Significant disparities remain in healthcare access especially in rural areas despite commitment to achieving SDGs 3
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By Akanji Alowolodu, Bauchi
It has been observed that despite Nigeria’s commitment to achieving the Sustainable Development Goals (SDGs), particularly Goal 3 (Good Health and well-being), significant disparities remain in healthcare access especially in rural areas.
The observation was made during a Stakeholders engagement meeting on a World Bank assisisted Rural Emergency Services and Maternal Transport (RESMAT) Programme with 15 impact State by the National Emergency Service and Ambulance SYSTEM6 (NEMSAS) held at the Ministry of Health, Bauchi on Friday.
Head Claims Management of National Emergency Medical Service and Ambulance Service (NEMSAS),
Nasir Nuhu Yakubu said that, “This gap is most pronounced in maternal and child health and emergency ervices, where rural areas suffer disproportionately high rates of maternal mortality and face difficulties in accessing timely emergency medical interventions.”
According to him, “The lack of functional Emergency Medical Services (EMS) and transport options exacerbates this level to develop sustainable rural emergency service and maternal transport systems.”
He explained that the National Emergency Medical Service and Ambulance System (NEMSAS) is the
Operational arm of Emergency Medical Treatment (EMT) and was established to fill a critical Health Sector Gap that ensure Emergency Medical Services and transport to citizens.
He stressed that, “This system is designed to provide 24/7 Medical Emergency Services to citizens who need it, anywhere in the state at no cost to the patient for the first 48 hours with a fleet of different categories of Ambulances, such as Advance Life Support (ALS), Basic Life Support (BLS) Ambulances and Tricycle (Keke) Ambulance from Public and Private Sector.”
Nasir Nuhu Yakubu added that,”The Programme is to be domesticated at state level as State Emergency Medical Service and Ambulance System (SEMSAS) headed by a Chairman. The NEMSAS will roll out Ambulance Services and Emergency Treatment throughout the country in phases, F.C.T, Anambra, Yobe and Osun States have rolled out and commencef Operations.”
“As part of President Bola Ahmed Tinubu’s drive in accelerating Nigeria towards achieving Universal Health Coverage through last mile access to quality healthcare, This vision is envisaged to be actualized through a Sector Wide Approach Programme (SWAP) themed Nigeria Health Sector Renewal Investment Initiatives championed by the Coordinating Minister of Health; Prof Muhammad Ali Pate,” he stated.
According to him, “Crucial to this strategy is a need to ensure access to appropriate, effective, efficient and timely Emergency Transport for rural dwellers who bear the bunt from observed limited access to health care through evidence based emergency Service Programme.”
He stressed that,”Nigeria aims to address this EMS gaps in communities across the country, particularly to reduce preventable morbidities arising from obstetrics, perinatal and under 5 Emergencies through the Rural Emergency Service and Maternal Transport Programme.”
He also stated that,”In addition, the World Bank through the IMPACT Project is supporting 15 IMPACT Project States with EMS assets, capacity and financial resources to jump start the Rural Emergency Service in targeted and most needed Communities in these states.”
The goal is to drive demand for, and improve access to timely, quarterly, effective, and efficient Rural Emergency Services, and Maternal Transportation for1,700,000 Pregnant Rural Dwellers in 15 Selected IMPACT Project States by December 2025.
The Specific Objectives is to drive demand generation through coordinated Advocacy and behavioral change communication activities and to Strengthen NEMSAS governance for effective and efficient delivery of programme goals.
It is also to Strengthen the capacity of frontline rural health workers, tricycle operators, non-Ambulatory private cperators, and programme managers to ensure timely, quality, effective, and efficient Rural Service, and maternal
transport in the States as well as to Ensure the avaiability of appropriate rural Emergency transport by procuring, equipping, and disk Luting tricycles and Boat Ambulances.
The programme is to optimize RESMAT Services and fiduciary processes by scaling the National Integrated Emergency Medical Service Software.
In his opening remarks, Commissioner of Health, Bauchi State, Dr Sani Mohammed Dambam commended President Bola Ahmed Tinubu for approving the establishment of the National Emergency Medical and Ambulance Services (NEMSAS) which is aimed at ensuring effective and efficient healthcare service delivery in the country.
Represented by the Director, Medical Services of the Ministry, Dr Suleiman Aliyu, the Commissioner said that, “It may surely be recalled that last week, Tuesday, the Coordinating Minister has inaugurated, Emergency Medical Services and Ambulance System here in this Ministry, which is no longer a story, in line with that, the officials of NEMSAS are here to have a meeting on how to kick start the process.”
The Commissioner added that,” We Sincerely appreciate the efforts of Mr. President and that of the Coordinating Minister, because this is by far one of the best interventions that is going to affect our rural populace.”
He added that,”Anybody anywhere, who promised you that you are going to be giving free medical services, tell that person it is likely unapplicable to be realistic. But with this system, it is actually going to be impactive.”
According to him, “Reason is because from wherever accident victim is picked, be it medical or surgical or fatal accident to the point of care, to the next 48 hours, everything is going to be free. I don’t think there’s any period in American term that is called golden period rather than at this.”
“So, if somebody has taken over responsibility of the golden period, that is fantastic because if you are allowed to be there unattended to, you may end up dying, though, that is in the hand of God for surely, even if you did not die, you may end up with serious and life long consequences,” he added.
The Commissioner stressed that, “Honestly, we appreciate that effort. We appreciate these giant strides, and we welcome you to Bauchi. I assured you that we are going to listen, we are going to collaborate and we are going to apply 100 percent of whatever instructions you can impart us with. We thank you very much and may God bless all of you.”
While giving an overview of NEMSAS, a Resource Person with NEMSAS, Dr Lawal Ahmadu Kuki explained that initially it has got two Gateways but now it has four gateways saying that the first two getaways are for the National Primary Healthcare Development agency, while the second Gateway is at the National Health Insurance Agency Gateway, “but later on, we have now established two gateways.”
He added that, “Again, the National Emergency, Medical Treatment Gateway and the National Public Health, Emergency Gateway, is housed in the National Centre Nigerian Centre (NCDC) for this control while the national emergency treatment is housed under the Coordinating Minister of Health and Social Welfare.”
According to him,”And under that, the organogram, we have the Coordinating Minister, then we have the Permanent Secretary, then we have the National Emergency Treatment Committee. So, under that committee, we have the National Coordinator. So, under the National Coordinator, just like any other Agency, we have Finance, we have Operations and so many others which is going to be the same within this STEMSAS.”
“So just briefly, I know, you know about what NEMSAS and STEMSAS means. So our own is based on the yearnings and aspirations of this Administration and our Coordinating Minister under the World Health sector approach. They want every individual to be cared for and possess they care that he needs,” he added.
The Resource Person added that,”And because of that, we have initially NEMSAS operate at the urban areas and we are now moving to the rural settings. So in this presentation, I will be restricted to Rural Emergency Service and marginal transport. And this is the reason for our coming here to engage with the stakeholders in the state.”
Lawal Ahmadu Kuki stressed that,”We should come together to design and find out the gaps and the challenges that we are going to pass in the implementation of this program. And together we are going to Look what the solutions and what are the ways forward.”
He concluded that, “And we are going to look at the uniqueness of the state. Is there any existing system within the state? So we are going to leverage on that existing programs. So that to implement this Rural Emergency Service and Marginal Transport. So this is the outline. So As we all know, We always remember this.”
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