I hereby setup a school of public policy. This school shall attempt to solve almost all problems of governance by way of policy statements,bearing recommendations.

These statements are meant for use by the government and NGOs, and are to be seen to be solution driven based on available data in the public. And shall in no way attempt to leak any official secrets, nor criticize government whether past or present.

This has become necessary as daily, whether you tune to radio or television, all you hear are complaints. Whether these complaints are directed to the appropriate authorities who deserve to know is for someone to attempt to solve. Governance all over the world must run on effective policy statements driven by data. This will ensure the appropriate resources are utilized in the right areas of need.

Yes, I understand this effort might not be ok to some, but the much complaints have not really solved anything. That is why in some countries, regions and states setup institutes of public policies. Their research work form serious basis of government actions. And in some cases ministers with various years of experience come as fellow to these colleges; where they mentor students whose daily assignments are tasked with solving individual problems of the society from highly sophisticated to little as policy on public parks and parking areas. These students graduate from MPA or MPP courses to go into government agencies and are very effective in policy positions advising their principals.

While I am not a graduate of any of the above, I wish to by the coming weeks attempt to solve many of these problems. You are welcome to present any exact problems you have noticed and we can attempt to produce a short policy statement for it. By this, you might just in a way be part of the solution.

So here we go!

Policy Statement on Basic Primary Health Care

Background

The implementation of the basic healthcare system is key in every society as it ensures larger coverage of health care services. This ensures easy access to medical personnel, facility and care as well as entails better output in the overall health status of the citizens under consideration.

Therefore, when compared to Uganda, Kenya, Tanzania and Senegal it can be observed by available data in the assessment of primary healthcare system performance indicator conceptual framework of 2016 that Nigeria has a health expenditure of 0.88% of GDP compared to Senegal with 2.22%. Also, while we have health worker density per 1000 populatio of 18.8 which is impressive as when compared to these other countries, we maintain minimum equipment of 20% while Uganda and Tanzania has 78%. Our drug availability is 49% while Tanzania is 76% and Senegal 78%. Correct diagnosis of conditions for Nigeria is 37% compared to 56% in Uganda and 56% in Kenya. It was also observed in the analysis that in Nigeria the average time spent with patients is 10mins compared to 29mins in Tanzania. Despite Nigeria having vaccine availability of 76%, immunization coverage is 25% while Kenya has 71% and Tanzania 75%. Hence the report indicates that this and many other factors might be the reason for result of under- five mortality per 1000 live births being at 105 for Nigeria when compared to 49 in Kenya and Tanzania and 47 for Senegal.

Recommendations

1. The first priority is to alert the general public on the danger of continuing to run the public healthcare system based on the dwindling government revenue alone in the face of rising country population, and public infrastructures amongst other needs to be addressed.
2.There is the need to adopt and implement a generic health insurance policy across the federation, that is affordable and effective.
3. It shall be mandatory requirement for every state resident to hold a basic health insurance, this shall be tied to the tax identification number.
4. There shall be a list of accredited hospitals in each local government both government and private for implementation, it shall be a condition to award of licence for operation that it shall make it services available to primary health services of government.Even where they are super specialty hospitals must run skeletal services for primary health care. Their services shall be regulated periodically by a quality assessors of Ministry of Health, and where there are violations of rights of subscribers or issues, their licenses may be withdrawn.
5.The quality of services shall be evaluated monthly/quaterly and a complaint, approval and referral desk situated in each hospital. The referral desk shall ensure where it is impossible to attend to such patient, referral is processed to another accredited hospital with less burden to patient. Evaluation results of less than 45% from collated surveys shall amount to sanction of hospitals, medical director and might go as well as facing medical boards or inquiry. This is as it involves lives of citizens.
6. Each subscriber shall be eligible to pay a subscription fee of N650-N750 monthly and shall be on individual basis.
7.Elderly of 55 years and children of less than 5years are free.
8. Subscription of basic health insurance shall cover services defined currently by the National Health Insurance. Future provisions may be made for cover for major issues.
9. The subscription fee of N750 monthly from 27million (Nigerians who voted in 2015 elections) would generate N20,250,000,000 and
N243,000,000,000 annually
10. N243,000,000,000 annually added to our current health budget would give each of the 774 local governments N313,953,488.372093 annually.
11. That the N243,000,000,000 is very good sum for massive expansion of health facilities, development and stocking of public pharmacies, supply of vaccines, purchase of high tech medical and laboratory equipment at designated public health facilities and maintenance agreements, as well as implement and administer other healthcare programs and allowances for volunteer health workers among others. This is in addition to our present budgetary allocations, counterpart interventions programs and donations from charity organizations.
12. It shall be an offence for an hospital housing such procured high tech equipments to deny access to use by referred cases or frustrate quick testing of patients. This is the case in most hospitals where patients have been lost before results are released as it takes weeks, and instances where patients arrive for a simple procedure but are booked to be attended to in a register with dates being allocated to sometimes 2-3 months.
13. There shall be an established electronic system where hospitals for referred test cases can upload test results for ease of access by the primary requesting hospital for analysis.
14. If effectively implemented, every citizen shall have access to an efficient primary healthcare and shall have no reason to complain if otherwise, afterall it shall be a question of "have you paid your insurance for the month?"

Policy Statement on Massive Repair and Upgrade on Public Infrastructure



Background
Considering the present price of crude, the remittances from other sources if not monitored closely have shown not to leave much for the government for capital projects. Somehow justifies the reason for more borrowings. This is in addition to the financial requirement to maintain the work force for social and essential services, which will not reduce as the population continues to grow.

This sometimes results to infrastructure decay as a result of lack of funds to initiate building new ones. As a citizen I can only imagine the worry of government when confronted with need to raise capital. This I can tell from the recent bond issued in order to be able to undertake projects under the ministry of works.

However, when we observe closely, we would notice that there are certain services/goods that are accessed in large volume accros the country. Such products might be useful in raising capital for capital expenditures, and particularly where these projects are pre-defined and costed.

It is therefore important to note that where there is trust, the citizens can bear minute burden of development as it is for common good. Worse case the tenure for this burden may be defined as they will know how long and appreciate the communication and engagement.

Recommendations
1. A period of years be defined as the time needed to raise funds for particular list of projects; say 4 years
2. The projects should be costed and scheduled by year of commencement and completion
3. The the pricing template for fuel indicates it can be sold within a range up to 145 or so, but major marketers and the NNPC sells for 139-142. This is commendable, and can be leveraged on to request it be fixed at 145 for period of 4 years. This is because daily consumption is at 33Million litres and a N3 to government per little could be remitted to dedicated account with CBN.
4. For N3 saved for 33million daily consumption would yield N99Million daily and N2.97Billion monthly amounting to N35,64Billion annually. This would amount to N142.56Billion in 4 years.
5. A bond may be issued as can be seen most bonds recently have been over subscribed, projects commenced and completed at record time. This will serve as boost for the confidence of the citizens as N3 deductions can be clearly be seen to have positive effects on their lives.
6. This addition of N35 Billion annually for a period of 4 years to public projects such as roads in addition to the yearly annual budgets for capital expenditure would serve a very great purpose.
7. That based on the allocated 16.67Billion to each geo political zone in the recent bond, N35Billion generated annually can undertake projects in 2 geo-political zone per year and the 6 zones covered in just 3 years.