At a time the nation’s health sector is in distress, it is sad that 3,000 primary health centres (PHCs) across the country have been abandoned and literally overtaken by weeds. Making the disclosure recently in Abuja, the Secretary to the Government of the Federation (SGF), Boss Mustapha, also gave assurance that the government will soon revive them and improve the health sector.
Since most of the primary health centres were neither completed nor commissioned, we call on the government to probe the circumstances that led to the poor execution of the project and sanction anyone found culpable. It is lamentable that such project meant to ensure adequate health coverage for many Nigerians was abandoned midway. With increasing population and increasing disease burden, there is urgent need to prioritise the nation’s primary healthcare system. Getting it right at this level will go a long way in ensuring the overall wellbeing of all Nigerians. Therefore, the government should revisit the moribund centres and ensure that they are completed and put to use.
We believe that revamping the health centres will drastically reduce the nation’s disease burden, which is higher at the primary care level at over 70 per cent. Moreover, more Nigerians reside in the rural areas where most of the primary health centres are located. Neglecting healthcare at the primary level will increase our soaring disease burden and encourage medical tourism. As the welfare of the people is also part of the primary duty of government, we call on the government to treat healthcare, especially at the primary care level, as a right of the citizens. Considering the inseparable link between health and wealth, all tiers of government must work together to revive the abandoned primary health centres. Failure to do so will spell doom for the sector and the country.
To underscore the importance of the primary health centres at the United Nations (UN) high level Universal Health Coverage (UHC) meeting in 2019, member countries committed themselves to strengthen the sector. The World Health Organisation (WHO) also recommended for every country to allocate additional one per cent of its Gross Domestic Product (GDP) to primary health care.
The primary health care, according to the UN, is a whole-of-society approach to health that aims at ensuring the highest possible level of health and wellbeing and their equitable distribution by focusing on people’s needs as early as possible. It addresses the broader determinants of health and focuses on the comprehensive and interrelated aspects of physical, mental and social health and wellbeing. It also provides whole-person care for health needs throughout the lifespan, not just for a set of specific diseases.
Primary health care ensures that people receive quality comprehensive care – ranging from promotion and prevention to treatment, rehabilitation and palliative care – as close as feasible to people’s everyday environment. Nigeria’s PHC policy as enunciated by former Minister of Health, the late Prof. Olikoye Ransome-Kuti, laid emphasis on preventive medicine and health-care services at the grassroots. Other components of the initiative were exclusive breast feeding practice, free immunisation to children, the use of oral rehydration therapy by nursing mothers, compulsory recording of maternal deaths, and continuous nationwide vaccination and effective HIV/AIDS campaign.
It is pathetic that the policy has been observed more in the breach over the years. Statistics indicate that the current state of PHC system in Nigeria is low with only about 20 per cent of the 30,000 PHC facilities across the country working. Most of the centres lack the capacity to provide essential health-care services, in addition to poor staffing, inadequate equipment, poor condition of infrastructure, and lack of essential drug supply. Nigeria should have gone beyond the teething problems associated with the primary health care system. The inability of PHC centres to provide basic medical services to the Nigerian population has exposed the secondary and tertiary health-care facilities to undue pressure due to influx of patients.
The rot in the PHCs is a direct consequence of the neglect of the local government administration. It is regrettable that some local government areas do not have functional health care centres. We urge the government to revisit the issue of the primary health centres and ensure that there is at least one in each of the nation’s 774 local government areas.
Let the government look into the factors impeding the development of the PHCs. Its lethargic attitude to primary health care system is unacceptable. The centres should be made to work, given that they are at the base of the nation’s health care system. The PHCs need to be adequately funded and equipped to be able to take care of the basic health needs of Nigerians. We commend the states that have functional PHCs and ask others to emulate them.