Strengthening financing at primary healthcare level

Primary healthcare is the foundation of any efficient healthcare system. Thus adequately financing and strengthening services at this level of care not only ensures access to basic health services for Nigerians but it is also key to the attainment of Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs).

Many Primary Healthcare Centres (PHCs) in the country have continued to experience poor infrastructure, inadequate manpower, drugs and consumables as a result of poor fi nancing from the various tiers of government.

AFN canvasses votes for World Athlete of the Year nominee, Amusan

AFN canvasses votes for World Athlete of the Year nominee, Amusan

Quality health service delivery at the primary healthcare facilities also enables children to access immunisation, protection from childhood killer diseases and their general health and well-being as
well as that of their mothers. This will further reduce maternal and child mortality in the country.

PHC financing in Nigeria particularly by states was the thrust of a recent forum organised by the Nigeria Health Commissioners’ Forum in collaboration with the Nigeria Governors Forum (NGF),
UNICEF and other partners in Abuja.

The stakeholders called for innovative solutions towards ensuring sustainable financing at the primary level of care.

UNICEF Nigeria Chief of Health, Eduardo Celades, said one of the major challenges bedevilling primary healthcare in the country is inequity, adding, “There is a huge divide between North and South, between the fully vaccinated and unvaccinated children, between the rich and poor people, the educated and uneducated”.

He said most of the funds go to secondary and tertiary hospitals; and not to PHCs even when we know PHCs are the foundation of the system.

He said it is not about working harder but working smarter till we can get effi cient use of our resources.

He said another call to action is to strengthen the public financing management system to address inefficiencies and how to maximise the spending levels with a budget focusing on increased spending at the local government and community levels.

He said: “Th ere are huge out-ofpocket expenses, which is the second highest in the world. The National Health Insurance Authority Act is a massive opportunity. Also, with the BHCPF, we now have the instrument to move in that direction. We, therefore, need strong leadership and collaboration.

“We need to get value for money in cost efficiency. We can do more with less. We need efficient use of our resources. We need to strengthen public financing systems, especially at the community level where we can make a diff erence.”

Chairman, NGF, and Ekiti State governor, Dr Kayode Fayemi, said the ability of the country to guarantee this right for all Nigerians has been slow, largely due to how the health system is financed and delivered, adding that this has been further exacerbated by the COVID-19 pandemic which has exposed signifi cant weaknesses in our health sector, especially in primary healthcare.

Th e NGF chairman called for utilisation of the Basic Healthcare Provision Fund (BHCPF) to finance essential health services, especially for the vulnerable and to improve the country’s capacity to address public health emergencies, consolidation of funding to address primary care and essential public health functions, and the exploration of innovative ways to pool funds for non contributory healthcare coverage.

Nasarawa State Governor Abdullahi Sule who also represented the NGF chairman said the country could not continue to rely on development partners and foreign investments to finance its healthcare system.

He said there is a need to look towards other sources to fund primary healthcare. Vice Chairman of the Health Commissioners Forum, and commissioner for Health and Human Services, Yobe State, Dr Muhammad Lawan Gana, said the COVID-19 pandemic has brought out the need for standard and functional primary healthcare at the sub national levels into spotlight.

“PHC is the most promising platform for providing basic essential preventive and promotive health interventions and other public health functions and is widely recognised as a key component of all high-performing health systems as well as an essential foundation of Universal Health Coverage,” he said.

He said the COVID-19 pandemic has brought out the need for standard and functional primary healthcare at the sub national levels into the spotlight.

The Executive Director, National Primary Health Care Development Agency (NPHCDA), Dr Faisal Shuaib, said in spite of COVID-19, Nigeria is among 10 countries globally that have shown progress in immunisation and other aspects of PHC service delivery.

Chairman, Nigeria Health Commissioners’ Forum and Ekiti State Commissioner for Health and Human Service, Dr Filani Oyebanji, said PHC, all over the world, requires adequate financing and service delivery. He said performing health systems recognise the importance of having an effective PHC service as a key driver of achieving universal health coverage (UHC), adding that strengthening PHC strongly relies on the PHC structures across Nigeria, to deliver individual-based care and essential public health functions to all.