Poor PHC policies implementation responsible for 80% of deaths in rural Nigeria – Researchers

About 80 per cent of deaths in rural communities across Nigeria are due to poor implementation of Primary Healthcare policies, a doctor and researcher, Tolu Fakeye, has said.

Mr Fakeye spoke Tuesday at the 8th Annual Scientific Conference and General Meeting of the Epidemiological Society of Nigeria (EPiSON) held in Jos, Plateau State.

The event was organised by EPiSON in partnership with PACFaH@Scale.

Mr Fakeye made a presentation on research titled “A scoping Mission on Primary Health Care Under One Roof in Nigeria (PHCUOR)”.

The research was conducted by the Society for Public Health Professionals of Nigeria (SPHCN).

The shortcomings of the PHCs have forced many women in Nigeria to patronise traditional birth attendants, despite the risks involved.

According to a survey conducted by CISLAC, one in 13 women dies during pregnancy or childbirth in Nigeria.

Several attempts have been made to revive Nigerian PHCs which remains dogged by multiple challenges, chiefly because of the mismanagement of billions of naira allocated over the decades to keep it up and running.

The latest was in January 2017 when President Muhammadu Buhari flagged-off a scheme to revitalise about 10,000 PHCs across Nigeria.

But more than a year after, PREMIUM TIMES found that very little had been done as PHCs are still in a terrible state all over the country.

The PHCUOR policy was brought on board as a watershed for the PHC situation. It is modelled on the principle of integration of all PHC services under one authority.

It is meant to be coordinated by the National Primary Health Care Development Agency (NPHCDA) through the State Primary Health Care Boards (SPHCB).

Like previous attempts, Mr Fakeye, the FCT Chairman of SPHCN, said the research findings identified several factors responsible for poor implementation of the PHCUOR policy.

He noted lack of sincere and adequate commitment in governance and ownership; poor minimum service packages; inadequate plan for repositioning of the existing and new structure; and the dearth of human resource for health as major drawbacks to the policy.

Presenting findings of the research, Sabastine Esomonu said implementation of PHCUOR proved difficult on four of its nine pillars.

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He listed poor funding and lack of human resources as major impediments to the PHCUOR policy.

The medical doctor said no state has established a high-level human resources structure through the state primary health care board so as to drive the PHCUOR policy.

“PHCs across Nigeria are acutely running short of qualified hands, thereby putting the few secondary and tertiary institutions under severe pressure.

“While the majority of professional doctors and nurses prefer working in higher institutions in urban areas, PHCs are largely run by retired nurses, community health workers, and on-and-off NYSC (National Youth Service Corps) doctors with little clinical experience.”

Mr Esomonu said most states do not have human resources and database. “All the states are facing critical shortages of manpower for PHCs”.


Wrapping up the presentation, Mr Fakeye recommended more funding and coordination of the state primary health board. He said the PHUOR plan needs to be redesigned to touch other areas left behind.

Intensification of advocacy to local government councils; expansion of technical assistance to enhance the capacity of human resources; and increased funding of the services were some of the major recommendations.

A participant raised concern on the need for medical officers to be included as an integral part of the PHCUOR policy implementation.

“Even the institutions that produce these human resources are also key in the engagement,” he noted.


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