Lagos flagship primary health centres initiative
The Lagos State government is currently pursuing a programme geared towards revamping primary health care in order to bring health care services closer to the people across the state and ultimately reduce the pressure on secondary and tertiary health facilities in the state. The state government is concerned over the rate at which people die prematurely and has, therefore, decided to overhaul primary health care in the state, so that certain killer diseases could be discovered and treated before they take dangerous dimension. Hence, it has come up with a collaborative initiative to assist local governments to develop at least one flagship centre across the 20 LGAs and 37 LCDAs. This, on its own, is a welcome development as it is a reminder that local and state governments must work together to create a sustainable and affordable healthcare system for the people.
Bringing health services closer to the people is a reflection of the state government’s perspective about the defining difference distance can make between life and death, at very critical moments. Therefore, the flagship Primary Health Care (PHC) initiative signifies the unrelenting commitment of the Lagos State government to expanding access to health services to the general population, and particularly pregnant women, thus creating the enabling environment for improving the infant and maternal mortality indices.
The flagship approach is to make PHCs more efficient at the grassroots and is in line with the key health strategies of the state government and the policy to have a PHC facility in each local government/LCDA in the state. However, in view of limited resources and other such constraints, the adopted alternative is to start with the flagship facility. This is to at least make one PHC that is central in each of the 57 LGAs/LCDAs fully functional with the maximum amount of services to people in the community. One of the problems at the primary health care level is that of personnel. Thus, central to this new initiative is the plan to completely staff the flagship facilities, which start with the needed doctors, nurses and other categories of staff.
One fascinating feature of these flagship centres is that they operate on a 24-hour basis. Thus, patients are sure to get the services of at least a doctor, a nurse with the additional benefit of a functional laboratory where tests can be conducted. There would equally be staff to carry out other auxiliary services. Screening is also being provided for all ailments like tuberculosis, hypertension, diabetes, cholesterol, malaria, HIV/AIDS, all free of charge. To sustain the system, the state government is making effort to upgrade the knowledge of its medical personnel such as doctors, nurses, pharmacists and laboratory scientists on the latest management of diseases such as hypertension, diabetes and heart attack in its primary healthcare centres.
In its bid to make the vision a reality, the state government recently handed over the fifth 24-hour comprehensive PHC in Eredo, Epe (having earlier handed over the ones at Iga Idungaran in Lagos Island, Mosan/Okunola in Alimosho, Ajara in Badagry and Ejire at Itire/Ikate), thereby emphasising the aspiration of the state government to lay a solid foundation for a medical care referral system predicated on a robust primary healthcare that goes from primary to secondary and tertiary levels. It represents a commitment to making grassroots healthcare a local matter. The ultimate aspiration of the state government is to build a referral health care system that moves from a robust and intensive grassroots healthcare starting from 24-hour service delivery at the various LGAs through to the general hospitals up to the teaching hospital.
A referral system that is aggregated through the primary to the secondary and tertiary level is the model that has succeeded in every part of the world and it is the model that the state government is committed to applying in order to boost health care delivery at the grassroots. This is the only way to fully integrate, redistribute our assets and optimise them. We need to discourage the tradition of everyone heading to Lagos State University Teaching Hospital (LASUTH) for every small ailment in order to safeguard the state’s healthcare system.
Interestingly, the state government’s investment in PHC is currently paying off as reflected in latest statistics across the centres in the state. For instance, in 2012, the Eredo PHC recorded 97 childbirths, 2,262 children immunisation, 1,085 antenatal cases, 1,575 adult malaria cases and 276 family planning services. However, since January this year when the revitalisation programme came to Eredo PHC, 55 babies have been delivered, which is more than half of the babies delivered last year. So far this year, 1,903 children have been immunised, 847 ante-natal cases have been recorded, while 89 family planning cases have so far been witnessed.
When put alongside the recent breakthrough of the state government in establishing Mother Child Centres across the state to reduce cases of maternal and child mortality and other similar initiatives in the health sector, the commitment of the state government to enhancing citizens’ access to quality health care delivery would better be appreciated.
It is understandable that it might take some time before the people adapt to the current development in the state’s health sector. With time, the long-term attachment to secondary health facilities and the belief that the PHCs are not well-suited for consultation for certain ailments can be overcome. However, also with time and given the commitment of the state government to upgrading PHCs across the state, it won’t be long before the people would get use to the current trend and eventually realise that it is for their good.
It is, however, important to remind community members, community leaders and other stakeholders that the flagships PHCs are the assets of the people which may require to be maintained from time to time in order to ensure that the investment of the state government in this respect is preserved.
Ogunbiyi is of the Features Unit, Ministry of Information and Strategy, Alausa, Ikeja.
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