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Time to revamp primary health care services

In confirmation of the state of neglect of health care delivery at the grassroots, the Executive Secretary of the National Primary Health Care Development Agency,…

In confirmation of the state of neglect of health care delivery at the grassroots, the Executive Secretary of the National Primary Health Care Development Agency, Dr Faisal Shuaib, on February 14, said more than 70 per cent of  the country’s Primary Health Care Centres (PHCs) do not have the right infrastructure, drugs and utilities.

Shuaib, who was speaking at the signing of a memorandum of understanding between the agency and a civil society organisation, Connect Development (CODE), on the strengthening of health sector accountability, also said majority of healthcare centres had limited workers.

To buttress this point, the chief executive of CODE, Hamzat Lawal, said PHCs in Nigeria face a myriad of challenges even though they are the first port of call to a greater number of Nigerians who live in the rural areas.

Citing an example, Lawal said in July 2021, CODE tracked 90 primary health care centres in 15 states across the country and discovered that 80 per cent of them were substandard and unfit to store and effectively administer COVID-19 vaccines.

The story of the country’s primary health care centres over a long period has been that of lack of access, lack of unqualified personnel as well as absence of drugs and other basic equipment.

We recall that in 2019, a group of women in Jigawa State had to contribute money from the stipend they got under the Conditional Cash Transfer to buy a car to convey pregnant women to the clinic for delivery. This was because the state government’s ambulance service had failed.

A survey by the World Health Organisation in 2020 showed that Nigeria’s maternal mortality rate was 814 per 100,000 births. Another survey said Nigeria and India account for 34 per cent of the global maternal deaths, yet another report in 2019  said the lifetime risk of a Nigerian woman dying during childbirth, post-partum or post-abortion was one in 22 in contrast to 1 in 4,900 in developed countries.

The report attributed the deaths to delay in locating and arriving at a health facility, lack of qualified personnel to handle the situation and lack of basic equipment and drugs.

Nigeria is not any better in child mortality rate either as the figure was put at 117 in 1000 births in 2019.

Another study in 2018 showed that Nigeria has a total of 34,000 primary health care centres to cater for its more than 200 million population. It is doubtful if this figure has significantly changed in the last three years.

However, a more worrying issue is the fact that most of these health facilities are in a sorry state. It is hard to fathom that over the years, our governments have failed in providing this basic necessity to teeming Nigerians, which is in clear breach of the constitution.

The provision of basic health care is the responsibility of the state and local governments, but over the years the federal government had intervened under several avenues including the setting up of the National Primary Health Care Development Agency at the federal level while each state also set up its own.

The 8th National Assembly, in 2018, provided for the setting aside of one per cent of the Consolidated Revenue to address primary health care.

In addition to this, there have been other interventions through bilateral and multilateral arrangements to boost heath care delivery at the grassroots. Yet the situation has remained the same with a large section of the populace left to cater for itself and a large chunk vulnerable to the activities of quack medical personnel.

On February 16, 2022, the Senate voted to probe the N400 billion National Primary Health Centre project initiated by the Obasanjo administration in 2006. The project was to build a 60-bed Primary Health Centre in each of the 774 local government areas in the country. However, most of the contractors abandoned the work.

We strongly submit that governments at all levels have failed Nigerians in providing one of the basic needs of life to the average Nigerian. It is time for all those responsible to wake up and do what is required of them.

Our political leaders should feel ashamed of this failure and immediately set in place the machinery to save the lives of millions of Nigerians. This is what they have individually sworn to do and they must do it.

We also urge the committee set up by the Senate to probe the primary health care project to do its work diligently and ensure that it exposes all those responsible for this failure.

It is indeed a shame that in this modern times Nigeria cannot guarantee basic health care to its citizens. It is time to change the narrative.