How primary healthcare can change Nigeria’s health sector narrative

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.

In February this year, Nigeria was ranked 187 out of 191 countries in the world’s health systems, showing the country has a lot to do in improving its health system and making healthcare affordable and accessible to the millions of its citizens.

Findings reveal that with more than half of Nigerians leaning on hospital facilities for the most minor of ailments, there is a clear need for improved access to primary care practitioners, local health facilities, tracking health indicators and a wider availability of information about health, nutrition and fitness.

“This approach is further reinforced by the fact that majority (65 per cent) of Nigerians believe improved access to health facilities would make them more effective in managing their health, thus alleviating pressure on the healthcare system,” a recent survey by Royal Philips said.

Doyin Odubanjo, chairman, Association of Public Health Physicians of Nigeria, Lagos Chapter, said there was a 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 the scheme.

In addition to this, the Senate in May this year approved that one percent of the consolidated Revenue fund be set aside for the Basic Health Care.

The fund will ensure that every primary centre will have some money coming directly to the health centre and not going to the local government before they can get it.

Fifty percent of the fund would be dedicated for disease control. This will help the country achieve some of the Sustainable Development Goals especially SDG 3, which talks about Good Health and well-being by 2030.

Hence, there will be no reason for that primary health centre not to have basic drugs and not to have salaries to pay its workers.

Francis Faduyile, president Nigerian Medical Association (NMA), said that the recently approved one per consolidated revenue will strengthen the system.

“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 lrvrl. So if we can meet it at the board, at the primary healthcare centre, it will improve it,” said Faduyile.

According to Isaac Adewole, minister of health, over 3128 Primary Healthcare Centres have been upgraded across the country.

“We are working hard to achieve universal health coverage. To accomplish this we are committed to the revitalisation of 10,000 PHCs. Presently over 3128 PHCs have been upgraded with support from government and partners” Adewole said.

Analysts say there is a need to devote more funds to the primary healthcare while also training and re-training medical personnel who will take pre-eminence in this task.

ANTHONIA OBOKOH