pays for includes the ff interventions:
- For pregnant women: Antenatal Care, Delivery, Emergency Obstetric and Neonatal Care, CS.
- Urinalysis Test
- Immunization (Under-5s)
- Malaria Treatment for all Nigerians

Basic Healthcare Prov Fund is a mouthful, admittedly. So the Prog has been given a name.

No it’s not ‘Buharicare’ :)

It’s called ‘HUWE’. Huwe is an Ebira word that means “LIFE”

Ebira is an ethnic/linguistic group in Central Nigeria (I’m told Kogi, Kwara, Nasarawa, Edo)