FG attributes PHC failure to inadequate funding, health workers’ maldistribution

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2 years ago

Ehanire

The Federal Government has said limited financing for the Primary Health Care (PHC) system stands out as a factor that has significantly limited its advancement over the years

It said several other challenges which have bedeviled the Nigerian Primary Healthcare System are the shortage and maldistribution of healthcare workers, dilapidated infrastructure, and weak referral systems.

The Minister of Health, Dr Osagie Ehanire, in his Special Remarks at the National Health Dialogue pointed out that National Health Account reports published over the past decade indicate that expenditure on primary healthcare has been sub-optimal, with significant spending on curative healthcare.

The dialogue which was organized by the Centre for Journalism Innovation and Development (CJID), and its sister organisation Premium Times, themed: Primary Health Care Financing: Role of State and Non-state actors

Ehanire who was represented by the Director of Health Planning, Research and Statistics, Dr Ngozi Azodo, 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.

Ehanire said: “The 1978 Alma Ata declaration and the recent 2018 Astana declaration on Primary Healthcare indicate the need for a multi-sectoral 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.”

Ehanire, however, said to strengthen the primary healthcare system, the Federal Government of Nigeria has continued to make efforts to improve the proportion of resources allocated to the primary healthcare system.

According to Ehanire, the Basic Health Care Provision Fund 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,” he said.

Ehanire further said 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,” he said.

Similarly, the Country Representative of the World Health Organization (WHO), Dr Walter Kazadi Mulombo, also 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.

Mulombo said this leaves the remaining 70.5% of healthcare spending in Nigeria including primary healthcare to households who pay out-of-pocket with catastrophic potentials.

“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%),” he said.

Mulombo however said considering the above, the task of ensuring that all citizens have access to the quality healthcare they need without falling into poverty is a deliberate political decision and in a large federal nation like Nigeria, therefore, this would depend on how the governments at the different tiers complement themselves but most importantly collaborate with non-state actors including the private sector.

“Non-State Actors have therefore been integral partners towards ensuring that no one experiences financial hardship and unmet.

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“Protecting people from the financial consequences of paying for health services out of their own pockets reduces the risk that people will be pushed into poverty because unexpected illness requires them to use up their life savings, sell assets, or borrow – destroying their futures and often those of their children.

“Although COVID-19 pandemic revealed global fractures in all systems with far-reaching consequences even in sectors beyond health, it however has provided clear opportunities to demonstrate the importance of health not only as a social service but a key enabler of economic development of any nation, reaffirming that health is wealth.

“Indeed, COVID proved that meaningful investment of non-state actors such as CACOVID in Nigeria can significantly strengthen the hand of government in accomplishing huge milestones,” he added.

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.

“Collaboration with private sector through Public Private Partnership (PPP) to improve access to PHC service delivery Expanding service delivery to marginalized groups through the Use of Demand-side incentives such as Conditional cash Transfer (CCT).

“A regulated community-based health insurance (CBHI) model within the National Health Insurance Authority (NHIA) Increased collaboration with relevant Partners to build capacity for emergency preparedness such as seen in the Ebola and COVID19 cases (NCDC, NAFDAC, INGOS etc).

“Primary Health Care Under One Roof (PHCUOR): national reform agenda to strengthen primary health care delivery by centralizing its governance under SPHCBs, to reduce fragmentation and improve accountability and coordination Strengthening decentralized systems of management and financing (Learning from NSHIP, DFF, IMPACT, BHCPF),” she stated among others.