Second National Strategic Health Development Plan 2018-2022: Forewords

The Government of the Federal Republic of Nigeria, through the Federal Ministry of Health, led the development of the first National Strategic Health Development Plan 2010-2015. The development of the Plan involved active participation of national, subnational and international stakeholders. The Plan was launched in 2010 at the national level and subsequently many States launched their plans. The joint annual reviews, mid-term and end-term evaluations of NSHDP I showed variable success at state and national levels. 

According to the end-term evaluation, significant achievements include state domestication of the Primary Health Care under One Roof policy, passage of the National Health Act which includes the Basic Health Care Provision Fund for Universal Health Coverage and the launching of a comprehensive National Health Policy. Furthermore, significant progress was recorded in key public health programmes. Notably, increased investments in procurement and distribution of insecticide-treated-bed nets led to significant reduction in malaria incidence and reduction in HIV prevalence, especially among the youth. 

A BioTalk on the Overview of the National Strategic Health Development Plans

While innovative programmes such as the Midwifery Service Scheme, the free Maternal and Child Health policy contributed to increased access to, and utilisation of RMNCH+N services, more still need to be done to accelerate reduction of maternal and neonatal mortality in Nigeria. These indicators are relevant to the Sustainable Development Goals and have been prioritised in the NSHDP II. The NSHDP II builds upon the successes and challenges of NSHDP I which was implemented over the past six years. 

Some of the challenges identified in the NSHDP I end term evaluation and which have been considered in NSHDP II include: gaps in political will and poor programme ownership at lower levels especially state and LGA levels; weak donor coordination and harmonisation of development and technical assistance; low level of government financing of healthcare at the three levels of government; weak M&E systems to monitor implementation of the state Strategic Health Development Plans and weak Primary Health Care structures. 

The development of NSHDP II could not commence as scheduled and so the 58th session of the National Council on Health, the highest policy-making body on health matters in Nigeria, approved a one-year extension of implementation of NSHDP I in order to allow time for comprehensive development of a successor plan which would cover the period of 2017-2021 and which should reflect the 2016 National Health Policy. However, the NSHDP II development took much longer than scheduled and the plan was only finalised in June 2018. This led the 61st NCH to change the implementation period of NSHDP II to 2018-2022. NSHDP II is anchored on the 2016 National Health Policy which recognizes Nigeria’s aspiration to attain Universal Health Coverage by operationalizing the policy to have one functional Primary Health Clinic per ward. 

The NSHDP II also considers the expansion of prepayment social health insurance schemes for UHC, the unfinished business of the Millennium Development Goals, the Sustainable Development Goals and the Global Post 2015 Development Agenda including the renewed Global Commitment for countries to progressively attain Universal Health Coverage. The plan further aligns with the Economic Recovery and Growth Plan (2017-2020) and the National Vision 20:2020. The National Health Act serves as a major legislative framework for effective articulation and delivery of the strategies of the NSHDP II. 

At the initial stage of the development process, a NSHDP II framework to provide uniform guidance for States to produce their respective plans was developed and validated by all stakeholders. The second stage was the use of the framework to guide the development of specific cost plans by the 36 States, the FCT and the Federal level. The final stage involved harmonisation of the State and Federal plans into one National Plan and its subsequent validation by stakeholders. The NSHDP II addresses lingering and emerging health sector challenges. It also offers the opportunity to ensure better health outcomes by 2022 through consolidation of the gains made and incorporation of the lessons learned from NSHDP I.  The NSHDP II will ensure, among other things, that we collectively achieve better cohesion that guarantees greater participation, ownership, sustainability and full implementation of the Plan at all levels of government including communities. 

This bottom–up approach is geared towards the realisation of our goal of ONE FRAMEWORK, ONE PLAN AND ONE M&E for the Nigerian health sector. It is important to point out that while the NSHDP I primarily addressed the health system building blocks under eight priority areas of the 2004 Health Policy, the second Plan takes a more comprehensive, inclusive and holistic approach to address both health service delivery and systems strengthening. 

Therefore NSHDP II is organised into the following five strategic pillars, together with the priority areas:

  1. Enabled environment for attainment of sector outcomes which focuses on (i) Leadership and Governance, (ii) Community Participation and Ownership, and (iii) Partnerships for Health;
  2. Increased utilisation of Essential Package of Health Care Services which covers (iv) RMNCAH and Nutrition, (v) Communicable Diseases and NTDs, and (vi) Non-Communicable Diseases, Mental Health, and Care of the Elderly; (vii) Emergency Medical Services and Hospital Care, (viii) Health Promotion and Social Determinant of Health;
  3. Strengthened health system for delivery of Essential Package of Health Care Services which focuses on (ix) Human resources for Health, (x) Health Infrastructures (xi) Medicines, Vaccines and other Health Technologies and Supplies, (xii) Health Information System, (xiii) Research for Health;
  4. Protection from health emergencies and risks, which focuses mainly (xiv) Public Health Emergencies, Preparedness and Response;
  5. Increased Sustainable, Predictable Health Financing and Risk Protection which focuses mainly on (xv) Health Financing.

Unlike the first Plan, NSHDP II is accompanied by a dedicated Monitoring and Evaluation plan which shall facilitate our tracking of progress towards the targets and attainment of our goal to ensure healthy lives and promote the wellbeing of the Nigerian populace at all ages. I believe that Nigeria is now well positioned to attain Universal Health Coverage in line with our commitment to SDGs. 

Therefore, I beckon to all our stakeholders including health professionals, civil society groups, development partners and others to work together with the State and Federal Governments for us to jointly achieve the NSHDP II goals. I have no doubt that with the unwavering political commitment of government, engagement and ownership of the pursuit of health by all Nigerians, active community participation, coupled with the steadfast commitment of our health workers, the support of our development partners and other stakeholders, we will succeed in achieving the NSHDP II goals.

Professor Isaac F. Adewole, FAS, FSPSP, FRCOG, DSc. (Hons),
Former Honourable Minister of Health, Federal Republic of Nigeria

Facebook Comments

Leave a Reply