To guarantee the fundamental right of every Nigerian
in accessing the highest attainable standard of health, stakeholders have
called for urgent revitalisation of the Primary Healthcare Centres (PHCs)
across the country, noting that this will drive socio-economic development.
The call came after a facility visit of some
lawmakers and Civil Society Organisation (CSO) activists to Powerline Primary
Healthcare Centre and Soretire Orile-Agege Primary Healthcare Centre, both at
Agege Local Government Area, Lagos State, recently.
The site visit was part of the ‘South West Policy
Dialogue on Revitalisation of Primary Healthcare.’ It was organised under a
project titled, “Reinvestment: Increasing Legislative Oversight on Primary
Health Care in Nigeria,” by CISLAC in Lagos.
The dialogue was aimed at providing enabling
platform for all-inclusive recommendations in revitalising PHCs to ensure
appropriate legislations and policy directions in the country, after first-hand
visits to PHC sites.
Article 25 of the Universal Declaration on Human
Rights states, “Everyone has the right to a standard of living adequate for the
health and wellbeing of himself and of his family, including food, clothing,
housing and medical care and necessary social services.”
To this effect, the legislators, members of House of
Representatives and activists from Civil Society Legislative Advocacy Centre
(CISLAC) stressed that revitalisation of PHCs’ goes beyond refurbishing of old
buildings and buying new equipment.
According to them, this is an important first step
in setting up health systems that work, though, it is not the only step needed.
However, they lamented that paucity of funding is
affecting PHC revitalisation in the country which is worsened by poor budgetary
allocation to health.
For instance, the budget allocated to health which
was four per cent in 2016 and 2017 only increased marginally from 4.4 to 4.75
per cent in 2018 and 2019 respectively, but shows a sharp drop at 4.14 per cent
in the 2020 proposal.
Similarly, the commencement of Basic Health Care
Provision Fund (BHCPF) implementation in 2019 put at N51.22 billion also shows
a sharp decline to N44.50 billion in the 2020 budget proposal.
Making his presentation at the occasion, Dr Francis
Ahanyido, a public health physician, in his presentation stated there is a
correlation between healthy citizenry and wealthy nations; even as he called
for urgent revitalisation of the primary healthcare system.
Ahanyido further stated that workable machinery such
as comprehensive insurance scheme needed to be in place, a structure that
protects everybody, both the rich and the poor.
For example, if a street cleaner gets sick, she
might not be able to pay for her treatment.
And even if she goes for a loan to treat herself or
her child, paying back such loans would mean her entire family has to go
without food and other needs for a very long period.
And therefore, it is very necessary to put in place
a scheme that gives everybody protection, he insisted.
He further stated that CISLAC has been able to
activate the passage of national health act of one per cent Consolidated
Revenue which has been included in the budget.
According to Ohanyido, the money may not be much,
but at least it shows commitment on the side of the federal government.
The States and local governments also need to play
their own part because the federal government can’t do everything, he added.
Prof. Akin Abayomi, the Lagos State Commissioner for
Health, reiterated the government’s plan to restructure healthcare in order to
restore public confidence.
The Commissioner who was represented by the
Permanent Secretary of Lagos State Primary Health Care Board, Dr. Tayo Lawal
also said that poor funding and medical personnel are major challenges facing
effective primary healthcare in the country.
The Ministry of health boss said, “Lagos states has
like 360 primary healthcare centres, the role of maintaining and managing these
centres is very critical.”
According to Dr. Samuel Adejare, the Deputy
Chairman, House Committee on Health, representing Agege constituency said, “We
as Legislators make laws that would support health workers in PHC’s to be
mobilised to work effectively and functionally. If we should have a concise
number of PHC’s that are highly functional, it will help Nigeria a whole lot.”
The Deputy Chairman, House Committee on Health,
however tasked his colleagues to sponsor bills that will help improve PHC’s in
the country, to better the lives of Nigerians and avoid needless deaths from
preventable as well as avoidable diseases.
Also speaking, Dr. Jubril Bashar from the Health
Policy and System Development Unit, Ahmadu Bello University, Zaria, said the
minimum standard for primary healthcare in Nigeria which has been in existence
was revised some time in 2006, but a number of people are not aware of it.
He said, “The programme is aimed at sensitising
especially, the legislative arm of government to see that the need for a
functional primary healthcare was achieved. This is particularly so now that we
are talking about revitalising healthcare and actualising functional primary
healthcare in the country – that is the concept of a standard primary
healthcare.
Bashar said, “It is not rocket science. If the
political will is there, it will not be a difficult thing to do. Revitalising
the primary healthcare is possible. Already, many things are coming on board,
State are signing, funds are being made available some States are going into
partnerships with private sectors and are preparing analysis. Some States are
even talking about the contributory state healthcare financing – these are
other sources of income and with the federal declaration of minimum of 15 per
cent of the annual budget to be allocated to health, it will go a long way if
there is compliance.”
He added that primary healthcare in Nigeria is less
than what is expected even for the downtrodden, the poor and those that cannot
afford standard quality healthcare.
“If everyone is aware that primary healthcare is not
just for the poor, but everyone, they would start accessing primary healthcare before
going to the higher levels of secondary and tertiary healthcare.”
Chioma Kanu, Programme Manager For Health with
CISLAC, said, “That the essence of this retreat is for the Legislative members
to start thinking about how they can actually move the health sector forward
from where it is. Actually, primary health care is the first point of call for
all the masses. The Secondary and Tertiary health care are known majorly for
specific big health issues.
“The site seeing is for our law makers to come and
see what these PHC’s look like and make serious commitment to putting things in
place. At least, let us have some primary healthcare centres if not all that
are up to the minimum standard of primary healthcare.”
Kanu said, “with the national assembly and
representatives on revitalizing health care. Two regions among the six
geopolitical zones in Nigeria, have been visited like the South-east and
south-south and then this is the south-west part.
“We still have North-east, North central and North
West; normally we take these law makers to some primary health care facilities
so they can have a feel of what the places look like so that they will be able
to perform their oversight function in the relevant department and ministries
with the hope to raise the standard of primary health care in Nigeria.”
