From Fred Ezeh, Abuja
The outcome of a survey conducted by the ONE Campaign has revealed that the FCT, Enugu and Anambra are on top of the table of states with improved Public Health Care (PHC) services.
The report survey also highlighted the fact that health care systems in 18 states are seriously weak, thus resulting in poor healthcare service delivery, especially in public facilities.
It specifically mentioned Zamfara State as having the worst record of health care service delivery particularly at the Primary Health Care (PHC) level, while FCT, Enugu, and Anambra states are the top performing states.
The African Executive Director, ONE Campaign, Edwin Ikhuoria, who spoke at the launch of the Report in Abuja, explained that the report provided an in-depth and systemic review of the implementation of the Basic Health Care Provision Fund (BHCPF), compliance of the states with the National Health Act and National Health Policy, among others.
He said the research included recommendations for how state governments should strengthen their fragile health systems, enhance the existing implementation of the BHCPF, and raise strategic and operational planning for health in order to promote access to, and utilisation of primary healthcare services.
He recalled that in 2014, the National Health Act established BHCPF which comprises 1% of the federal government’s Consolidated Revenue Fund (CRF) and additional contributions from other funding sources and is designed to support the effective delivery of PHC services, provision of a basic minimum package of health services and emergency medical treatment to all Nigerians.
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“But despite the provisions of the BHCPF, the report’s findings exposed the precarious state of PHCs in Nigeria, where access and utilisation of health services continue to be marred by systemic challenges. Public health facilities in states and the FCT are deficient, and the experiences of community members seeking health care at public facilities are consistently awful.
“BHCPF was poorly implemented in 13 states including Zamfara being the most difficult state in Nigeria to access PHC services, and the fact that the basic causes of Nigeria’s deteriorating health care system are linked to Nigeria’s weak governance structures and operational inefficiencies.”
The Chairman of the Senate Committee on Health, Senator Ibrahim Oloriegbe, who unveiled the report stressed the need for continuous oversight to ensure that BHCPF works for Nigerians.
“We have recorded successes at the federal level because of the independence and the interdependence between the executive and the legislative arms of government, and because of the fact that National Assembly has been able to perform its oversight functions. This must be replicated across the different state houses,” he stated.
“It is also important for citizens to join the advocacy and demand on their state governments to release appropriate funds, and ensure adequate monitoring of the funds to improve public health facilities, especially the PHCs. We must ensure medical supplies and the required human resources are available.”
In his remarks, ONE Campaign’s Nigeria Director, Stanley Achonu, said that
weak governance poses a major obstacle to improved healthcare delivery, and it has hampered efficiency and effectiveness and resulted in weak infrastructure, poor user experiences, and poor health outcomes.
“The burden of strengthening the healthcare systems and services lies heavily on governance and leadership. At all levels, the government needs to take responsibility as a building block of the health system, especially in system design, policy guidance, oversight, regulation, accountability, coalition building, monitoring, and enforcement,” he stated.
“The success recorded with polio eradication, containment of Ebola and the COVID-19 pandemic has shown that Nigeria can deliver on critical health issues given the required political will and leadership commitment. We have to act quickly to avert primary healthcare collapse.”
Chairman, National Advocates for Health Group, Muhammad Usman, in his submissions, called on the government to provide the required leadership to ensure that PHC services are improved across the country.
He suggested that the federal government must ensure timely release of funds allocated for BHCPF services and ensure effective utilisation of same at the sub-national level to improve PHC services nationwide.
Similarly, the Managing Director, Nigeria Health Watch, Vivianne Ihekweazu, registered her optimism that the Report will help government and stakeholders understand the opportunities and gaps in state-level healthcare delivery.
She said: “As partners, we are determined to disseminate the findings widely and use them to hold policymakers, especially at the sub-national level accountable for improvements in healthcare delivery for all Nigerians,” she said.