Osagie EhanireThe Federal Ministry of Health(FMoH), has said the focus on Primary Health Care (PHC), in the country is timely and well-placed, considering that PHC has been identified as the path to Universal Health Coverage(UHC), a goal the country continues to pursue.
The Minister of Health, Dr Osagie Ehanire, said this on Tuesday in Abuja, the 2022 edition of the annual National Health Dialogue.
The News Agency of Nigeria(NAN) reports that the high-level platform was organised by the Centre for Journalism Innovation and Development (CJID), in collaboration with Premium Times, to advance conversations around key health issues in Nigeria and Africa by extension.
The 2022 dialogue is themed: “Primary Health Care Financing; Role of State and Non-state Actors”.
Ehanire, who was represented by Dr Ngozi Azodoh, Director of Health Planning Research and Statistics, FMOH, said UHC is key to the health and well-being of all Nigerians as it guarantees needed quality healthcare services for all persons without financial hardship.
He said that the country’s journey to UHC has been slow, but remarkable milestones have been achieved, adding that with heightened efforts to revitalise and strengthen the PHC system, he is confident that the country would inch closer to attaining UHC.
He said that several challenges have bedevilled the country’s healthcare system, describing some of these challenges as shortage and maldistribution of healthcare workers, dilapidated infrastructure, and weak referral systems.
He, however, said that limited financing for the PHC system stands out as a factor that has significantly limited the advancement of the healthcare system.
“The National Health Account reports published over the past decade indicate that expenditure on PHC has been sub-optimal, with significant spending on curative healthcare.
“The inadequacy in funding the PHC system has negatively impacted the delivery of services such as immunisation and maternal and child health services.
“Robust financing 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 PHC systems, a significant proportion of the progress with financing for PHC is dependent on the role of non-state actors,” he said.
The minister said that the private sector, civil society organisations, the media, faith-based organisations, trade unions, professional organisations, academia, community groups, and private citizens alike can all contribute to financing PHC in Nigeria.
He said the country has continued to make efforts to improve the proportion of resources allocated to the PHC system, noting that the Basic Health Care Provision Fund (BHCPF) has been a game changer and resulted in increased financing for the PHC system through the different gateways.
Speaking on “PHC financing, the role of government in achieving optimum PHC performance”, Dr Faisal Shuaib, Executive Director of the National Primary Health Care Development Agency (NPHCDA), said that it has been recognised that health is a fundamental universal right for all.
Shuaib, who was represented by Dr Ngozi Nwosu, Director PHC, NPHCDA, said that health is an essential condition for the integral and sustainable development of the people and a necessity for economic growth with equity.
He said that the failure of many countries to achieve health for all led to a global commitment that aims to strengthen PHC systems as an essential step towards achieving UHC.
The NPHCDA boss said that the PHC approach is the most effective way to sustainably solve health system challenges.
“The government’s role in PHC is well documented in-country and is supported through partnerships with the private sector, NGOs and charitable institutions.
“The signing of the National health act into law proves the Nigerian government’s commitment to achieving UHC by 2030.
“Beyond policy declarations, the health sector significantly underperforms on key health outcomes such as life expectancy, maternal mortality and child health indices,” he said.
He said that the increased challenges caused by the COVID-19 pandemic and subsequent economic constraints have brought new challenges for achieving accessible health care for all Nigerians.
He said that at this point, the provision of health services is a shared responsibility for all three tiers of government.
“While the federal government is responsible for overall policy-making, coordination and regulation, provision of tertiary care and support to PHC through NPHCDA, state governments hold the core service delivery mandate on health.
He said that the local governments also need to take charge of health care delivery within their community.
Noting that although remarkable progress has been made in PHC development, the system has remained weak with health outcomes being suboptimal due to fragmentation of services and other multiple challenges in various aspects of the health system framework.
“At this point, the importance of adequate financing for PHC cannot be overemphasised. This is important to build resilient health systems. This is very important because health financing is the enabler to major parts of the health system operation,“ he explained.
He said that there were so many challenges facing Africa’s largest economy, noting that the country’s increased wealth has not translated to better health outcomes due to large inequities.
“This means Nigeria has fallen behind most other African countries and much below international standards in terms of health financing and health outcomes,” he said.
The NPHCDA boss highlighted the inadequacy of the majority of PHCs across the country, saying “Some PHC facilities across the country are poorly equipped, with only a quarter of facilities having more than 25 per cent of the minimum equipment package”.
He said that the limited coverage of important PHC interventions is further aggravated by poor quality care, with the poor performance of health workers also contributing.
He, however, acknowledged that there is an urgent need to improve data quality and information platforms which would further ensure evidence based decision making and policies.
He also called for a strong political will, with a robust and sustained focus on PHC, which, he said, is vital to ensure a transformational change in the country’s health sector.
Earlier, Mr Tobi Oluwatola, Executive Director, CJID, in his welcome address, said that the event was coming at a time the country’s health system is facing a lot of challenges.
Oluwatola said the country is Africa’s most populous nation, but still accounts for high maternal mortality rates, and a high number of deaths from malaria, cholera and other diseases that can be easily prevented.
He said that the government has continued to give insufficient attention to the health sector and the budget allocated to the sector was never enough to address the health needs of the citizens.
According to him, until the government starts prioritising the health sector, the system will continue to be in bad shape. “There is a need to examine the value that drives us in getting quality health care.
He said the dialogue is a great opportunity to make great decisions that would change the face of health care in the country.
“Decisions made here today will go a long face in shaping the future of Nigeria’s health system,” he explained.
NAN recalled that the event brought together policymakers and experts to discuss key issues in the PHCs subsector, such as financing, insurance and human resources for health.
