Nigeria can learn from Ghana’s healthcare model to increase financial protection and access to the needed health services in order to make progress towards strengthening the primary health care in achieving Universal Health Coverage (UHC).
The following opportunities exist to strengthen the primary health care system in Nigeria reducing out-of-pocket payments by increasing enrolment in the National Health Insurance Scheme (NHIS). Because NHIS coverage is still low, and out-of-pocket payments are high, devoting attention to increasing enrolment in the NHIS will help reduce out-of-pocket payments.
Another lesson Nigeria can also learn is increasing attention to promoting preventive services at the primary health care level in NHIS coverage should be critical including services such as family planning and health education.
Strengthening the primary health care system with government investment will improve efficiency in recognising the funding task in the health sector and also gives opportunity to shift some of the at the tertiary level to PHC.
Provide guaranteed universal package of primary health care services, by reviewing the National Health Insurance Scheme (NHIS). However, this approach will increase the population coverage, ensuring access to the poorest and most vulnerable.
Reflecting on Ghana’s primary healthcare model, analysts say there is a need to devote more funds to primary healthcare while also training and re-training medical personnel who will take pre-eminence in this task are important.
Primary health care is the first point of contact for most Nigerians. It is mainly provided by general practitioners, but community pharmacists, opticians and dentists are also primary healthcare providers.
Data show that 70 per cent of health burden and deaths in Nigeria are as a result of primary health care issues.
A recent survey shows that compared to peer countries in Africa (Uganda, Kenya, and Tanzania, and Senegal), Nigeria ranks the lowest or second lowest in all Primary Health Care Performance Initiative (PHCPI) indicators but has high levels of health facility density and health worker density, which are often thought to be the major cause of underperformance of PHC systems.
This is despite that in the country today, there are many PHCs spread across the states, and 744 local governments of the federation.
Doyin Odubanjo, chairman, Association of Public Health Physicians of Nigeria, Lagos Chapter, said there is need to make the primary healthcare centre functional so as to make them available to provide some level of delivery services when needed.
“The current backdrop and next steps for improving the quality of health care in Nigeria is through collaboration and addressing the gaps in the primary healthcare,” said Odubanjo.
The federal government, on January 10, 2017, through the Saving One Million Lives Initiative, desirous of reversing the poor health indices and ensuring universal health coverage initiated the revitalisation of 10, 000 primary healthcare centres (PHCs) nationwide by inaugurating Kuchigoro Clinic, Abuja.
This model was supposed to be financed by NHIS since attaining universal health coverage was one of the core mandates of the scheme.
Francis Faduyile, president Nigerian Medical Association (NMA), the key of the problem of the health sector is at the level of the primary healthcare centres where the majority of 70 per cent of Nigerians live.
“There is a need for the government to hasten their plans for the primary healthcare centre in area of prevention of many of the diseases that will cause more complications at the secondary level. So if we can meet it at the board, at the primary healthcare centre, it will improve it,” he said.
Roughly 95 per cent of Nigerians are accessing health care through out-of-pocket payment to meet their health needs. This is not only left with less than 5 percent of Nigerians covered by National Health Insurance Scheme, according to a 2014 study by the World Bank reveal huge health inequality gaps with stretching the attainment of the Universal Health coverage.
Umar Sanda, president, Healthcare Providers Association of Nigeria (HCPAN) believes that mandatory health insurance in Nigeria is “the only way forward for health sector in the country.
“This will reduce all price indices and many people will have access to quality HealthCare. It will enable Nigerians to access care in the hospital without the fear of paying out of pocket.
“When you are on the health insurance scheme, it means you have prepared yourself for any unforeseen health issues, because your health insurance will take care of it when you are sick,” said Sanda.