Lack of needed commitment at both the states and local governments are real reasons why the federal government has not delivered the 10,000 Primary Health Care(PHC) units it promised to revitalize since early 2017.
This delay comes amidst concerns of a decaying health system with several challenges and resultant poor health indices, despite meagre progress though.
According to available statistics, Nigeria makes up only 2% of the world’s population but accounts for 14% of the global maternal death burden. One in every 8 Nigerian children dies before their fifth birthday; nearly 10% of new born deaths occur in Nigeria, while the country loses about 2,300 under-5s and 145 women of child bearing age each day.
The federal government in an effort to address challenges pledged to revitalize 10,000 PHC centres across the country. President Muhammadu Buhari who kicked off the scheme early 2017 hoped it would ensure delivery of quality basic health care services to the majority of Nigerians and drive Universal Health Coverage.
Government’s target was to revive one PHC centre per ward to widen access.
However, the scheme has achieved meagre success, nearly three years after because the project lacks a sustainability plan, defined budget, as well as required human resource amongst other challenges, according to information available to BusinessDay.
“So far, about 4,000 primary health care centres have been renovated, not revitalized,” Faisal Shuaib, Executive Director and Chief Executive of National Primary Health Care Development Agency (NPHCDA), told journalists in Abuja on Tuesday as he heaped blames on states and also faulted poor human resource required to drive the project.
According to him, President Buhari kicked of that policy thought out by the ministry of health to ensure that at least in every political ward in Nigeria have at least one Primary Health Care centre that can provide basic and essential health care to all Nigerians.
“It was always supposed to be a collaboration between the federal government, the state and LGAs, but principally states. “I think this is something that really needs to sink in.
“Ours is to provide the oversight and we will continue to advocate, oversight, to help coordinate, and make sure that primary healthcare is delivered,” he assured.
According to him, “You can advocate all you can but it is also important that you have a responsive partner who is willing to do something to change the landscape,” expressing satisfaction that the current governors are prioritizing primary health care.
“The key challenge has always been the human resources, revitalization is not just about renovating the building, but also providing the full complements require to make a health facility functional,” he added.
“That means the infrastructure is solid, there is electricity, water, drugs and commodities, but very importantly, that you have adequate human resources, midwives, nurses, community health extension workers, doctors in some that will actually attend to the citizens in a way that is dignified, respectful, compassionate. This is what revitalisastion is about and the federal government cannot do it alone.
Shuaib, however noted that the NPHCDA is now addressing critical issues through initiatives like the primary health care under one roof which seeks to remove the fragmentation in the management of primary healthcare and bring all interventions under the state primary healthcare board and make delivery of primary healthcare services the responsibility of primary health care boards as well.
He said this means that all primary health workers are now brought under the state primary healthcare board which can hire and fire, expressing satisfaction with the recent pronouncement by the governors to ensure that the project succeeds.
He said in the NPHCDA, has renovated 800 PHCs in the last two and half years alone from the domestic resources in its budget and is now working with the states to audit available human resources and how to close the gap.
Over the last 2 years and 10 months, the NPHCDA has initiated several innovative interventions which cut across organizational strengthening, financial and programmatic reforms and has achieved varying degrees of success in implementing the initiatives.
According to him, the agency has so far disbursed funds received by Gateway totaling N5.8billion while N5.5billion has been disbursed programmatic funds to States through NPHCDA Gateway.
As a result of the agency’s proactive measures, 23 states and FCT have opened TSA accounts so far, including Delta, Edo, Kaduna, Abia, Niger, kano, Adamawa, Kwara, Plateau, Bayelsa, Benue, Ebonyi, Osun, Nasarawa, Lagos, Imo, Bauchi, Oyo, Enugu, Ekiti, Bayelsa, Katsina, and Yobe.
Funds have also been disbursed to 15 states including Delta, Edo, Kaduna, Abia, Niger, kano, Adamawa, Kwara, Plateau, Bayelsa, Benue, Ebonyi, Osun, and Nasarawa and FCT, while eight states including Osun, Abia, Edo, Anambra, Bayelsa, Niger, Adamawa and Delta have gotten their username and passwords, and can access the Remita platform.
He said the Agency’s vision is to drive concrete results in the health sector, including to immunisation rates up to 84% by 2028, noting progress made so far on vaccine supply chain and RI service delivery, and gradual improvements in immunization coverage
NPHCDA program to finally declare Nigeria polio free has also been successful in interrupting the transmission of wild polio virus, “but we are not relenting, until Nigeria is certified polio-free,” the ED stressed.
He also noted that the NPHCDA is taking the lead on developing a pragmatic PHC delivery model to reduce maternal and child mortality and ensure universal health coverage for All by 2030
Onyinye Nwachukwu, Abuja