A public health expert, Professor Tanimola Akande, says although primary health care (PHC) is Nigeria’s health system backbone in achieving health for all, initiatives put in place by the federal government have not made a significant impact in ensuring equity in access to health services in the community.
Akande, a consultant public health physician at the University of Ilorin Teaching Hospital, who spoke at the 2021 Nigeria Health Watch PHC Policy Dialogue webinar, said the impact from the federal government’s interventions need to go far beyond what it is to strengthen primary care and drive Universal Health Coverage.
He stated that these initiatives are faced with a lot of challenges, including fragmentation in governance and coordination, poor funding, poor infrastructure, shortage of human resources for health, inadequate supply of commodities as well as poor and verticalised PHC services.
According to Professor Akande, “The PHC is designed to cater for more than 70% of Nigerians, but only caters for less than 20% and is because people don’t have confidence in the PHC level of care and then they bypass it to go to secondary and tertiary level of care.
“PHC poor performance is a major contribution to the weak health system. Routine immunisation coverage although is improving gradually, it is still very low. We also have a high burden of communicable diseases and non-communicable diseases.”
The don said the federal government’s new health reform committee is an opportunity to ensure public funding of PHC is significantly improved, to ensure a reduction in reliance on out-of-pocket expenditure for health care and fast-track progress towards achieving UHC by upgrading PHC infrastructure.
On his part, ACIOE Associates’ Chief Executive Officer, Mr Ekenem Isichei, stated that achieving universal health coverage would require public-private partnerships, data collection and low-cost technology solutions, setting up a medical development fund, health insurance system and government political will and commitment.
He added: “We need to think about how we make decisions based on lack of data or inaccurate data and also adopt the use of low-cost technology solutions. Lastly, we need to set up a good development fund. So, the key here is having clear frameworks with the private sector involved.”
In her remarks, Managing Director, Nigeria Health Watch, Vivianne Ihekweazu, said primary health care has continued to be the weakest tier of Nigeria’s health care system and that webinar was to ensure stakeholders at the event reflect on the state of Nigeria’s primary health care and its critical challenges.
She said: “We are looking to a day where we have one functioning primary health care centre in every state fully functional, and that is one of the things the Basic Health Care Provision Fund (BHCPF) is supposed to achieve.”
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