Public health experts have raised concerns over Nigeria’s primary healthcare system, revealing that only about 40 per cent of local government areas (LGAs) have medically qualified Medical Officers of Health (MOHs).
This means more than 460 out of the 774 LGAs in Nigeria lack medically trained officers to supervise health services, a situation that experts describe “unacceptable” for a country with a population of over 200 million people.
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The shortage of MOHs was spotlighted at the just concluded 41st Annual General Meeting and Scientific Conference (AGM&SC) of the Association of Public Health Physicians of Nigeria (APHPN) held in Abeokuta, Ogun State.
The conference, themed “Primary Healthcare Delivery in the Face of Multidimensional Challenges,” brought together healthcare professionals from across Nigeria from 9 to 14 March.
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National health crisis
At the conference, APHPN discussed the implications of the shortage of MOHs, who are responsible for overseeing essential public health activities at the local government level, including disease surveillance, immunisation campaigns, and health emergency responses.
“The role of Medical Officers of Health is critical to the delivery of healthcare in Nigeria. It is unacceptable that only about 40 per cent of LGAs in Nigeria have medically qualified MOHs,” APHPN noted in its communique.
The communique, which was signed by the National President of APHPN, Terfa Kene, and the National Secretary, Augustine Ajogwu, called for urgent reforms to fill this gap and strengthen the country’s public health infrastructure.
The association advocates for the appointment of medical doctors with additional training in public health to serve as MOHs in every LGA, “in line with public health laws and global best practices.”
Challenges facing PHCs
Apart from the shortage of medical officers, the communique also highlighted several challenges hindering the effectiveness of Nigeria’s primary healthcare system.
It pointed out that the implementation of primary health care in Nigeria has been “suboptimal since its inception.”
“Effective implementation of Primary Health Care is a sine qua non to optimal healthcare delivery,” it noted.
It observed that Nigeria is still grappling with a double burden of communicable and non-communicable diseases, which are compounded by psychosocial and mental health issues.
This combination, according to APHPN, is contributing to poor health indices across the country and a deteriorating human development index.
Other challenges include inadequate political will, a weak healthcare system, limited human resources, and a lack of motivation among health workers.
The report also flagged the issues of poor infrastructure, health insecurity, and an uncoordinated approach to healthcare as major obstacles to efficient service delivery.
The communique further emphasised the importance of a collaborative, multisectoral, and transdisciplinary One Health approach to improve healthcare delivery and public health practice.
Investment in Adolescent health
The experts also raised concerns about the state of adolescent health in Nigeria.
They emphasised the importance of investing in adolescent healthcare for demographic, human rights, economic, and health reasons.
The communique pointed out that the insufficient provision of adolescent-friendly services and a shortage of health workers trained in delivering these services were significant barriers to addressing the healthcare needs of young people.
APHPN called for capacity building for health workers in every state regarding provision of adolescent friendly services.
“This includes a need for sub-speciality training in adolescent health in the curricula of postgraduate medical colleges,” it noted.
More recommendations
The communique also recommended the establishment of Public Health and Community Medicine departments in all secondary and tertiary healthcare facilities in Nigeria to better prepare the country to handle the rising incidence of communicable and non-communicable diseases.
Health workers were urged to adopt a CEO mindset, developing skills in business, project management, and financial literacy to improve health service delivery.
The communique also recommended school-based prevention programmes to address substance abuse, policies prioritising rehabilitation over punishment, and the strengthening of occupational health practices through improved legislation and awareness.
To address the challenge of electricity supply in healthcare facilities, the experts suggested innovative, cost-effective, and environmentally friendly solutions, such as solar energy powered by lithium batteries.
The experts also advocated for leveraging digital innovations and artificial intelligence for enhanced disease surveillance and community engagement.
About the General Meeting
The 41st Annual Scientific Conference and General Meetings of APHPN brought together 650 participants, including 350 in-person and 300 virtual attendees, from various sectors such as academia, teaching hospitals, health facilities, government MDAs, NGOs, and the private sector.
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The conference featured eight plenary sessions, eight parallel scientific sessions, 79 oral abstract presentations, and 21 poster presentations.
The opening ceremony, held on 11 March, was chaired by Akin Osibogun, the former President of the National Postgraduate Medical College of Nigeria. The Ogun State Honourable Commissioner for Health, Tomi Coker, represented Governor Dapo Abiodun and declared the conference open.
Other dignitaries included the Minister of State for Health, Iziaq Salako, and the Special Adviser to the President, Salma Ibrahim Anas, represented by Tanko Yakasi, and members of the Board of Trustees of the association.
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