Nigeria to reposition PHCs to meet service delivery expectations

Gloria Essien, Abuja

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The Nigerian Government says Primary Health Care (PHC) facilities has not met expectations due to inadequate funding.

The Minister of Health, Dr Osagie Ehanire, made this known at the National Health Dialogue, organized by the Centre for Journalism Innovation and Development (CJID) and its sister organisation Premium Times, with the themed, Primary Health Care Financing: Role of State and Non state actors in Abuja. He said that shortage and misdistribution of healthcare workers, dilapidated infrastructure and weak referral systems are also issues affection the PHCs.

Dr. Ehanire noted that the inadequacy in funding for the primary healthcare system has negatively impacted the delivery of services such as immunization and maternal and child health services. “The 1978 Alma Ata declaration and the recent 2018 Astana declaration on Primary Healthcare, indicate the need for a multi-sectorial approach to primary healthcare with the involvement of different stakeholders, including the community. Both declarations call for adequate financing for Primary Health Care systems to ensure optimal access to quality healthcare services at the community level. Robust primary healthcare financing in Nigeria would require collaborative efforts of both state and non-state actors.

“While state actors in Government continue to play their roles to ensure that more public resources are available for the primary healthcare systems, a significant proportion of the progress with financing for Primary Health Care is dependent on the role of non-state actors. The private sector, civil society organizations, non governmental organizations, the media, faith-based organizations, trade unions, professional organizations, academia, community groups and private citizens alike can all contribute to financing primary healthcare in Nigeria.”

He pointed out that Nigeria has continued to make efforts to improve the proportion of resources allocated to the primary healthcare system across the country, with innovations such as the Basic Health Care Provision Fund, which has been a game changer and resulted in increased financing for the primary healthcare system through the different gateways.

“Efforts from agencies like the National Primary Health Care Development Agency and the National Health Insurance Authority, have contributed towards financing Primary Healthcare in Nigeria. Guided by data from the National Health Account Reports, which indicate astronomically high out-pocket expenditure for healthcare, the Government of Nigeria determined that it would provide more resources for health, hoping for a significant reduction in out-of-pocket spending and more funding for priorities such as primary healthcare.”

The minister also said that the Federal Government’s next level agenda provides mandatory health insurance for Nigerians and guarantees a basic package of health service at no cost to citizens through the Basic Healthcare Provision Fund of the National Health Act.

“The Government of Nigeria at the Federal and State levels will continue to intensify their efforts to increase funding for the Primary Health Care System. We hope these modest acts will fairly and progressively increase access to health services for all Nigerians. We believe that if Federal and State Governments significantly increase their budgetary allocations to the health sector, we shall make fast progress to guarantee equitable access to healthcare.”

On his part, the Country Representative of the World Health Organization (WHO), Dr. Walter Mulombo, disclosed that the National Health Account estimates that 16.6% of the Current Health Expenditure is from Government (Federal, State, and LGA), 11.8% is from development partners while 3.6% is from Insurance. He said that number of persons paying for healthcare out of pocket was with catastrophic potentials was still high.

“In addition, it is important to note that 61.4% of health spending in Nigeria is on communicable diseases such as Malaria (36.2%), HIV and other STDs (10.4%), Tuberculosis (5.5%) and vaccine-preventable diseases (4.7%),” Mulombo said.

He urged governments at all levels to complement themselves and collaborate with non state actors including the private sector to boost healthcare. Non State Actors have therefore been integral partners towards ensuring that no one experiences financial hardship and unmet. In her presentation, the Director of PHC System Development of the National Primary Health Care Development Agency (NPHCDA), Dr Ngozi Nwosu who highlighted the Federal Government’s efforts to improve PHC said, the introduction of the NHAct 2014 is to provide access to health services for all Nigerians and increased investment through the BHCPF which is at least 1% CRF.

“Use of Innovative and results based financing approaches for efficient allocation of resource improving health budgets by analysing the fiscal space for health, to provide additional budgetary resources for the health system, expanding access to a basic minimum package of services through the BHCPF,” she said.

She further said the Primary Healthcare Under One Roof (PHCUOR) scorecard mechanism to improve quality through rigorous assessment of PHC Systems.

 

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