The Universal Health Coverage: Making It Count for Women and Girls

Ngozi Nwosu-Juba

BY: Ngozi Nwosu-Juba      July 1, 2019       0339PM

Nigeria is the biggest country in West Africa with diverse people and cultures. Nigeria’s Universal Health Coverage is one of the many areas the country is working to keep pace with leading countries in the world. The target of the National Health Insurance Scheme was to provide universal coverage for all Nigerians by 2015. Unfortunately this target has not been met. To close the existing gap in health care for women and girls is therefore critical towards achieving Sustainable Development Goals goal 3:7.  Currently, only about 5% of Nigerians have prepaid health care through the National Health Insurance Scheme (NHIS). The large majority of Nigerians (95%) are without any form of coverage.  Among the 95% are women and girls.  

Nigeria has the third highest infant mortality rate in the world and also the largest contributor to global mortality rate. The rates are high not because the diseases leading to death cannot be cured or prevented, Women, girls and children are dying from preventable and treatable sexual health complications as a result of entrenched resistance to women’s autonomy and control over their bodies. This is often justified on the basis of culture and/or religion. Poor health care systems and weak policy implementation add to women’s risk of death.

The recently released National Demographic Health Survey (NDHS) 2018 data in the country states that unmet need for family planning declined from 20% in 2008 to 16% in 2013 before increasing to 19% in 2018. 10% of maternal deaths in Nigeria are due to unsafe abortion. Access to safe abortion is restricted in Nigeria. A 2015 national study of abortion incidence in Nigeria reveals the challenges that remain to improve conditions for Nigerian women and girls. Only 16 percent of all women of reproductive age use any contraceptive and an even lower percentage of 11 percent use a modern method, which results in almost 10 million unintended pregnancies, of which more than half end in an induced abortion.

The slogan of leaving no one behind CAN only be achieved if government health plan target those most in need of it; women, girls and children. There is need for universal access to quality and affordable comprehensive sexual and reproductive health information, education, including comprehensive sexuality education, and health services and ensuring that gender is cross cutting on all issues relating to the coverage.

Central to women and adolescents health and well-being is the realization of their human rights, including their sexual and reproductive rights. To achieve Sustainable Development Goals and Universal Health Coverage, special attention must be paid to women, children and adolescents and their health needs. Efforts must made to remove obstacles such as negative laws that restrict choice; women and girls must take charge and ownership in health care delivery.

As Nigeria joins other African nations and indeed the world at the United Nations high-level Meeting on universal health coverage in September 2019, it has a critical role of ensuring that it invests substantially into the health Scheme by partnering with private sector and civil society groups.  The Second National Strategic Health Development Plan which is the country’s road map through its five strategic pillars and 15 priority areas must focus on bridging the existing health care gap for women and girls. Government’s 1% funds allocation tagged ‘Basic health care provisions Fund’ must target the unmet needs on SRHR for women and girls. Political will is required to achieve the implementation of health commitments which must benefit women and girls whose health needs remain unmet. 

The Universal Health Coverage Must Count for Women and Girls.

Ngozi Nwosu-Juba
Project Director
Vision Spring Initiatives, Lagos Nigeria and Steering Committee Member CSO League, Africa.

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