Revitalising primary health care to achieve universal coverage in Lagos
Abayomi who spoke recently at a Breakfast meeting organized by the Franco Nigerian Chamber of Commerce and Industry stated that PHC system, which comprises the PHC centres forms the foundational healthcare structure at the community level of any UHC strategy.
The Commissioner noted that across the whole of Nigeria, a good number of primary healthcare centers are dilapidated and not able to provide the services required.
Abayomi said: “The situation is not very different in Lagos. Therefore, it is imperative that we begin to engage all tiers of government to find the right funding and operational model.
“In addition, the right statutory governance oversight is required to ensure that we jointly take responsibility for these centers through efficient management systems.”
Abayomi noted that the constitution of Federal Republic of Nigeria, and the Lagos State Health Reform Act placed a huge responsibilities and roles on the Local Government Area (LGA) health authority and Ward Committees to be responsible for the functioning of the PHCs He said that concerted advocacy efforts at this tier of government is required to initiate the revitalization process and long term sustainability of the PHC system.
According to him, the success of the Lagos State Government mandatory health insurance scheme, known as the Lagos State Health Scheme, which is aimed at delivering basic health care to the majority of the resident of Lagos and help attain UHC is dependent on a functional PHC system.
While noting that the Lagos State government had developed policies and currently implementing strategies aimed at reviving the PHC system, Abayomi opined that the resources of the State Government are under strain noting that to attain UHC in record time, there is a growing recommendation for the State and local government to partner with the private sector for innovative solutions.
The Commissioner stated: “One of such innovations is the ‘Access to Finance Scheme’ where the State in the previous dispensation, had commenced a pilot where 43 of underutilised PHCs would be allocated to the private sector for revitalisation in a Public-Private Partnership (PPP) arrangement.
“These private sector players would also have access to concessionary repayable loans bankrolled through blended financing which would ensure they have the capital for start-up and to provide affordable services to the enrollees of the State mandatory health insurance scheme”
“But for this pilot project to be potentially effective, further stakeholder engagement at the community and LG level is necessary to get the buy-in of the necessary structures to ensure the pilot is viable.”
He explained that the present administration Governor Babajide Sanwo-Olu as part of the THEMES mandate has pledged to gradually increase the allocation to health from present eight percent to approach 15 percent over the tenure stressing that this is aimed to achieve UHC and in line with the Abuja declaration of allocating 15 percent of the budget to health.
He said: “Although, the allocation is different from drawdown on the approved budgetary allocation. All efforts will henceforth be made to ensure that funding is available for capital and recurrent expenditure to ensure public facilities are well maintained and running efficiently.
“Moving forward, we will prioritise income generation projects, efficiencies, and cost containment.”
Outlining the demographic profile of Lagos as a challenge that needs to be addressed in attaining UHC, the Commissioner stated that the population of Lagos State has surpassed 20 million and rising daily qualifying it as a hyper city.
He explained this situation is brought about by constant migration of people into the city, either induced by the insurgencies and climatic forces north of Lagos or the attraction of the economic viability of Lagos.
“This brings about a great strain on the existing facilities in the State by people who require healthcare services and also threatens its biosecurity. This is why there is an urgent need for all relevant stakeholders, including the Federal Government, to be involved in the propagation of primary care to congregate and brainstorm on the appropriate financing mechanism to rejuvenate this system”.
“As a matter of priority, we are going to deeply engage with the LG structures and the house of Assembly on this critical issue. It is of utmost importance that all stakeholders agree on a collective and unified common agenda on a way forward and the State Ministry of Health will go to all lengths to find a funding model and administrative support to the local government structures in this endeavor”, he said.
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