Making primary health care centres functional
The goal of primary health care (PHC) was to provide accessible and affordable basic health services for all that is Universal Health Coverage (UHC). Unfortunately, this is yet to be achieved in Nigeria and seems to be unrealistic in the next decade.
Several studies have shown that PHC, which is supposed to be the bedrock of the country’s health care policy, is currently catering for less than 20 per cent of the potential patients. The Guardian investigation revealed that while most PHC facilities are in various state of disrepair, with equipment and infrastructure being either absent or obsolete, the referral system is almost non-existent.
The goal of the National Health Policy (1987) is to bring about a comprehensive health care system, based on primary health care that is primitive, protective, preventive, restorative and rehabilitative to all citizens within the available resources so that individuals and communities are assured of productivity, social well-being and enjoyment of living.
According to the revised National Health Policy 2016, the health services, based on PHC, include among other things: education concerning prevailing health problems and the methods of preventing and controlling them, promotion of food supply and proper nutrition, maternal and child care, including family planning immunization against the major infectious diseases, prevention and control of locally endemic and epidemic diseases and provision of essential drugs and supplies.
According to the Nigeria Constitution (1999), the provision of health care at PHC level is largely the responsibility of local governments with the support of state ministries of health and within the overall national health policy.
Unfortunately, this novel initiative conceptualized during the Alma Ata Declaration in 1978, is not functioning properly in Nigeria. The Declaration of Alma-Ata was adopted at the International Conference on PHC, Almaty (formerly Alma-Ata), Kazakhstan (formerly Kazakh Soviet Socialist Republic), September 6–12, 1978. It emerged as a major milestone of the twentieth century in the field of public health, and it identified primary health care as the key to the attainment of the goal of Health for All.
Past administrations had built structures without proper equipment and medical personnel to man them.
The Guardian found that some of the buildings are now housing animals and hoodlums. Patients with conditions that could be conveniently handled at PHCs now visit secondary and tertiary hospitals, while others resort to quacks.
However, as part of efforts to correct the anomaly, reverse the poor health indices in the country and ensure universal health coverage, President Muhammadu Buhari has flagged off the revitalization of 10,000 Primary Health Care (PHC) Centres nationwide with the inauguration of Kuchigoro clinic, Abuja, as a model.
Buhari, in his address, said the vision is to revitalise 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 Federal Capital Territory (FCT) Abuja,” he said.
The President said the provision of quality health care service would reverse the poor health indices in the country. “I am hopeful that our women will no more be dying during childbirth; our children will no more be dying as a result of vaccine preventable diseases or common ailment; access to health care will not be limited because of not having money to pay,” he said.
Mr. President said Kuchigoro Primary Health Care Centre has been renovated, as a model primary health care where quality health care services will be obtained at little or no cost to the beneficiaries. This, Buhari said, is through the collaboration of the government through the Federal Ministry of Health (FMoH), National Primary Healthcare Development Agency (NPHCDA), Federal Capital Development Administration (FCDA) and the University of Abuja Teaching Hospital; and partners such as General Electric and Sterling Bank.
The President said the model, which he is flagging off is one of the models, which will be replicated in all the states of the federation with slight modifications depending on the location. “I want to assure all Nigerians that Government will continue to ensure that all Nigerians have access to quality basic health care services,” he said.
Buhari said: “My presence here today demonstrates our commitment to put health of Nigerians as a top priority. Our goal of revitalizing the Primary Health Care Centres is to ensure that quality basic health care service is delivered to majority of Nigerians irrespective of their location in the country. We shall focus more on the people living in the rural areas and the vulnerable population in our society such as women, children under five years of age and the elderly in collaboration with national and international partners.”
The President said the revitalization programme is in alignment with the agenda of the All Progressive Congress (APC), which did promise to provide succor to the poor while at the same time providing for all other segments of the society.
Minister of Health, Prof. Isaac Adewole, said that the health system in the country has only favored the rich but under the present administration, they are concentrating on the poor.
He explained that the initiative is to provide qualitative and affords able health services the people, basically the poor.
Adewole stated that ministry has developed guidelines for the utilisation of the Basic Healthcare Provision Fund to ensure transparency and accountability in the country’s health sector.
He also called on the private sector to participate in the management and implementation of various health services across the country.
Acting Executive Director, NPHCDA, Dr. Emmanuel Odu, said that while they target to revitalize 109 health care facilities across the country, the agency has completed two already.
“We are targeting 109 but we have completed the work in 2 healthcare facilities. Voka in Niger state and Kunchigoro in the FCT,” he said.
He stressed that “having the President Muhammadu Buhari flagging off the revitalization of a nation wide initiative means so much.
“It kick start the process of getting Primary healthcare services available to all Nigerians everywhere especially in the rural areas and it is a great development.”
He however assured Nigerians that the program would be sustained beyond this Government because of the array of stakeholders that have been put together around this initiative.