Health
EXPERT say Primary care is the initial point of contact between a patient and the healthcare system that provides individuals with access to the information and resources they need for optimal health outcomes.
In 1987 former President Ibrahim Babangida inaugurated the PHC plan with the intension to make it the pillar of Nigeria’s health system
Its main objectives included accelerated health care personnel development; improved collection and monitoring of health data; and ensured availability of essential drugs in all areas of the country.
Others were implementation of an Expanded Programme on Immunisation (EPI); improved nutrition throughout the country; promotion of health awareness.
It was also meant to develop a national family health programme as well as widespread promotion of oral rehydration therapy for the treatment of diarrheal disease in infants and children.
After 36 years that it was inaugurated, some experts say that the establishment of the National Primary Health Care Development Agency (NPHCDA), and the 30,000 PHC facilities across Nigeria provide an opportunity for the effective implementation of PHC in Nigeria. Successive governments have paid lip service to PHC.
But what appeared to be a glimmer of hope for them came o Jan. 10, 2017 when then president, Muhammdu Buhari, made an ambitious promise to revitalize 10,000 of them scattered all over the country.
“Our vision is to revitalize 10,000 Primary Health Care Facilities in Nigeria using a phased approach. The first phase of this approach is what we are flagging off today. It will signal the revitalization of the first 109 Primary Health Care facilities across the 36 states and the FCT”, Buhari said.
He spoke at Kuchingoro, an FCT suburb during the inauguration of Kuchingoro Modeel PHC.
Meanwhile five years after President Mohammadu Buhari’s administration promised to refurbish 10,000 Primary Healthcare Centres (PHCs) across the 774 Councils, a new study has indicated that about 80 per cent of the facilities are still non-functional.
The work, commissioned by the Embassy of the Kingdom of The Netherlands in Nigeria and put together by PharmAccess Foundation’s Nigeria Office (PAF), is entitled “Nigeria Health Sector: Market Study Report.”
According to the study, there are 34,076 PHCs in Nigeria, accounting for 85.3 per cent of total hospitals and clinics in the country. Of this number, it is estimated that only 20 per cent are functional.
“Most of them lack the capacity to provide essential healthcare services, in addition to challenges of poor staffing, inadequate equipment, poor condition of infrastructure and a lack of essential drug supply”, the report said.
The Executive Director, NPHCDA, Dr Faisal Shuaib, said the agency is aware of the challenges faced by PHCs and would ramp up effort to revive them
“If you cast your mind back to 2019, we declared a state of emergency on the number of mothers and children dying every day in Nigeria.
“NPHCDA set up a national coordination centre known as National Emergency Maternal and Child Health Intervention Centre (NEMCHIC) to provide oversight on reproductive, maternal, newborn, child and adolescent health plus nutrition in Nigeria.
“Through this centre, our agency has conceived and has been coordinating a set of related high-impact interventions nationwide to reduce preventable maternal and under-5 mortalities across the country.
“One of such intervention has to do with the provision of skilled health workers in our PHC facilities,” he said.
Shuaib said that the availability of skilled health workers in the PHC facilities was critical to curbing maternal, perinatal, and neonatal morbidity and mortality.
“In pursuit of this and other goals for advancing primary health care in the country, the Federal Ministry of Health in collaboration with NPHCDA held a well-publicised Primary Health Care summit in March 2022, during which we presented a 4-point agenda for PHC re-imagining.
“As part of this agenda, we discussed the need to close the gaps in the adequacy and distribution of human resources for health at the primary healthcare level.
“To be guided by evidence, we followed this with a national health facility assessment in 2022.
“Findings from the assessment revealed that only 1.8 per cent (463 out of 25,843) Primary Health Care Facilities in our country have the minimum number of required Skilled Birth Attendants (SBA) which is four per facility,” he said.
The state of the PHCs has also drawn attention from development partners and international organisations with UNICEF calling of more investment in that area.
The UNICEF Chief of Health in Nigeria, Dr Eduardo Celades, was quoted by the media as saying the investment should cut across all tiers of government.
Celades made reference to the Universal Health Coverage (UHC) priorities outlined in the National Health Policy and the National Strategic Health Development Plan II (NSHDP II).
“The main objective of these documents is to reduce maternal and newborn mortality rates by providing timely, safe, appropriate, and effective healthcare services to mothers and newborns before, during, and after childbirth.
“Over the past ten years, strategic actions and initiatives have been implemented to improve the landscape for Maternal, Neonatal, and Child Health,” he said.
He said that the country had adopted various global best practices strategies and guidelines to enhance maternal, neonatal, and child health outcomes.
“These include the RMNCAH coordination platforms, the National RMNCAH Quality of Care (QoC), the National Guideline for Basic Newborn Care, and the Guideline for Comprehensive Newborn Care.
“They also include the National Operational Guideline for KMC (Kangaroo Mother Care), as well as the National Pneumonia Control Strategy and implementation plans.
“A NPHCDA report from 2022 reveals that 97 per cent of PHC facilities across Nigeria have fewer than two nurses/midwives,” he said.
The Federal Government is unrelenting in ensuring that the primary health care provision for the grassroots is accelerated and funds provided, to augment the efforts of the PHCs.
Dr Dogara Okara, Secretary of the Ministerial Oversight Committee for Basic Health Care Provision Fund (BHCPF) in the Ministry of Health, said that BHCPF was one of the key drivers to attaining equitable health for all Nigerians.
Okara said that by addressing these areas from the grassroots, there had been a huge positive turnaround in service delivery.
“The objectives of the BHCPF are; To achieve at least one fully functional public or private primary health care (PHC) facility in each political ward within seven years.
“To achieve at least three fully functional public or private secondary health care facilities, benefitting from the BHCPF in each state within five years.
“It also seeks to establish effective emergency medical response services in 36 states and the Federal Capital Territory (FCT) in five years, including a national ambulance service”, the media quoted him as saying.
According to him, BHCPF has enrolled 1.280 million poor and indigent Nigerians as beneficiaries of a comprehensive Basic Minimum Package of Health Services provided through health insurance.
Former Minister of Health, Dr Osagie Ehanire, acknowledged that more needs to be done hence the introduction of National Community-Based Health Research Innovative-Training and Services Programme, (CRISP).
“One of the strategic pillars for achieving this is ensuring the adequacy, competency, and distribution of a committed multidisciplinary primary health care workforce supported through effective management, and supervision within an enabling environment,” he said.
`The CRISP initiative is one of the country’s programmatic ways of achieving the first of the interrelated four-point agenda on PHC transformation.
“CRISP is a partnership between the NPHCDA, the tertiary teaching hospitals, the Federal Medical Centres, the State Primary Health Care Boards, Local Government Areas and the communities to support PHC development”, he said at the inauguration of the initiative in Abuja.
Experts say more than 60 per cent of ailments to be addressed by primary healthcare are seen daily by secondary and tertiary healthcare facilities and this is not good enough.
As the new administration under the leadership of President Bola Tinubu settles down, it is crucial that it takes necessary steps to fix the nation’s primary healthcare.
“If government is interested, PHCs will work. When Nigeria wanted to build rail lines, they went as far as borrowing loan from China and pursued the project.
“Imagine if such commitment and resources was channeled to the health sector” said Onyechi Adaobi, a public health expert in a media report. (NANFeatures)
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Tags: Dr Faisal Shuaib Health Care Development Agency (NPHCDA) Ibrahim Babangida Muhammdu Buhari UNICEF
