By Hassan Zaggi
The recently concluded National Primary Health Care (PHC) Summit organised by the National Primary Health Development Agency (NPHCDA), as expected, brought to the fore many issues.
At some point, the same issue keeps reechoing and reverberating as many speakers hit at it. At another point, some well-known issues and challenges in the health got their suggested solution twisted, as according to their proponents, their solution can only come when they are turned upside down.
Indeed, the issues raised at the summit will be subject of discussion among experts and health sector analysts for a long time.
The summit which was with the theme ‘Reimagining PHC’ was aimed at finding solution to the challenges bedeviling the primary healthcare sector in the country.
The general consensus among experts and stakeholders who attended the summit was that our primary health care system where over 80 per cent of Nigeria assess healthcare services is not working, hence, needs a drastic reimagining and recalibration.
While declaring the Summit open, the Vice President, Yemi Osinbajo, noted that the government cannot fund the primary healthcare sector alone, therefore, the need for partnership with the private sector.
He, however, reiterated the need for a compulsory health insurance scheme, which, according to him, will help resolve the issues around funding for the primary healthcare sector.
The Vice President further called for the private sector involvement in the provision of primary healthcare services in the country.
“The role of the private sector in the establishment of a chain of primary healthcare centres across Nigeria in all the 774 local government areas and applying market-based reforms to provide low-cost health services to the people and descent staff is an important initiative and it will bring succor to the private sector efficiency into the primary healthcare driven by market ideas,” he said.
Osinbajo further noted that: “For us to achieve an emerging PHC, we have to address out-of- pocket expenses to access healthcare and I think we clearly need compulsory health insurance scheme where premiums for certain categories of vulnerable people are paid.
“Our target is the 100 per cent coverage of the poor and vulnerable in a short to medium term. There is no way that health care funding can be paid by the government budgets alone, this is impossible.
“The size of the federal government budget itself is over stretched. We definitely cannot afford to fund health by just budgets and therefore healthcare insurance is an important pool of resources to fund healthcare on a scale that is required for the country to move forward.”
The Vice President also raised the critical issue of constitutional provision as regards who, among the three tiers of government should be in charge of the primary health care sector.
“The second thing is addressing the controversy occasioned by the concurrent constitution status of the primary health care. There is a great need for synergy to prevent a situation where the federal, state and local governments and private persons duplicate primary health care facilities and there is no real planning around what should be where.
“The third is encouraging and supporting serious private sector interventions,” he stressed.
On his part, the Minister of Health, Osagie Ehanire, reechoed the need to strengthen the PHCs, which he said, will reduce the workload on the already over-stretched secondary and tertiary healthcare levels. It will also bring down the catastrophic out-of-pocket patient spending on health.
He noted that the government must utilize the present opportunity to rebuild the primary health sector, which he lamented was left unattended to for a long time.
“But we also have opportunities to build back better, with the goodwill and funds that have flowed into the system since then.
“It is in that light that we wish to rebuild our system by correcting the imbalance among the levels of care, beginning with this PHC summit.
“The Federal Ministry of Health wishes to build on gains of the past and partner with all sectors to achieve national and global targets,” he said.
In his address of welcome, the Executive Director of NPHCDA, Dr. Faisal Shuaib, explained that the ‘Reimagining PHC’ summit is solutions-focused and dedicated to delivering improved PHC across the country.
Some of the interventions toward investing in PHC infrastructure across the country, he clarified, include constructing and restoring health centers; ensuring provision of general laboratories, clinic and personnel equipment; availability of quality drugs; ambulances for accessibility; and training and employing quality nurses, midwives, clinical staff and non-clinical staff at health centers across Nigeria.
Dr. Shuiab, however, reechoed what the Vice President said earlier. He reiterated the need for partnership with the private sector in terms of funding.
“The PHC system is the backbone of health care, we must radically change our PHC to begin delivering quality, accessible care to all Nigerians.
“This change is possible, it’s realistic. We have a deeply flawed and inadequate health system in Nigeria and people are dying because of it. But current challenges can be solved through public-private cooperation in fundraising and execution of the Reimagining PHC programme. Together, we can create monumental impact,” Shuaib said.
In her goodwill message, the Managing Director/CEO, Aliko Dangote Foundation, Zouera Youssoufou, emphasized that the Nigeria’s PHC System, through which 80% of Nigerian’s health needs are met is not working properly.
She regretted that the COVID-19 pandemic highlighted and exacerbated the vulnerability in Nigeria’s PHC.
While also echoing the need for private partnership involvement, the Managing Director said: “I believe that our focus should be on improving Public Private Partnerships, which will enable us create the system we need to support the health of our over 200 million citizens.
“This includes pharmaceutical manufacturing, investments in technology, training of health workers and improved PHC infrastructure, among others.”
As a way of proffering solution to resolving the challenges bedevilling the primary health care sector, she said: “This is why I am particularly enthusiastic about the Adopt-A-Health Facility Program (ADHFP), which I understand is now part of the NPHCDA strategic plan.
“This is great because when this project was conceptualized and designed by the Private Sector Health Alliance of Nigeria (PSHAN) which I helped found, and still fund, the goal was to make sure we have the support of NPHCDA.
“The primary goal of the ADHFP is to deliver, at least, one global standard PHC in each of the 774 Local Government Areas (LGAs) in Nigeria.”
By Hassan Zaggi